Eating disorders are among the deadliest and fastest-growing Mental health conditions, yet they remain largely misunderstood. Popular portrayals reduce these illnesses to superficial stereotypes, obscuring their true complexity and hindering meaningful intervention.
Eating disorders are complex, brain-based illnesses that affect up to one in ten people over their lifetime. They manifest through behaviors such as restriction, purging, bingeing, compulsive exercise, and food rituals. These disorders rarely exist in isolation, often co-occurring with other phenomena such as anxiety, depression, substance use disorders, or trauma.
When a clinician finds themselves with a client who is struggling with food or their body, an essential question often goes unasked: “Do you have a history of trauma exposure?”
Over the past two decades, research has illuminated the strong connection between trauma and eating disorders. However, these empirical findings have not completely translated to mainstream clinical practice.
Childhood sexual abuse, the most extensively studied form of trauma in this population, has emerged as a significant predictor of eating disorder prognosis. A robust body of evidence indicates that individuals who experience early sexual trauma are not only more likely to develop eating disorders than those who have not, but also face more severe symptoms, earlier onset, and prolonged illness duration.
Additionally, individuals who have more severe eating disorder symptoms are more likely to have a history of trauma and a co-occurring PTSD diagnosis. A 2020 study found that nearly half of all adults in residential treatment for an eating disorder met the criteria for PTSD—a stark contrast to the general population’s lifetime prevalence rate of just 6.8%.
Trauma often leaves individuals with an overwhelming sense of helplessness and a persistent fear that harm will strike again. Attempts to control one’s body size, shape, or food intake can become a way to regain a sense of stability and predictability. This drive for control is reinforced by pervasive cultural narratives equating physical appearance with self-worth, contributing to the overlap between trauma and disordered eating behaviors.
Sexual violation profoundly shapes how individuals relate to their bodies and food. Studies reveal that trauma impacts brain regions responsible for processing sensory and emotional information, leading to a disconnection from bodily sensations like hunger, fullness, and physical awareness. This numbing effect creates fertile ground for disordered eating, as individuals either seek to feel something or escape overwhelming sensations.
The consequences of overlooking trauma in eating disorder assessment and treatment are significant. Left unaddressed, trauma-driven behaviors often perpetuate cycles of shame, self-punishment, and maladaptive coping mechanisms that keep the eating disorder afloat. Traditional treatment models that focus solely on eating behaviors without addressing the root causes may be insufficient for many cases.
Trauma-informed care, beginning with a thorough trauma assessment and grounded in principles of safety, trust, and empowerment, offers a path to more effective treatment. These interventions go beyond targeting eating behaviors, helping individuals reconnect with their bodies and emotions in a way that fosters healing and resilience.
With eating disorder rates rising across all demographics, greater awareness of the link between trauma and disordered eating is vital. Shifting the focus from surface-level symptoms to the underlying psychological and physiological impacts of trauma can pave the way for more compassionate and effective care. Recognizing trauma is not just essential for recovery—it’s a crucial step toward addressing one of the most misunderstood dimensions of these illnesses.
