Trigger Warning: This post will address the topic of trauma and names specific eating disorder behaviors.
You may have heard people say that eating disorders are not just about food, but instead, a way to cope with some form of significant distress. This distress can show up in a number of ways, but for many, it can be a way to cope with unresolved trauma.
Recent statistics estimate that over 8 million people in our country meet the criteria for post-traumatic stress disorder (PTSD) each year. Of those 8 million, 38-44% also struggle with bulimia nervosa, 16% have anorexia nervosa, and 24% have a diagnosis of binge eating disorder. Brewerton, Timothy D. 2007. “Eating Disorders, Trauma, and Comorbidity: Focus on PTSD.” Eating Disorders 15 (4): 285–304.
PTSD typically manifests in 3 different areas:
Hyperarousal or Hypervigilance – A key feature of PTSD is the presence of an increased startle response or hypervigilance. People with PTSD often say they constantly feel on edge or ‘keyed up.’ The fight or flight system is turned on, making it extremely difficult for the individual to relax or sleep. There may or may not be somatic symptoms present, such as stomach aches, headaches, muscle tension.
Avoidance of Triggers – Someone who is suffering from PTSD will often go to great lengths to avoid encountering anything that reminds them of the trauma they endured. They may find themselves avoiding specific places or things that remind them of the trauma. Driving past a certain location may be avoided as a way to prevent panic attacks or flashbacks. Social situations may be avoided because they feel unsafe.
Intrusive Symptoms – Intrusive symptoms show up through nightmares, flashbacks, body memories, dissociation, and reoccurring thoughts about the event. These intrusive symptoms bring the past trauma into the current moment, making it extremely difficult to realize that you are safe and that the trauma is no longer occurring.
For many people, food becomes the tool to try to tolerate these distressing symptoms. Anorexia nervosa is characterized by restricting one’s food intake. Restriction of food intake often results in a disconnection from the body and feelings, which may be a positive thing for someone experiencing flashbacks, panic attacks, and somatic symptoms. The longer restriction goes on, the more preoccupied a person becomes with food, weight, and shape, which may decrease the intrusive trauma thoughts. When we eat, our bodies produce endorphins, the feel-good hormone. This endorphin rush can also lead people to engage in binge eating as a way to stuff or numb against unwanted thoughts, feelings, and somatic experiences. Although the eating disorders behaviors may decrease or shut down the PTSD symptoms for a period of time, eventually, the trauma and ED symptoms continue to increase until a person is in significant distress.
Recovery is Possible
If you are struggling with PTSD symptoms and/or an eating disorder, please reach out to a mental health professional to discuss the appropriate treatment approach. There are several effective treatment modalities available, and recovery is possible.
Be well.
– Laurie Mueller, MSW, LICSW
