Eating disorders are known to affect 30 million individuals in the United States and carry the highest mortality rate out of all mental illnesses. Eating disorders stem from a need to have self-control as the majority of individuals with an eating disorder lack control in most aspects of their life. The need to manage food, weight and body shape is more about control rather than food itself and as a result extreme unhealthy behaviors such as self-induced vomiting, diuretic and laxative abuse, excessive exercise and binging are practiced in an effort to mask feelings and past experiences such as trauma and abuse. According to The Diagnostic & Statistical Manual (DSM-V) the most common eating disorders are anorexia nervosa, binge eating disorder and bulimia nervosa. The two other disorders in the DSM are known as avoidant-restrictive food intake disorder (ARFID) and Other Specified Feeding and Eating Disorder (OSFED). Although each of these disorders may differ by their signs, symptoms, and presentations, they all have one thing is common: similar underlying triggers. Many underlying factors contributing to eating disorders include low self-esteem, major life transitions such as divorce or relocating to a new school, poor coping skills, a perfectionistic personality, substance abuse, poor parental relationships and bullying. A common trigger occurring with eating disorders that behavioral health specialists are seeing today is trauma. Some studies have shown that 60-70 percent of individuals seeking residential treatment for their eating disorder experienced some form of trauma in the past.
What is trauma?
Trauma can be divided into two major categories: catastrophic events such as physical abuse or injury, sexual assault or a natural disaster or repetitive emotionally painful experiences such as child neglect, bullying, verbal abuse or the loss of a parent. Many think of trauma as the former however the latter can result in indefinite emotional scars leading to eating disorders and other mental health illness such as depression or anxiety.
How can trauma lead to eating disorders?
The earlier these traumatic events occur in one’s life, the more intense the outcome can be. A child who witnessed an emotionally abusive parental divorce or a house fire at a very young age will most likely be burdened by this trauma later in life. Eating disorders manifest trauma at a later age, usually during a transitional period such as early teenage years or at times of stress such as going through your own divorce as an adult. Trauma of a sexual nature is most apt to result in an eating disorder. This is due to the interpersonal nature of sexual trauma and is particularly the case if the violation was at the hand of an authority figure or family member. An eating disorder allows the woman or girl to avoid the pain, shame or guilt associated with the violation. The years in between the traumatic event and the development of an eating disorder are crucial years in order to seek treatment to learn to cope with that traumatic event however many people do not show signs or symptoms until a later transition or stressful period in their lives.
Grief, another form of emotional trauma can occurs when a family member, a friend, a pet or even a relationship is lost. Grief can result in severe sadness and denial and food can easily become a tangible way in which comfort is sought. In the presence of both trauma and grief, food can commonly become a way in which one feels able to establish control, such as through means of restricting calories, or a way in which to find comfort or relief. Being consumed with food, calories an weight can become a way to find distraction from feelings of emptiness or despair and to hide one’s emotions. While these methods might be ways to initially cope with the intense burden of grief or trauma, these behaviors can quickly escalate into an eating disorder.
Seeking professional treatment for an eating disorder is the only safe way to reach a healthy state of mind and avoid medical complications associated with the eating disorder. Trauma informed care is often provided when needed which works to uncover the underlying traumatic events triggering the unhealthy relationship with food and body image. Eating disorder treatment and trauma informed care provide specific therapeutic approaches where individuals can learn healthy coping skills and learn how to regulate their thoughts and emotions.