| Written by Allison Rosa, MA, LAC
When we talk about eating disorders, it’s easy to focus solely on food, weight, and body image. But beneath the surface, there’s often a much deeper story—one that is deeply complex and influenced by a variety of factors. One contributor often overlooked is unresolved emotional pain and trauma. Many people struggling with disordered eating have experiences that are traumatic in nature, which can play a significant role in the development and maintenance of their eating disorder.
What we know is that trauma affects eating behaviors, and can affect the way people relate to food in ways that may not be immediately obvious. While everyone copes with stress differently, individuals who have experienced trauma may develop specific eating patterns as a way to deal with their emotions.
If we think about it, our appetites fluctuate all the time when faced with periods of stress. Culture, family patterns, upbringing, genetics, relationships, and overall environment significantly contribute towards our relationships with food. Whether you’re personally impacted or supporting someone who is struggling with disordered eating, understanding the link between trauma and eating disorders is an important step toward healing.
What is Trauma?
Trauma can be defined as a psychological or emotional response to a distressing event that overwhelms our ability to cope, leaving us feeling powerless, helpless, or in danger. While stress is a normal part of life, trauma happens when stress becomes so intense that it starts to cause emotional or physical damage. This happens when our usual coping mechanisms, such as talking to a friend, meditating, or journaling, are no longer sufficient. When this point is reached, trauma can manifest in a variety of psychiatric disorders, including eating disorders.
How Trauma Contributes to Eating Disorders
The connection between trauma and eating disorders lies largely in how we cope with stress. Trauma survivors often struggle with overwhelming emotions, and eating disorders can emerge as a way to manage or numb those feelings. In fact, disordered eating behavior is oftentimes a way people try to gain control and achieve resiliency/ability to cope within themselves. Research shows that those who experience trauma are at a higher risk of developing eating disorders, especially those involving bulimic behaviors like bingeing and purging. Here are a few ways trauma can manifest itself into disordered eating habits:
- Avoidant Coping and Self-Punishment
Trauma survivors often resort to avoidant coping mechanisms, such as self-punishment through restrictive eating, bingeing, or purging. These behaviors temporarily dull emotional pain but perpetuate a destructive cycle. Avoidant coping can make us feel as though we are gaining control of something in our lives, but in reality, it often leads to deeper emotional and medical problems.- An example of avoidant coping that the everyday person may experience is in relationships. If you are harboring frustration and sadness over a disagreement with your partner rather than voicing your concerns, this is an example of avoidant coping. Someone who struggles with disordered eating may focus on controlling what they eat to avoid eating altogether rather than addressing anxiety, sadness, or low self-esteem.
- Self-punishment may look like “I’m going to have a big lunch at work today, so i’ll skip breakfast and go on a walk”. Rather than incorporating more balance and exercise as a positive practice for body-wellness, it becomes a punishment. This is an example of the every-day experience of self-punishment that may happen to each of us, but it’s more severe in eating disorders.
- Binge Eating, Purging, and Hyperarousal
Similar to how some people self-medicate with substances, many people with trauma use binge eating and purging to numb or avoid emotional pain. Bingeing may serve as a way to reduce anxiety or hyperarousal that results from trauma, while purging can become a means of self-punishment or control. These behaviors, while briefly effective in reducing distress, ultimately reinforce the cycle, preventing individuals from processing the trauma in healthy ways. - Body Dissociation and Emotional Disconnection
Trauma often leaves individuals feeling disconnected from their bodies, which is especially true in the case of eating disorders. This dissociation leads to a numbing effect, where people no longer feel attuned to their bodies’ needs, such as hunger or fullness. Eating disorders further this disconnection by focusing on controlling or punishing the body, which reinforces the emotional and physical distance.- Think about a time you’ve been sick and went to work regardless to get work done. At that moment, you were ignoring your body’s needs, pushing past the exhaustion and sickness pretending everything is fine. Even though your body is sending you signals that something is wrong, you are disconnecting yourself from that experience. This is an example of ignoring your body’s needs that people with eating disorders experience daily.
- Perfectionism
Trauma can lead to the development of perfectionistic tendencies, where individuals feel they must achieve certain standards to feel worthy or safe. This drive for perfection can contribute to restrictive eating patterns or excessive exercise, as individuals try to attain an ideal body or maintain strict control over their food intake. This is often a sign of black-and-white thinking patterns, where someone may struggle to see that perfection is unachievable. - Disruption of Trust
Trauma can severely impact one’s ability to trust themselves and others. Individuals may feel disconnected from their bodies or have difficulty recognizing hunger and fullness cues, leading to disordered eating patterns. They may also struggle to seek support from others, opting instead to rely on unhealthy coping mechanisms related to food.- Imagine preparing for a big presentation at work. During your presentation, you stuttered and appeared insecure in front of your colleagues. Despite your extensive preparation, you might find yourself fixating on small mistakes in your presentation or worrying that your coworkers are focusing on your nervousness rather than the content of your work. This feeling can lead you to second-guess your abilities and withdraw from seeking feedback or support, fearing that others will confirm your insecurities. Similarly, someone with an eating disorder might believe that others are constantly judging their appearance or eating choices, making it difficult for them to seek help or connect with others. This is similar to the experience of someone with an eating disorder, assuming others can observe and fixate on their perceived flaws in the same way they do. If you are attempting to approach someone you love about disordered eating, understand there is a disruption of trust already because they may feel as though you don’t understand and are trying to take away their one semblance of control.
Biological and Hormonal Impacts of Trauma
Trauma doesn’t just affect us emotionally; it also impacts the brain and body on a chemical level. When we experience trauma, our brain enters a “fight or flight” mode, leading to the release of stress hormones like cortisol and adrenaline. Over time, chronic stress alters brain chemistry, affecting how the brain processes fear, memory, and emotional regulation. This can leave trauma survivors in a state of hypervigilance or dissociation, increasing their vulnerability to disorders like anxiety, depression, and eating disorders.
For those predisposed to stress, including individuals with eating disorders, these hormonal shifts can exacerbate the cycle of disordered eating. For example, heightened levels of anxiety and fear may lead individuals to focus on rigid control over their diet or body weight in an attempt to soothe their heightened emotional state. Research shows that individuals with eating disorders often experience heightened sensitivity to stress, anticipate negative outcomes, and struggle with high levels of anxiety—all of which can be worsened by trauma. The starving brain can also impact our ability to make decisions, worsen anxiety/depression, and lead to diminished energy levels. Overall, our brain function decreases when the brain is starving, so recovering from trauma can be even more challenging with multiple factors counteracting eachother.
PTSD and eating disorders often coexist because both conditions involve difficulties with emotional regulation, dissociation, and avoidance of painful memories. Those with PTSD may engage in bingeing or purging behaviors to numb themselves from traumatic flashbacks or feelings of helplessness. However, these coping mechanisms prevent the processing of trauma, leading to a cycle where unresolved trauma perpetuates the eating disorder. Both diagnoses share the commonality of the avoidance of triggers.
What to Do If Someone in Your Life Has an Eating Disorder
Supporting a loved one with an eating disorder can be challenging and emotional. However, your support can be crucial in their recovery journey. Here are some practical steps you can take to help:
Approach with Care
- When addressing the issue, choose a calm and private setting to discuss your concerns. Use “I” statements to express your feelings without sounding accusatory, such as “I’m worried about your health” instead of “You need to eat more.” This can help them to feel they are cared for rather than to feel defensive about their one area of control.
Listen and Validate
- Be an active listener. Allow them to express their feelings and thoughts without judgment. Validate their experiences by acknowledging their struggles and emotions, even if you don’t fully understand them. This can help them feel seen and supported.
Encourage Professional Help
- Suggest seeking help from a healthcare professional who specializes in eating disorders, such as a therapist, dietitian, or doctor. Offer to help them find resources or accompany them to appointments if they feel comfortable.
Avoid Weight Talk
- Steer clear of conversations that focus on weight, dieting, or appearance. Instead, emphasize health and well-being. Encourage discussions about self-care, hobbies, and interests that foster a positive self-image.
Be Patient
- Recovery from an eating disorder is often not a linear process and can take time. Be patient and understanding, offering your support without pressure or expectations. Recovery may fluctuate depending on periods of stress.
Set Boundaries
- While being supportive is important, it’s also essential to set boundaries to protect your own well-being. Know your limits and take care of your mental health as you support your loved one.
Promote Healthy Activities
- Engage in activities that promote physical and emotional well-being together, such as walking, cooking healthy meals, or practicing mindfulness. These can serve as positive distractions and reinforce a healthy lifestyle.
Encourage Self-Compassion
- Help your loved one develop self-compassion and a kinder relationship with themselves. Encourage them to practice positive self-talk and engage in activities that promote self-esteem and body positivity. While disordered eating may be something you yourself are afraid to see in a loved one, self-compassion is crucial as they are already trying to stray from thoughts of self-hatred.
Seek Support for Yourself
- Supporting someone with an eating disorder can be anxiety-inducing. Consider seeking support for yourself through therapy, support groups, or talking to friends who understand the situation.
The Importance of Trauma-Informed Treatment
For individuals with trauma and eating disorders, treatment must address both conditions simultaneously. Trauma-informed care takes into account the profound impact of trauma on a person’s emotional, physical, and psychological well-being. Without addressing the trauma, recovery from the eating disorder is often incomplete, as the unresolved trauma can continue to fuel disordered eating behaviors, or escalate to other numbing behaviors such as substance abuse and self-harm.
Seeking Support and Moving Forward
Healing from trauma and eating disorders is not an easy journey, but with the right support, recovery is possible. Family and friends play a critical role in providing a supportive environment for disclosure and healing. Additionally, trauma-informed therapists can help individuals develop healthier coping strategies, rebuild their self-worth, and break the cycle of disordered eating and trauma.
If you or someone you know is struggling with an eating disorder related to trauma, it’s important to seek professional help. Recovery is not just about addressing food-related behaviors but also about processing the underlying trauma that contributes to them.
Allison Rosa is a Certified Trauma Professional, who specialized in Victim Counseling during her graduate program. Using person-centered techniques, Allison helps others to rewrite their trauma narratives and relationships with food. Allison is also an EMDR-trained therapist.
Check out Allison’s professional bio here.
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