Surprising as it may seem, eating disorders are generally not just about dysfunctional or irregular eating habits. In actual fact, often eating disorders aren’t even about food. Understanding the root cause of eating disorders is imperative in order to create an effective, sustainable treatment plan for clients. In many cases, the root cause of an eating disorder will be some form of unresolved, misdiagnosed or untreated trauma.
According to Timothy Brewerton from the Medical University of South Carolina, ‘The issues of psychiatric comorbidity and trauma history are unavoidable for clinicians who diagnose and treat patients with eating disorders (EDs).1)Brewerton, Timothy. (2007). Eating Disorders, Trauma, and Comorbidity: Focus on PTSD. Eating disorders. 15. 285-304. 10.1080/10640260701454311.’ He also states that trauma is more commonly found to have been experienced by individuals presenting with bulimic eating disorders or eating disorders characterised by bulimic symptoms such as binge eating disorder. A study conducted in 2001 found that ‘women who reported sexual trauma were significantly more likely to exhibit abnormal eating behaviors than controls, including higher rates of both PTSD and EDs [Eating Disorders].2)ibid’
However more recent studies, such as the study by Karen Mitchell et al which looked at comorbidity among both men and women with eating disorders, found that many other types of interpersonal trauma can also lead to an eating disorder. In her study she reported that ‘the vast majority of women and men with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) reported a history of interpersonal trauma.3)Mitchell KS, Mazzeo SE, Schlesinger MR, Brewerton TD, Smith BN. Comorbidity of partial and subthreshold PTSD among men and women with eating disorders in the National Comorbidity Survey-Replication Study. The International Journal of Eating Disorders. 2012;45(3):307-315. doi:10.1002/eat.20965.’
There are many different forms of trauma that can lead to eating disorders, including but not limited to: physical and emotional neglect, physical and emotional abuse and bullying. Essentially any trauma that causes the sufferer to experience PTSD is a risk factor for eating disorders. ’The National Women’s Study reported a lifetime prevalence of PTSD in 36.9% of women with bulimia nervosa (BN), in 21.0% of women with binge eating disorder (BED), and 11.8% in women with no eating disorder.4)Dansky BS, Brewerton TD, Kilpatrick DG, O’Neil PM. The National Women’s Study: Relationship of victimization and posttraumatic stress disorder to bulimia nervosa. Int J Eat Disord. 1997;21:213–28.’
Understanding exactly why there is a link between trauma and eating disorders is still unclear. What we do understand about trauma is that it dysregulates the nervous system, which in turn makes it difficult for the trauma survivor to regulate their emotions alone. Therefore they may turn to food, or eating disorder behaviours in order to help self-soothe.
If you have a client, or know of someone who is struggling with an eating disorder of any kind, reach out to Khiron. We believe that we can stop the revolving door of treatment and misdiagnosis by providing effective residential and out-patient therapies for underlying psychological trauma. Allow us to help you find the path to effective, long lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).
References [ + ]
|1.||↑||Brewerton, Timothy. (2007). Eating Disorders, Trauma, and Comorbidity: Focus on PTSD. Eating disorders. 15. 285-304. 10.1080/10640260701454311.|
|3.||↑||Mitchell KS, Mazzeo SE, Schlesinger MR, Brewerton TD, Smith BN. Comorbidity of partial and subthreshold PTSD among men and women with eating disorders in the National Comorbidity Survey-Replication Study. The International Journal of Eating Disorders. 2012;45(3):307-315. doi:10.1002/eat.20965.|
|4.||↑||Dansky BS, Brewerton TD, Kilpatrick DG, O’Neil PM. The National Women’s Study: Relationship of victimization and posttraumatic stress disorder to bulimia nervosa. Int J Eat Disord. 1997;21:213–28.|