Eating Disorders, Trauma and PTSD - Part 2

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Eating disorders are rarely solely related to abnormal or disturbed eating habits. In fact, eating disorders are rarely even about food. As an integrative medicine practitioner with over thirty years’ experience in treating eating disorders, knowing the root cause of eating disorders like bulimia, binge eating disorder and anorexia is critical to developing an effective treatment plan for patients.

In Part 1 of this blog, you learned about the relationship between eating disorders and trauma and what types of trauma can lead to eating addictions, binge eating, compulsive overeating and other eating disorders (EDs). Part 2 will cover what EDs and trauma have in common and more on what you can do.

What PTSD and Eating Disorders Have in Common

When looked at more closely, PTSD and eating disorders share some similar characteristics. They both have high rates of dissociation. Eating disorder behaviors may be a way to distance oneself from disturbing thoughts, emotions or memories associated with PTSD (Mitchell et al. 2012). It’s possible to see the psychological symbolism of these behaviors in sufferers of eating disorders. Purging can be seen as a way to get rid of something unwanted (emotion, memory or symptom) while bingeing can be seen as a way to fill a void. We know logically that we cannot fill an emotional void with food and we cannot get rid of unwanted feelings, memories or symptoms by emptying our stomachs. Yet, both provide relief for the sufferer in either managing the symptoms of PTSD or as a coping mechanism in dealing with an unresolved (and possibly subconscious) trauma.

Along with the shared characteristics between PTSD and eating disorders, there are also similar genetic and biological factors that might explain this correlation. However, even while there may be additional factors for this relationship between eating disorders and PTSD, studies continue to show that women and men with trauma and PTSD have higher rates of eating disorders than the general population (Mitchell et al. 2012). This suggests that, at the very least, eating disorders are much more complicated to treat than originally believed. This added layer of complexity must be understood in order to treat eating disorders, trauma and PTSD effectively when two or more are present concurrently.

One of the reasons PTSD is hard to diagnose in patients with eating disorders is that the Diagnostic and Statistical Manual of Mental Disorders-III does not include a diagnosis for partial PTSD, meaning that while some symptoms may be present, no diagnosis can be given unless all criteria are met. This limits the ability of professionals to properly diagnose patients who suffer from both PTSD and eating disorders or even draw a connection between the two.

The Proper Care and Feeding of Eating Disorders

If you suffer from an eating disorder, this doesn’t necessarily mean you’ve been traumatized. However, if you suffer from an eating disorder and you have a history of neglect, trauma or abuse, it is important for you to get help for trauma while getting treatment for your eating disorder. Trauma symptoms like loss of focus, nightmares, being easily startled or feeling you have to be on red alert all the time, anxiety, depression, insomnia, and/or hallucinations, may indicate a history of trauma or PTSD. Seeking proper treatment and care is critical to your health and well-being. While medication can be helpful in treating PTSD symptoms, trauma therapy is the cornerstone of effective treatment.

There are several forms of therapy available to treat eating disorders. Cognitive-Behavioral Therapy (CBT) with prolonged exposure is the most recognized and effective methods in treating eating disorders, and many forms of trauma related disorders. Eye Movement Desensitization and Reprocessing (EMDR) has also been shown to be effective especially in combination with CBT. Some types of medications can also be beneficial in treating mood and anxiety disorders associated with trauma and eating disorders but are best used in combination with therapy. There are medications for some of the symptoms of PTSD such as nightmares and flashbacks.

The first step in recovery is to get help. You do not have to suffer in silence or alone and there are ways to effectively cope with and heal from trauma, PTSD and eating disorders. Find a therapist who specializes in treating eating disorders, trauma and PTSD to ensure you meet with a professional who can address these needs. The therapy should also include some type of nutritional plan to help restore your body’s ability to heal as the disruptive eating habits may have left your body malnourished. As you begin to take steps to nourish the body, you will be better able to deal with therapy for trauma and the symptoms associated with trauma. A great indicator that you have the right therapist is you will be able to go at your own pace and learn effective and healthy coping mechanisms to deal with anxiety, discomfort and emotions that surface. If you try therapy and you don’t feel secure or safe, don’t give up. It may take some time to find a therapist who has the appropriate experience, the tools and the right bedside manner to help you recover.