Understanding the Complex Relationship: Sexuality and Eating Disorders
By Kate Smiley, LCSW, Re-Imagine Therapy
As a therapist specializing in treating adult men and women who suffer from eating disorders, I am deeply aware of how intertwined these issues are with personal experiences and societal pressures. My journey into this field is intensely personal. Growing up in Los Angeles, CA, I began showing signs of body dysmorphia at the tender age of eight, triggered by the sexual abuse I experienced at that age and older. The pressure of living in a city that often idolizes perfection and beauty further compounded these struggles. As I matured, I grappled with an eating disorder and developed a love-hate relationship with my sexuality. Sharing my story is crucial because shame should no longer be the narrative for myself or anyone else who has been a victim of sexual abuse, rape, or harassment. It is an honor to work with individuals struggling with eating disorders and body dysmorphia, who often place immense value on their appearance. In this piece, I aim to explore the complex relationship between eating disorders and sexuality, illuminating how trauma, societal norms, and personal identity intersect.
The Correlation Between Eating Disorders and Child Sexual Abuse/Rape
In my practice, I have seen firsthand how profound the correlation between eating disorders and experiences of sexual abuse can be. Research supports this, indicating that up to 30% of those with eating disorders have endured some form of sexual abuse (most likely more). Emily’s journey resonates with many; after surviving childhood abuse, she developed an eating disorder to assert control over her body. Similarly, Alexa, a victim of sex trafficking, used eating restriction to reclaim autonomy. Both women experienced intense self-loathing, which manifested as body dysmorphia and an overwhelming disgust with their own skin. Some clients describe wanting to “rip their skin off” due to the intense self-hatred. Like them, I have walked the path of reconciling these feelings and addressing trauma, recognizing the courage it takes to foster a healthier relationship with one’s body.
The Influence of Social Media: Pressure to Be Thin
Social media often perpetuates unrealistic beauty standards, glorifying thinness and exacerbating body image issues. In my sessions, I hear stories like Sarah’s, who spent countless hours comparing herself to seemingly perfect Instagram bodies, leading to feelings of inadequacy and shame. This shame often spills over into intimate relationships, where fear of judgment during sex can become overwhelming. Sarah’s story is a powerful reminder of how social media can distort self-esteem and reinforce unhealthy eating behaviors. Through therapeutic guidance, individuals like Sarah learn to step away from these toxic ideals and gradually embrace their bodies, a process I too have navigated.
The Intersection Between Gender Dysphoria, Body Dysmorphia, and Sexuality
Working with clients experiencing gender dysphoria, I witness the added complexity of reconciling one’s gender identity with body image. Transgender individuals, like Alex, often face a higher prevalence of eating disorders. His journey to align his physical body with his gender identity was fraught with challenges, impacting his sexuality and intimate relationships. Through gender-affirming care and community support, Alex found belonging and began healing from his eating disorder, a journey I deeply empathize with. It’s vital to create inclusive and supportive environments that facilitate recovery and acceptance.
Treating Eating Disorders and Sexuality
In my therapeutic practice, addressing eating disorders requires a holistic approach that considers both sexuality and underlying trauma. Eye Movement Desensitization and Reprocessing (EMDR) is particularly effective for clients with a history of sexual trauma. For example, in EMDR sessions, a client might focus on distressing memories related to their trauma while following a light bar’s guided eye movements. This process helps desensitize the emotional impact of those memories and reprocess them more adaptively, reducing the hold they have on the individual’s present life.
Internal Family Systems (IFS) therapy complements this by helping clients explore the different “parts” of themselves, such as the critical inner voice or the protective parts that have developed due to trauma. Through IFS, clients learn to understand these parts and integrate them into a cohesive sense of self, promoting self-compassion and healing from within.
Incorporating a feminist perspective into therapy challenges societal norms and promotes self-acceptance. It encourages individuals to question the unrealistic standards of beauty imposed by society and empowers them to define their own standards of worth and beauty. This approach not only supports the healing process but also fosters resilience and self-discovery, crucial elements for recovery.
Conclusion
The relationship between eating disorders and sexuality is complex and multifaceted, shaped by personal trauma, societal pressures, and gender identity issues. By exploring these connections through personal stories, statistics, and therapeutic interventions, we can deepen our understanding of the path to recovery. It is a privilege to support individuals like Emily, Alexa, Sarah, and Alex in achieving healthier relationships with their bodies and sexuality. Together, we can redefine narratives and embrace healing.
