07 Apr Trauma and Eating Disorders: How Trauma Shapes Disordered Eating and What Helps
Most eating disorders are not really about food. They often develop as coping strategies to manage emotions that feel overwhelming or unsafe.
Trauma and eating disorders are closely connected. Research shows that about 52 to 70 percent of people with eating disorders have a history of trauma, with even higher rates in binge and purge patterns where about 37 to 45 percent experience PTSD.
Compared to other mental health conditions, eating disorders have some of the highest levels of trauma exposure, second only to substance use disorders. This highlights that trauma is often a central part of the picture, not just a side factor.
Why Are Trauma and Eating Disorders Connected?
One of the most supported explanations is that eating disorder behaviors develop as a way to cope with overwhelming emotional experiences. Trauma can disrupt the nervous system, leaving people in a state of heightened stress, shame, or disconnection from their bodies. I often tell clients that eating disorder behaviors are extreme coping skills developed to manage extreme emotions.
Trauma can both lead to and maintain eating disorders in several key ways:
Emotion regulation
Restricting, bingeing, purging, or over-exercising can temporarily numb or release distress.
Control
Eating behaviors can create a sense of control after experiences of chaos or helplessness.
Avoidance
Symptoms can distract from painful memories, emotions, or body sensations.
Dissociation
Disordered eating can support disconnection from the body and internal signals like hunger and fullness.
Shame and Self-punishment
Trauma often leaves people with deep shame, and eating disorder behaviors can reinforce this cycle.
Temporary relief
These behaviors work in the short term, which is why they are so hard to stop.
Do You Treat the Eating Disorder or the Trauma First?
The answer depends on stability. If someone is medically unstable or unable to keep themselves safe (from self-harm or suicidal thoughts or actions), the priority is always physical stabilization first.
That said, trauma-informed eating disorder treatment is often most effective when both the eating disorder and trauma are addressed together once safety is established.
What Treatments Work Best?
The most effective approach combines behavioral, emotional, and trauma-focused therapies:
CBT Enhanced (CBT-E)
Helps stabilize eating patterns, body image, and rigid thinking.
EMDR (Eye Movement Desensitization and Reprocessing)
Helps process trauma in a safe, adaptive way so it no longer triggers the same emotional and physical responses. EMDR for eating disorders can be especially helpful when behaviors are tied to body-based distress.
DBT (Dialectical Behavior Therapy)
Builds skills for emotion regulation, distress tolerance, and reducing impulsive behaviors.
Cognitive Processing Therapy (CPT)
Helps shift trauma-related beliefs about safety, control, and self-worth.
You Can Heal From Both Trauma and an Eating Disorder
If you struggle with an eating disorder and have experienced trauma, it is important to work with a therapist who understands both. With over 14 years of experience treating eating disorders and advanced training in EMDR, I provide trauma-informed care that addresses both the behaviors and the underlying causes.
If you are ready to move beyond coping and begin real healing, reach out to get started.
