Why eating disorders and trauma often overlap

After going through a particularly stressful time, it can be common to turn to comfort food to relieve our stress. Many studies show that eating carbohydrate-rich foods raises levels of serotonin, the chemical in our brains that regulates mood, and reduces feelings of depression, anxiety, and irritability in the process.

Yet the trauma associated with PTSD goes beyond short-term distress. People with PTSD often experience symptoms that last longer than several months and interfere with their lives. They may continue to relive the trauma through nightmares and flashbacks and struggle with feelings of fear and helplessness. People with PTSD may turn to disordered eating in order to get short-term relief from trauma-related symptoms. 

Although not everyone who has PTSD is an emotional eater, there’s a demonstrated link between eating disorders and trauma. One study found that 80% of people who restricted their food intake, or had another eating disorder, also reported exposure to trauma. 

In addition, people with eating disorders often have other mental health conditions, like depression, anxiety, or unhealthy substance use. It’s also important to address any underlying factors like low self-esteem, history of abuse and trauma, and temperament traits like obsessive thinking as part of your treatment and recovery. 

How trauma can affect eating behaviors 

Experiencing a traumatic event can significantly affect your mood, diet, sleep patterns, relationships, and overall ability to engage in daily life. Researchers believe eating disorders may develop as a way for those with PTSD to cope with the long-lasting effects of trauma. 

While PTSD is the result of a single traumatic event, like a natural disaster or car accident, complex PTSD (C-PTSD) occurs after repeated or multiple forms of trauma. C-PTSD is often seen among survivors of domestic violence, childhood abuse, military veterans, first responders, and people who’ve lived through ongoing physical abuse and neglect.

Symptoms of PTSD and C-PTSD can include: 

• Nightmares or bad dreams
• Flashbacks, involving reliving the traumatic event
• Sweating and rapid heartbeat
• Negative beliefs about yourself
• Profound guilt or shame
• Loss of interest in previously enjoyed hobbies and activities
• Problems sleeping
• Avoidance of places, thoughts, or feelings related to the traumatic event
• Being easily startled, tense, difficulty concentrating, irritable, and memory loss

People with C-PTSD can also have additional symptoms, including issues with:

• Emotion regulation
• Identity and sense of self
• Relationships

Researchers also believe trauma may cause or exacerbate symptoms of low self-esteem, perfectionism, self-criticism, poor body image, and disassociation, leading to the development of eating disorders.

Can PTSD lead to an eating disorder? 

Not all survivors of trauma develop an eating disorder, and not all people with eating disorders have a history of trauma — yet there’s a link between the two. One study found that 43.8% of people with an eating disorder reported experiencing more than one traumatic event in their lifetime. 

While most of us will experience a traumatic event at some point, our initial feelings of exhaustion, confusion, sadness, and numbness will eventually resolve. Yet in some cases, these feelings remain unresolved, making you more vulnerable to developing an eating disorder.

Research shows that people who‘ve experienced multiple episodes of trauma (C-PTSD) and early traumatic and stressful events are at risk of developing an eating disorder. In addition, the rate of trauma is higher among women and men with bulimia nervosa and binge eating disorder compared to the general population.

Additional risk factors that can increase your risk of developing an eating disorder after trauma include:

• Low self-esteem
• Feelings of shame
• Anxiety and depression
• Sense of powerlessness
• Poor coping skills
• Chronic stress

After a person has experienced trauma, they may develop an eating disorder by using food to manage or suppress their emotions.

This can include adopting behaviors such as:

• Avoiding meals
• Overeating
• Purging or vomiting after meals
• Eliminating specific food groups

Trauma-informed care for eating disorders 

To achieve a full recovery, it’s important to find a therapist who’s trained in treating both trauma and eating disorders. Working with a therapist trained in trauma-informed care (TIC) allows you to explore your past trauma in a safe environment. This can help you understand how you developed an eating disorder as a coping mechanism.

Both PTSD and C-PTSD can be effectively treated with eye movement desensitization and reprocessing (EMDR) and cognitive behavior therapy (CBT), even years after the traumatic event has occurred. 

Cognitive processing therapy (CPT) is also used to treat eating disorders and PTSD. This type of therapy helps people to understand how trauma contributes to their eating disorder, learn coping skills, and helps them to adopt a healthy mindset around eating.

Find care with Rula 

If you or someone you love is navigating the complexities of overlapping PTSD and eating disorders, know that support is available. Working with a trauma-informed therapist can help you work through any underlying trauma and heal your relationship with food. 

At Rula, we’re here to help you access supportive, specialized mental health care from the privacy of your home without the typical long wait time. In just a few minutes, we can match you with a therapist who takes your insurance and specializes in the treatment of trauma and eating disorders. With our diverse network of providers, you can begin therapy and start your recovery as soon as tomorrow.

Find a therapist with Rula