The link between self-harm and eating disorders

Self-harm — otherwise known as non-suicidal self-injurious behavior (NSSI) — is any attempt to intentionally harm one’s body without the intent of attempting suicide. Many people are familiar with the common form of self-harm known as cutting. But self-harm can take many different forms, including burning, embedding objects under the skin, and head banging. 

Research shows that, among the general population, approximately 12% to 37% of adolescents and 12% to 20% of adults in the U.S. engage in self-harm. But among people with eating disorders, that number jumps rapidly. As many as 55.2% of young people with eating disorders engage in self-harm. This behavior can range from a mild injury, like a light scratch, to serious injuries that require emergency medical attention. 

Experts are still working to understand the link between eating disorders and self-harm. But it’s important to note that both conditions can be life threatening, even without the presence of suicidal intent. 

Learning more about these behaviors can help you recognize them in yourself and others. And in raising awareness, we can reduce stigma and increase access to life-saving support. 

Understanding non-suicidal self-injury

If you don’t have personal experience with self-harm, someone intentionally inflicting pain on themselves can seem confusing. To better understand what causes someone to self-harm, we need to take a closer look at the way the brain responds to stress. 

Self-harm is usually a response to some form of emotional distress. This can stem from things like:

• Abuse or neglect
• Bullying
• Untreated mental health conditions, like anxiety or depression
• Relationship problems
• Unhealthy substance use
• Major life transitions or other stressful events
• Problems with self-esteem or self-image

A buildup of stress can interrupt healthy brain functioning, specifically in the areas responsible for emotional regulation and reward processing. In response, self-harm can act as a pressure-release valve for the mind and body, providing a temporary release of uncomfortable emotions. 

Other reasons for self-harm may include:

• A desire to feel in control
• As a form of self-punishment
• To quiet upsetting memories
• As a way of feeling something or overcoming emotional numbness 
• To signal to others that there is an unmet emotional need 

Signs of self-injury

Often, people who self-harm do so in secret. They might feel embarrassed by their behavior or worry about what might happen if someone finds out about it. So they may attempt to conceal any visible evidence of self-harm, and this can make it more difficult to detect. 

However, there are some common indicators of self-harm:

• Frequent scabs, cuts, burns, or scars in the same place and shape
• Wearing long or baggy clothing even when it’s hot outside
• Explaining evidence of injuries as clumsiness or accidents
• Other compulsive behaviors, like skin picking or pulling out hair

How are eating disorders and self-harm related?

We don’t fully understand the relationship between eating disorders and self-harm. But we do know that having one may increase your risk of developing the other. This connection might be due to some shared underlying factors. 

Both eating disorders and self-harm may be connected to:

• Impulse control issues
• Problems with emotional regulation
• Being highly self-critical
• An overwhelming need for control
• Co-occurring mental health conditions
• Having a history of trauma or abuse

Are eating disorders a form of self-harm?

Eating disorders are recognized mental health conditions. To be diagnosed with one, you need to exhibit a specific set of behaviors or diagnostic criteria. However, self-harm is a category of behavior, not a standalone diagnosis. A person can engage in self-harm without having an eating disorder or another mental health condition.  

That said, the harmful behaviors that accompany eating disorders (like binging, purging, and restricting) can be considered forms of self-harm. They often provide some of the same emotional and psychological outcomes, like a sense of relief or feeling in control.  

Overcoming self-harm and disordered eating

To experience recovery, people engaging in self-harm and disordered eating can greatly benefit from therapeutic services.  

This typically involves a combination of:  

• Enhanced cognitive behavioral therapy (CBT-E): One of the most effective therapies for treating eating disorders, this is a modified form of CBT that focuses on thoughts and behaviors related to food and eating. It helps participants break unhealthy patterns, learn new ways of coping with stress, and improve their self-image.
• Dialectical behavioral therapy (DBT): Another form of CBT, DBT leverages mindfulness to help people improve emotional regulation, enhance stress tolerance, and learn new coping strategies. 
• Family therapy: Involving the whole family in the healing process can help young people who are engaging in disordered eating and self-harm. It can help improve communication, address unhelpful dynamics, and strengthen a person’s support system.
• Medication: Sometimes, medication is part of a treatment plan for self-harm and disordered eating. You can talk to your provider about whether this option is right for you.

In addition to offering these approaches, therapists who specialize in treating eating disorders and self-harm typically collaborate with other professionals. For example, they may work with psychiatric providers, doctors, and nutritionists to ensure that their clients receive well-rounded care.

Find care with Rula

Self-harm and disordered eating often accompany one another. While experts are still working to understand the relationship between these two experiences, it’s important to know that they can both be life threatening. So if you’re dealing with disordered eating, self-harm, or both, the best thing you can do for yourself is ask for help. 

At Rula, we’re committed to making it easier for you to access life-changing care, no matter the mental health challenge you’re facing. When you need help, we invite you to explore our therapist-matching program. In just a few clicks, you can find a therapist who takes your insurance, schedule your first appointment, and begin receiving support as soon as tomorrow.

Find a therapist with Rula