PTSD and Eating Disorders

The link between PTSD and eating disorders

Did you know that eating disorders and PTSD, two very debilitating conditions, often co-occur? Some experts refer to an eating disorder as a brain disorder; many refer to posttraumatic stress disorder (PTSD) as a brain injury. Here are some facts about these disorders in the US:

• For adults with bulimia nervosa, 37 to 45 percent will experience PTSD at some point in their lifetime.
• For adults with binge eating disorder, 21 to 26 percent will battle PTSD during their lifetime.
• When it comes to anorexia nervosa, the odds of having PTSD are higher in individuals who engage in bulimic behaviors like binge eating and/or purging.
• PTSD affects 5 to 12 percent of individuals without an eating disorder.

According to studies, it seems that PTSD, not the actual trauma itself, is what contributes to the development of an eating disorder.

For some people, PTSD symptoms are so devastating that eating disordered behaviors become a way to cope, particularly binging and purging. As an example, in an effort to alleviate the hyperarousal symptoms that occur with PTSD (e.g., feeling keyed up, irritable, and/or startling), some might binge. In an attempt to decrease the intense emotions associated with flashbacks (another symptom of PTSD), others might purge. Some do both.

Having said this, not all people with PTSD will engage in eating disordered behaviors. And, importantly, not everyone who experiences a trauma will develop PTSD.

Recovery from both conditions is possible

Since I was well into my eating disorder recovery work when my trauma occurred, there was only a short time when the two disorders collided. Looking back, I can clearly see that there were instances when I used my eating disorder as an attempt to deal with the emerging symptoms of PTSD.

Both eating disorders and PTSD are real, life-threatening illnesses; they are not choices.

Treatments for eating disorders and PTSD

There are a variety of evidence-based treatments for both PTSD and eating disorders. Here is a list of some things that I’ve personally found to be helpful in my own recovery:

• Cognitive behavioral therapy (CBT), which was particularly helpful for my own eating disorder recovery
• Prolonged exposure therapy and eye movement desensitization reprocessing (EMDR), which were particularly helpful for me in dealing with PTSD
• Alternative therapies like yoga, acupuncture, massage and somatic therapy can help us reconnect and make peace with our bodies

Some who battle both PTSD and an eating disorder find it best to tackle both simultaneously while others find it more helpful to approach the illnesses one at a time.

If you (or your loved one) struggle, professional help that is individualized by experts with experience in treating both disorders is often recommended.

Learn more about eating disorders and trauma:

• Fight, Flight, Freeze, Fawn: What Does Fawn Mean?
• Healing Childhood Trauma
• Podcast Episode: Generational Trauma

References:

• Brewerton, T. D. (2007). Eating disorders, trauma, and comorbidity: focus on PTSD. Eating Disorders, 15(4), 285-304.
• Dansky, B. S., Brewerton, T. D., Kilpatrick, D. G., & O'Neil, P. M. (1997). The National Women's Study: relationship of victimization and posttraumatic stress disorder to bulimia nervosa. International Journal of Eating Disorders, 21(3), 213-228.
• Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3), 348-358.
• Reyes-Rodriguez, M. L., Von Holle, A., Ulman, T. F., Thornton, L. M., Klump, K. L., Brandt, H. A., . . . Bulik, C. M. (2011). Posttraumatic stress disorder in anorexia nervosa. Psychosomatic Medicine, 73(6), 491-497.