June is post-traumatic stress disorder (PTSD) awareness month. PTSD can develop after exposure to any traumatic event, such as abuse, interpersonal violence, disasters, accidents, or sexual assault. Symptoms include persistent anxious and/or frightening thoughts, memories of the event(s), sleep problems, dissociation, flashbacks, panic attacks, and the development of other psychological disorders, including eating disorders.
Studies have shown a strong connection between trauma, PTSD, and the development of eating disorders (Brewerton, 2007; Mitchell et al., 2012). In fact, one study found that the vast majority of men and women with anorexia nervosa, bulimia nervosa, or binge eating disorder reported a history of interpersonal trauma. Furthermore, 33% of women with bulimia, 20% with binge eating disorder, and 11.8% other eating disorders met full criteria for PTSD (Mitchell et al., 2011). On average, approximately one in four people with an eating disorder has symptoms of PTSD (Tagay et al., 2014). Males with PTSD are also significantly more likely to develop an eating disorder than males without PTSD (Mitchell et al., 2012).
Research shows higher trauma rates among individuals who struggle with binging and/or purging as well. Two major studies have shown that individuals with bulimia or binge eating disorder have significantly higher rates of PTSD than individuals without an eating disorder. When PTSD symptoms are considered without necessarily meeting full criteria for the diagnosis, well over half of individuals with bulimic symptoms have PTSD or PTSD symptoms (Brewerton, 2007).
While it is still unclear exactly why trauma contributes to the development of an eating disorder, trauma can cause disruption to the nervous system (Ross, 2018). This can make it difficult for individuals to regulate their emotions, which can contribute to the development of disordered eating as a way to cope with emotions.
Eating disorders are also commonly associated with control. Traumatic events can leave a person feeling powerless and vulnerable. Restricting food intake, structuring their exercise routine, or purging food may feel like a way to regain a sense of control in their lives. Bingeing and/or purging can temporarily reduce the anxiety related to trauma by serving to numb, avoid, or even forget about the traumatic event(s). These behaviors are reinforcing, making it very difficult to break the cycle.
Treating trauma and eating disorders
Eating disorders and PTSD are both very complex and can be debilitating if they go untreated. Recovery is possible, though. It is important to seek treatment from qualified professionals that utilize trauma-informed and evidence-based treatments and have experience with treating both trauma and eating disorders. If one goes untreated, it can interfere with overall recovery.
If you have struggled with disordered eating, traumatic experiences, or both, our diverse team of experienced therapists and dietitians can work with you to restore hope and inspire healing on your road to recovery.
Stay tuned for an inspiring story of recovery from a Chrysalis client!
Brewerton, T. D. (2007). Eating Disorders, Trauma, and Comorbidity: Focus on PTSD. Eating Disorders,15(4), 285-304. doi:10.1080/10640260701454311
Mitchell, K. S., Mazzeo, S. E., Schlesinger, M. R., Brewerton, T. D., & Smith, B. N. (2012). Comorbidity of partial and subthreshold ptsd among men and women with eating disorders in the national comorbidity survey-replication study. International Journal of Eating Disorders,45(3), 307-315. doi:10.1002/eat.20965
Ross, C. C. (2018, February 20). Eating Disorders, Trauma, and PTSD. Retrieved June 2, 2021, from https://www.nationaleatingdisorders.org/blog/eating-disorders-trauma-ptsd-recovery
Tagay, S., Schlottbohm, E., Reyes-Rodriguez, M. L., Repic, N., & Senf, W. (2014). Eating disorders, trauma, PTSD, and psychosocial resources. Eating disorders, 22(1), 33-49.