Many young people with eating disorders have experienced some form of childhood trauma. Childhood trauma makes it more likely that young people may develop other mental health conditions, which in turn increase the risk for eating disorders. But trauma also makes eating disorders more likely independently of other psychiatric disorders.
Understanding the connection between childhood trauma and eating disorders helps to identify young people who are most at risk. It can also play a key role in the treatment and recovery process, addressing the underlying causes of thought patterns and behaviours that perpetuate eating disorders.
What Are Eating Disorders?
Eating disorders are serious mental health conditions that usually begin during adolescence. Disordered eating attitudes and behaviours are about more than just food or body image. Sometimes they are a way to cope with or distract from difficult emotions or memories.
Eating problems can express themselves in different ways. They might include restricting energy intake, compulsive exercise, engaging in binge and purge cycles, or experiencing a loss of control while eating.
The DSM-V defines several types of eating disorders. These include:
- Anorexia nervosa, characterised by a low body weight
- Bulimia nervosa, involving cycles of binging and purging
- Binge eating disorder, characterised by episodes of loss of control eating
Not every eating problem fits into the criteria of an eating disorder. But that doesn’t mean it’s any less serious. It’s important that any young person who has an eating problem receives care and support.
What Types of Childhood Trauma are Associated with Eating Disorders?
Childhood trauma is common among young people with eating disorders. One study found that 75% of adolescents entering residential treatment for eating disorders had experienced at least one form of childhood trauma, while 38% met the criteria for PTSD.
Childhood trauma is defined as very scary or distressing experiences that happen in childhood, including physical, sexual, and emotional abuse, neglect, bullying, and accidents or events that threaten a child’s life or physical integrity. Childhood trauma can also involve witnessing a traumatic event happening to someone else.
Research has found that several different types of childhood trauma are linked to disordered eating attitudes and behaviours during adolescence. This includes emotional abuse, physical neglect, sexual abuse, and bullying. Young people who experience trauma symptoms alongside an eating disorder are also more likely to encounter additional challenges and have more symptoms of anxiety and depression.
Emotional Abuse, Emotional Dysregulation, and Eating Disorder Symptoms
Childhood trauma not only makes developing an eating disorder more likely but is also linked to a greater severity of eating disorder symptoms. Research also shows that not all forms of childhood trauma have the same impact on ED symptoms. Studies suggest that emotional abuse may have the biggest effect on disordered eating attitudes and behaviours.
Experts think that the link between emotional abuse and eating disorders may be partly explained by emotional dysregulation. Emotional dysregulation is when someone has difficulties managing and responding to emotional states, resulting in lasting intense emotional reactions.
Emotional abuse during childhood can prevent the usual processes of emotional development, causing difficulties in identifying and understanding emotions, controlling impulses, accepting feelings, and managing emotions. This can cause young people to use alternative, often harmful coping mechanisms to deal with their intense feelings, including disordered eating behaviours.
What Processes May Explain the Link Between Childhood Trauma and Eating Disorder Symptoms?
Alongside emotional dysregulation, experts have identified several other pathways that may explain the connection between childhood trauma and eating disorders. These include dissociation, self-criticism, and body dissatifaction.
Dissociation
When a young person has dissociative symptoms, they experience changes in the way they relate to memories, their identity, or their consciousness. Studies suggest that young people with eating disorders are more likely than others to experience dissociative symptoms. In particular, they may feel detached from their bodies, emotions, and thoughts.
Experiences of childhood trauma are also linked to dissociation. Experts think that dissociation happens as a form of defence mechanism to escape from emotional distress that may be caused by traumatic events. Research has found that dissociation partly mediates the link between childhood trauma and eating disorders.
Self-Criticism and Body Dissatisfaction
Several studies have found a link between childhood trauma, self-criticism, and symptoms of eating disorders. Young people who experience excessive criticism, repeated insults, or some form of sexual or physical abuse during childhood may develop a harsh, self-scrutinising perception of themselves.
This self-criticism may cause the development of a variety of harmful behaviours and emotions later on in life, including feelings of depression and self-harm. It may also develop into criticism about their bodies and appearance, leading to body dissatisfaction. Body dissatisfaction is common among people with eating disorders and can drive disordered eating behaviours as young people try to change their body shape or weight to cope with these feelings.
Can the Link Between Childhood Trauma and Eating Disorders be Explained by Co-Occurring Conditions?
Young people who have experienced childhood trauma are not only more likely to develop eating disorders but also other mental health conditions. This includes depression, anxiety disorders, borderline personality disorder, substance abuse disorders, post-traumatic stress disorder, and symptoms of disorders that relate to self-harm and suicidal behaviours. Co-occurring conditions are also more common in young people with eating disorders who have experienced childhood trauma than among those who have not.
For some young people, the link between childhood trauma and eating disorders may be explained by a co-occurring mental health condition. Co-occurring conditions are mental health disorders that exist alongside other disorders, such as an eating disorder. For example, a young person who has experienced trauma may develop a mood disorder like depression, which in turn leads to the development of an eating disorder.
However, research suggests that some forms of childhood trauma directly contribute to eating disorder symptoms, independently of co-occurring disorders. One study found that the link between childhood trauma and key symptoms of EDs, such as food restriction, weight, shape and food concerns, and daily functioning, were independent of other conditions, particuarly with respect to emotional abuse. It also found that young people who had experienced more types of trauma had more severe symptoms of daily functioning impairment, restraint, and concerns about body shape.
Recovering from Eating Disorders: Integrated Trauma Treatment
For young people with eating disorders who have experienced childhood trauma, addressing traumatic experiences as well as eating disorder symptoms is really important. Unaddressed trauma becomes a barrier to meaningful emotional and psychological recovery from eating disorders – and without healing from trauma, eating disordered behaviours are likely to return.
Recent research supports an integrated approach to eating disorder treatment where experiences of trauma are addressed from the start of a treatment program. Integrated trauma treatment leads to a reduction in PTSD symptoms and eating disorder symptoms, as well as fewer symptoms of anxiety and depression. Moreover, these improvements were mainly maintained 6 months after treatment.
The Wave Clinic: Trauma-Focused Recovery Programs for Eating Disorders
The Wave Clinic is a residential treatment space dedicated to adolescents and young adults. We’re a Global Centre of Excellence for the treatment of eating disorders, providing trauma-focused programs that set the standard for young people’s mental healthcare.
Our programs address the underlying causes of eating disorders, integrating trauma-based approaches into treatment from the start of a young person’s stay. We work through past experiences with sensitivity and care, encouraging and enabling meaningful healing and lasting change.
Every member of our staff, including support staff, is trained to appropriately understand and interact with young people living with eating disorders. At our centre, young people enjoy holistic support, companionship, and guidance as they develop themselves, grow in self-confidence, and build better futures.
If you’re interested in finding out more about our programs, get in touch today. We’re here to make a difference.
