Walking the Line Between an Eating Disorder and Past Trauma

When a patient has an eating disorder, it’s not uncommon for past trauma to lie below the surface. In particular, victims of sexual abuse and domestic violence, as well as those with post-traumatic stress disorder (PTSD), may be at higher risk for developing an eating disorder. 

“Patients who have experienced past trauma often feel helpless, out of control, angry, frightened, anxious, or ashamed and may seek ways to cope or gain control through food-related behaviors,” says Allison Lansky, EdS, LMFT, CEDS, NCC, Lead Senior Primary Therapist at Princeton Center for Eating Disorders.

“In these situations, behaviors like bingeing, purging, restricting, using laxatives, or excessively exercising may be used as a means of escaping or numbing painful emotions,” she adds.

Treatment Considerations

For patients suffering from both an eating disorder and the scars of past traumatic experiences, the treatment trajectory correlates strongly with individual coping skills when clients present for treatment. While simultaneous work is important, the degree to which past trauma is addressed during initial treatment can be a question of timing.

“If a patient is too psychologically or medically fragile, it can be critical to first stabilize the eating disorder and build coping skills that lay the groundwork for addressing the trauma,” says Lansky. “Sometimes, delving into a traumatic history in the absence of sufficient coping skills can do more harm than good. Once eating disorder symptoms are interrupted in a safe and supportive environment, healing from trauma can truly progress.”

The Princeton Center for Eating Disorders team provides effective therapeutic interventions for patients with eating disorders and past trauma, building coping skills throughout the course of treatment. Specifically, dialectical behavior therapy (DBT) is incorporated on many levels to provide grounding strategies for dealing with intrusive memories. Patients receive intensive individual or family psychotherapy five times a week, along with DBT-specific group sessions to provide skills and tools needed for recovery.