The Connection Between PTSD and Eating Disorders
By: Masha Sardari MS, RD, LDN
Published: October 8, 2024

These challenging conditions often occur together. And they’re both treatable with proper care and time.

There are two significant and ongoing misperceptions about post-traumatic stress disorder (PTSD) and eating disorders (EDs).

The PTSD one is that only veterans and first responders get this condition. In reality, those two groups constitute only a minority of total PTSD cases. Millions of people of all ages, genders, races, and demographic groups struggle with PTSD.

The ongoing misperception concerning EDs is that only young, underweight, white women get this condition. Again, absolutely untrue and inaccurate. People of all ages, genders, races, and ethnic groups are living with EDs.

A third and related misperception is that PTSD and EDs are rarely found in the same person. The truth is, it happens a lot. We see it frequently at Koru Spring.

Who gets PTSD, and why

PTSD affects about 3.5 percent of U.S. adults each year, and around 1 in 11 people will be diagnosed with it in their lifetimes, according to the American Psychiatric Association.

Women are about twice as likely to have PTSD as men, and it occurs in people from all walks of life.

The disorder affects people who have experienced or witnessed a traumatic event or series of events. Examples of trauma include accidents, natural disasters, chronic bullying, a violent act, prolonged hunger, combat, sexual assault, and intimate partner violence.

As a reaction to the traumatic event, people who develop PTSD have intense, disturbing thoughts and feelings sometimes for years afterwards, if their PTSD goes untreated.

Another common way people react to their PTSD? By developing an eating disorder. For many, this becomes the primary way they cope with the condition.

Exploring the PTSD/ED connection

PTSD often contributes to the development of an ED as a way to deal with their symptoms, but it goes in the opposite direction as well. That is, EDs can be highly traumatic for some people, and can lead to PTSD.

People with co-occurring PTSD and EDs sometimes exhibit persistent irritability. Experience has shown that many resort to binge eating as a way to deal with that irritability.

Another way that PTSD connects to an ED is when the original trauma was a sexual assault. That past trauma may lead to body dissatisfaction, because the person wants to leave their “assaulted body” behind.

Intense body dissatisfaction may also arise because the affected person wants to blame something—in this case their body—for the trauma they experienced.

Treating PTSD and EDs

This is a challenging combination of conditions—but completely treatable.

If the PTSD is known about when a person enters ED treatment, the key first step is them being removed from the traumatic situation if it’s ongoing.

Many times, however, a person entering ED treatment may not have a diagnosis of PTSD, because it gets pushed under the surface by the ED. In those cases, once the person is stabilized nutritionally and ED therapy begins, that’s when the PTSD shows itself. Through trauma-informed care, the two conditions can then be treated simultaneously.

A final point about a person coming into ED treatment without knowing they have PTSD. Often, these are people who’ve never been in treatment or therapy of any kind. So it’s nearly impossible for them to connect the dots between their conditions, or see cause and effect, or even to know exactly what they’re feeling or reacting to.

In treatment, they learn all that. For the first time, with help from medical professionals and their peers, they’re able to separate themselves from their conditions. In understanding the relationship between their PTSD and ED, individuals can build heathy coping skills and learn how to manage their symptoms and achieve full recovery.

Proven therapies—and some practical advice

The following therapies work well for people with co-occurring PTSD and EDs:

  • Exposure therapy (ET)
  • Cognitive processing therapy (CPT)
  • Interpersonal psychotherapy (IPT)
  • Cognitive behavioral therapy (CBT)
  • Acceptance and commitment therapy (ACT)

With help from the above-mentioned therapies, as well as proven medications when appropriate, it’s important to consider the following strategies:

  • Cut back on stimulants like caffeine and nicotine, which can exacerbate PTSD and EDs.
  • Develop real-world coping skills like mindfulness to handle emotions in a more functional way.
  • Get familiar with the body neutrality concept, which is simply the ability to take a more neutral stance toward your body, both physically and emotionally.
  • Create a positive support network of family, friends, and medical professionals who you can ask for help.
  • Learn how to check in with your emotions, and engage in self-dialogue that comes from a self-care place.

Final thoughts on PTSD and EDs

This much is true: There are medical professionals out there who know these conditions well, know how to untangle them. There are proven treatment modalities that work. It is possible to manage symptoms and achieve long-term relief from both conditions. And there is hope—always hope—for living a fulfilling, contented, productive life in full recovery.

 

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