How Eating Disorders Are Tied to Trauma, PTSD and Substance Abuse

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How Eating Disorders Are Tied to Trauma, PTSD and Substance Abuse

The bad news? Up to 20 million women and 10 million men in the U.S. will battle an eating disorder at some point in their lives, according to the National Eating Disorders Association (NEDA).

More bad news: A person dies every 62 minutes in the U.S. directly due to an eating disorder. Also, eating disorders have the highest mortality rate of any mental illness.

The not-so-bad news? Less than 1 percent of women will struggle with anorexia nervosa in their lifetime, less than 2 percent will struggle with bulimia nervosa, and less than 3 with binge-eating disorder (BED).

So while the development of any eating disorder is a serious issue, it’s not an epidemic. However, those who have suffered through trauma and those who have developed PTSD are at greater risk for an eating disorder, according to several recent studies. Furthermore, those who struggle with an eating disorder are at risk of developing a co-occurring disorder, such as alcohol or drug use.

Let’s take a closer look at the relationship between eating disorders and trauma and PTSD.

How Trauma Can Play a Role in Eating Disorders

The typical assumption about somebody with an eating disorder is that they were either picked on for their appearance in school or that they developed unhealthy body image issues in idolizing modern actors and models. What we now know about eating disorders delves much deeper than that, and sometimes doesn’t have anything to do with one of those two scenarios at all.

In most cases, eating disorders aren’t even about food; they are full-fledged mental health disorders, just as depression and anxiety are. It’s been common knowledge that sexual abuse during childhood increases the risk of an eating disorder, but researchers are finding other forms of trauma are risk factors, too.

Other forms of trauma that can contribute to the development of an eating disorder are:

  • Emotional and physical neglect (including food deprivation)
  • Emotional abuse
  • Physical abuse and assault
  • Sexual assault
  • Sexual harassment
  • Teasing and bullying

Scientists know that, physically, trauma can disrupt the nervous system and make it difficult for the person to manage his or her own emotions. If the trauma goes unaddressed or untreated, individuals commonly turn to abnormal or compulsive eating behaviors (the phrase “eat your feelings” comes to mind) to (mis)manage their emotions. The risk of alcohol or drug abuse increases in these individuals, as well.

How Common Is It to Struggle with an Eating Disorder and PTSD?

Among people with post-traumatic stress disorder (PTSD), the rate of eating disorders is much higher than in the general population. In fact, a 2012 study found that the following percentages of women with an eating disorder met the criteria for lifetime PTSD:

  • About 33 percent of women with bulimia
  • 20 percent with binge-eating disorder
  • Nearly 12 percent with non-bulimic/non-binge-eating disorders

PTSD has a lifetime rate of about 8 percent in the overall population.

The Differences Between the Two Types of Anorexia

While studies such as the one mentioned above have found clear connections between PTSD and bulimia nervosa and binge-eating disorder, the science is not so settled on restricting-type anorexia nervosa.

There are two major types of anorexia:

  • Restricting-type anorexia nervosa: The most well-known type of anorexia in which the person significantly restricts their food intake. Self-imposed restrictions may come in the form of limiting calories, number of meals per day, types of foods eaten, etc.
  • Binge-eating/purging anorexia nervosa: A person restricts their food intake, but also experiences episodes of either binge eating or purging. Purging behaviors include self-induced vomiting, over-exercising and misusing laxatives or diuretics.

Studies are showing a pretty strong connection between the second type of anorexia listed here, but the results when studying the restricting type are not so conclusive.

In any case, scientists are still trying to figure out exactly why trauma contributes to the development of eating disorders. Try as they might, this may be a search without an end; the reasons why somebody begins to struggle with an eating disorder are likely as vast and unique as are there are people with one of these disorders.

Finding the Right Therapist for Eating Disorder Treatment

If you or a loved one is afflicted by an eating disorder, your search for the right therapist is going to be crucial to recovering from this disorder. You may come across many “mental health specialists,” but how many have firsthand experience with treating eating disorders?

The first and easiest step is to ask the therapist how many patients with eating disorders he or she has worked with and how many years he or she has been in the field. Just as you wouldn’t ask a handyman with little or no painting experience to do a major paint job on your house, so shouldn’t you settle on a therapist with little eating disorder treatment experience.

And if this therapist in question does purport to have experience in eating disorder therapy, ask if he or she has any credentials or affiliations to back that up. For example, is this therapist a member of a national organization such as The Academy of Eating Disorders or the International Association of Eating Disorder Professionals?

Next, ask this therapist if he or she is willing to work with your doctor, a nutritionist and other experts to help you overcome this eating disorder. A therapist who’s worth his or her mettle in eating disorder treatment will understand the importance of working within an interdisciplinary team of professionals. Any therapist who hesitates at this question should get moved down in your list.

Effective Therapy Methods for Eating Disorders and PTSD

As you’re still searching for the right therapist, it’s important to ask which specific methods he or she will use to help you overcome an eating disorder. In particular, you should ask about these two methods:

  • Cognitive behavioral therapy (CBT)
  • Eye movement desensitization and reprocessing (EMDR)

Both of these methods are renowned for getting results quickly and, better yet, they both help with trauma/PTSD AND eating disorders. If you’re not sure exactly what they are, ask the therapist in question to explain them to you. If they struggle to articulate either one, it signals you may have to look elsewhere before committing to a therapist.

Learn More About CBT and EMDR

The Connection Between Eating Disorders and Substance Abuse

So not only do people with eating disorders have an unhealthy relationship with food, but many develop unhealthy relationships with drugs or alcohol, too. In fact, up to a whopping 50 percent of people with eating disorders will abuse drugs or alcohol.

The substances that people with eating disorders tend to misuse or abuse include:

  • Alcohol
  • Amphetamines
  • Heroin
  • Cocaine
  • Laxatives
  • Diuretics (water pills)
  • Emetics (medications that induce vomiting)

As explained earlier, if a person went through trauma, the ensuing emotional turmoil can have a number of unhealthy manifestations. That means substance abuse and an eating disorder are sometimes two sides of the same dangerous coin.

How Eating Disorders and PTSD Are ConnectedEating disorders and addiction actually share a number of the same risk factors, including:

  • Family history of either condition
  • Altered brain chemistry (due to trauma or other negative stimuli)
  • Depression
  • Social pressure
  • Low self-esteem
  • Anxiety
  • Compulsive behavior
  • Social isolation
  • Suicidal thoughts or behavior

Getting Treatment for Both
Addiction and an Eating Disorder

If you have a loved who struggles with not only an eating disorder, but a substance abuse problem, as well, it’s going to take more than a single therapist to recover from both conditions. In fact, inpatient treatment is ideal in this situation, especially a program that offers trauma-informed care (TIC).

Need help with finding a program that fits within these specific parameters?

Fight Addiction Now has got your back. Click on either “Get Help Now” or “Start Chat Now” for expert guidance in your search for a program that treats addiction, trauma and co-occurring disorders (such as eating disorders).

See Our Mental Health Disorders Fact Sheet

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