Key Takeaways
- Being a survivor of sexual abuse may increase your risk of developing an eating disorder. About 29% of people with eating disorders report a history of sexual trauma.
- Sexual abuse can affect a person’s mental and physical health in many ways. A survivor may use disordered eating as a way to feel in control or dissociate from painful emotions.
- Healing from eating disorders and sexual abuse is possible, but professional treatment is key. This typically involves a combination of therapy and, at times, medication.
Sexual abuse is a form of trauma that’s a significant risk factor for eating disorders and other mental health concerns. Research estimates approximately 30% of people with eating disorders have been sexually abused. Several types of eating disorders can impact a person’s mental and physical well-being. But people living with anorexia nervosa or bulimia seem to most often report having experienced sexual violence, versus people with other types of eating disorders.
Understanding this connection is critical for treatment to be effective. However, it’s important to remember that sexual abuse can be difficult to discuss, even in therapy. It typically requires that survivors have a strong foundation of trust with their provider, which can take time to establish. But once survivors feel safe enough to talk about their sexual abuse history, they can make significant progress in their recovery from their eating disorder(s).
Four ways sexual trauma can lead to disordered eating
Each person’s experience of abuse is different. But we know that sexual abuse can leave a lasting impact on the survivor’s body image, mental health, and relationship to food. While we don’t yet fully understand all the ways trauma can lead to disordered eating, experts have identified a few patterns that might help explain the link.
- Negative body image: Sometimes, sexual abuse can lead survivors to view themselves as damaged or flawed. They may mistakenly believe the abuse was their fault and carry misplaced guilt and shame about the experience. This can lead to a negative or distorted body image, and this is common among people with eating disorders.
- Dissociation: Dissociative experiences are especially prevalent among people with binge eating disorder (BED). This can be described as an “out-of-body experience” that temporarily numbs the emotional pain from sexual trauma.
- Self protection: Significant weight loss or gain due to an eating disorder can change a person’s appearance. Research suggests that this may be an attempt to appear unattractive or invisible to would-be abusers and therefore prevent further harm.
- Sense of control: Abuse can leave survivors feeling desperate to regain a sense of autonomy. Restrictive behavior around food or exercise can temporarily give a person a sense of control, even if it leads to negative outcomes in the long run.
Understanding the impact of sexual abuse and eating disorders
Sexual abuse can impact the mind and body in many ways. There can be physical injuries as well as psychological concerns like depression, anxiety, and suicidality.*
Sexual abuse also can lead to chronic, long-term consequences, like:
- Post-traumatic stress disorder (PTSD)
- Reproductive challenges
- Gastrointestinal problems
- Cardiovascular issues
- Sexual health problems
- Substance misuse (i.e. cigarettes, alcohol, other drugs)
- Risky sexual behavior
- Employment or academic difficulties
- Economic instability
- Low self-esteem
- Difficulty maintaining personal relationships
- Greater risk of intimate partner violence
Eating disorders can also have a significant impact on a person’s mental and physical health. Left untreated, they can increase the risk of:
- Cardiovascular issues
- Metabolic problems
- Digestive issues
- Laxative dependence
- Difficulty concentrating
- Neurological issues
- Hormonal imbalances
- Bone density loss
- Type 2 diabetes
- Disrupted menstruation
- Kidney failure
- Tooth decay
- Dry, brittle hair and skin
- Anemia
- Depression
- Anxiety
- Suicidality and self-harm*
In addition to the risk of suicidality and self-harm, eating disorders carry one of the highest mortality rates of any mental health condition. So if you or someone you care about is showing signs of an eating disorder, don’t hesitate to reach out for help.
*A note on safety: The 988 Suicide and Crisis Lifeline provides 24/7, confidential support with trained crisis counselors. If you or a loved one is in emotional distress or a suicidal crisis, please call or text 988. If it’s an emergency, please call 911.
Healing from sexual abuse and eating disorders
If you’re navigating the effects of sexual abuse along with disordered eating, know that effective treatments are available for both concerns. While the exact approaches your provider uses to support you will be based on your unique strengths and challenges, your treatment plan may include any of the following:
- Cognitive processing therapy (CPT): CPT is used to uncover and address unhelpful thought patterns and avoidance behaviors — both of which can occur due to trauma or eating disorders.
- Exposure therapy: This form of care involves the safe, gradual exposure to triggers under the supervision of a therapist. It’s used to help reduce unhealthy behaviors and increase distress tolerance.
- Eye movement desensitization and reprocessing (EMDR): EMDR helps people process traumatic memories through guided eye movements. Because many people with eating disorders also have a trauma history, EMDR can be used to treat both.
- Trauma-focused cognitive behavioral therapy (TF-CBT): This form of CBT is usually used with children and adolescents. It helps resolve trauma and eating disorder symptoms by addressing unhelpful thought and behavior patterns.
- Acceptance and commitment therapy (ACT): ACT helps promote positive change by helping people identify their personal values and make choices that reflect them. It can help people overcome avoidance, process trauma, and improve emotional regulation.
- Dialectical behavior therapy (DBT): DBT is especially helpful for addressing the emotional dysregulation that often accompanies sexual abuse and eating disorders. It focuses on mindfulness and improving distress tolerance.
- Motivational interviewing (MI): Sometimes, people who have experienced trauma and/or disordered eating may hesitate in helping themselves. MI is useful in instances in which a person might not be ready for change.
- Interpersonal psychotherapy (IPT): Both sexual trauma and eating disorders can affect a person’s relationships. IPT can help a person expand their capacity to connect with others and nurture healthy relationships.
- Family therapy: Involving trusted family members can help survivors feel empowered, supported, and less alone throughout their recovery.
- Medication: In addition to therapy, sometimes medications are used to treat trauma and eating disorders. You can talk to your provider about whether this is the right option for you.
Find care with Rula
Experiencing trauma like sexual abuse can often increase a person’s risk of developing an eating disorder. This may be due to a desire for control, a need to numb painful emotions, unhealthy body image issues, or other factors. However, know that with integrated treatment addressing both experiences at the same time, recovery is possible.
If you’re survivor of sexual abuse and you’re struggling with disordered eating, know that you’re not alone. When you need support that reflects your unique mental health challenges, Rula is here to help. In just a few clicks, you can use our platform to find a therapist that takes your insurance and offers the comprehensive care you deserve. No matter the issues you’re facing, Rula makes it easier than ever to find an in-network provider and make your first appointment as soon as tomorrow.
