Eating Disorders & Trauma: Understanding the Connection
By: Grace Kim BSN, RN, PMH-BC
Individuals living with an eating disorder and their loved ones may often wonder, “How did this begin?” or “Was there a specific event that triggered the eating disorder?” While the causes of eating disorders are complex and multifactorial, research consistently identifies trauma as a significant risk factor in their development.
What Is Trauma?
Trauma can result from a single, life-altering event, like an accident or assault. But it can also be ongoing experiences such as bullying, physical or emotional abuse, systemic oppression or persistent feelings of being unsafe. Trauma isn’t just about what happens to someone, but about the impact that experience has on their emotional, physical and psychological well-being. Trauma affects people differently. For some, the reactions of trauma such as feelings of sadness, anxiety, numbness, apathy, anger or dissociation, resolve and don’t leave lasting negative consequences. But for some, the impact of trauma can be long lasting causing issues in everyday functioning and in severe cases, can lead to post traumatic stress disorder (PTSD). Learn more about the relationship between PTSD and eating disorders here.
The Link Between Trauma and Eating Disorders
A study published in the International Journal of Eating Disorders found that 48.3% of individuals diagnosed with an eating disorder reported more than one traumatic event in their lives. Reactions to trauma vary from person to person but a common thread among survivors is difficulty regulating emotions and feeling a loss of control. If trauma is not processed in healthy ways, eating disorder behaviors can manifest as a way to cope to help manage overwhelming emotions, numb psychological pain or regain a sense of control.
Many individuals with eating disorders have experienced complex trauma, which is prolonged or repeated exposure to distressing experiences, often beginning in childhood. This type of trauma can interfere with healthy emotional development, damage one’s self-concept, and disrupt the ability to feel safe in one’s body. In these cases, the eating disorder can become a deeply ingrained coping mechanism.
Some trauma survivors may also experience dissociation, or a sense of being disconnected from their body. Certain disordered behaviors may serve to reinforce this disconnection or act as attempts to control the body in ways that feel predictable or soothing. Though these behaviors may provide temporary relief, over time they often intensify feelings of shame, isolation, and distress.
It’s also important to recognize that trauma is not always a single event or personal experience, it can be systemic. People who have experienced identity-based trauma such as racism, homophobia, transphobia, or weight stigma often carry a unique burden that can impact their relationship with food, body image, and mental health. These forms of trauma are often overlooked, yet they can significantly contribute to the development and maintenance of eating disorders.
Ultimately, trauma can distort how individuals see themselves, potentially leading to low self-esteem, self-criticism, and deeply rooted negative beliefs. Healing from both trauma and an eating disorder requires understanding these complex dynamics and addressing the root causes, not just the symptoms.
Trauma-Informed Care in Eating Disorder Treatment
Recognizing the impact of trauma is essential to healing. For many, the shame that’s often associated with trauma can make it hard to talk about. It’s very important to bring up these experiences to light, especially with trusted healthcare professionals, to receive the appropriate support and treatment.
Individuals with eating disorders that have a history of trauma can have a harder time recovering and in fact, this study shows higher rates of treatment dropouts and relapse after treatment. Integrating trauma-informed care can promote better chances of long-term recovery.
Trauma-informed care is based on these key principles:
- Safety: Ensuring physical and emotional safety for all, including creating welcoming environments, embracing diversity, and using supportive, non-confrontational language.
- Trustworthiness: Building trust by maintaining clear expectations, transparency, and consistent boundaries. This includes providing clear information and expressing patience and acceptance.
- Choice: Prioritizing individual autonomy and self-determination by informing individuals of available options, balancing flexibility, and reflecting on factors like race, gender, and culture.
- Collaboration: Sharing power and working with individuals, not doing things to or for them. This means seeking input, exploring others’ perspectives, and acknowledging power dynamics.
- Empowerment: Helping individuals recognize their strengths and capacities to foster hope and possibility. In practice, this includes using inclusive, affirming language and building on what’s already strong.
Finding Hope and Healing
Healing from both trauma and an eating disorder is possible. It takes time, self-compassion, and the right support system. Whether through trauma-informed therapies like EMDR or somatic experiencing, or through peer support, the path to recovery is deeply personal and rarely linear. Trust may take time to rebuild, and relapses are a natural part of the journey, not a sign of failure. It’s important to remember that you are not alone with these struggles and staying connected to those who understand and support your healing can be a powerful force in your recovery journey.
Resources
A resource list dedicated to trauma-focused care can be found here.
ANAD’s Weekly Eating Disorder Peer Support Groups can be found here.
ANAD and Equip’s 6-week email series packed with tips and resources to help you build practical recovery skills such as mealtime strategies, setting boundaries, and finding motivation, which can be found here.
