PTSD and eating disorders co-occur. This may not be too surprising given that a number of psychiatric disorders have been found to co-occur with PTSD, including, for example, major depression, anxiety disorders, borderline personality disorder, and substance use disorders.
Eating Disorders
Eating disorders are characterized by severe problems in eating behaviors. The Diagnostic and Statistical Manual of Mental Disorders, 4th edition recognizes two eating disorders: anorexia nervosa and bulimia nervosa.
Anorexia nervosa is condition where a person refuses to maintain a healthy body weight (determined by a person's age and height). Bulimia nervosa, on the other hand, is characterized by a cycle of uncontrolled bingeing behaviors following purging (such as vomiting or the use of laxatives), restricting behaviors (for example, fasting), or excessive exercise.
Trauma, PTSD, and Eating Disorders
People with eating disorders often report a history of trauma. Childhood sexual abuse, in particular, has been found to be a risk factor for the development of an eating disorder.
There is also some evidence that having PTSD may increase a person's risk for developing an eating disorder. Specifically, it has been found that people with PTSD are approximately 3 times as likely as someone without PTSD to develop bulimia nervosa. Likewise, people with bulimia nervosa may be more likely to have co-occurring PTSD than people with anorexia nervosa.
How Are Eating Disorders and PTSD Related?
In regard to bulimia nervosa, it has been suggested that the behaviors associated with this eating disorder may be a way of managing or regulating uncomfortable and distressing emotions. For example, it has been found that depression may be connected to the development of bulimia nervosa-related behaviors. People with PTSD often experience many strong unpleasant emotions (such as shame, guilt, sadness, and fear), and to the extent that people with PTSD do not have healthy ways of managing these emotions, they may develop or rely more on unhealthy behaviors, such as bingeing or purging.
The behaviors connected with anorexia nervosa may be a way of establishing a sense of control over one's body and life. This may be especially important for a person who has not felt as though he has had this control, such as someone who has experienced a traumatic event. Likewise, a person who has been abused may be more likely to be dissatisfied with his body and have a low self-image, leading to the unhealthy behaviors of anorexia nervosa.
Treatments for PTSD and Eating Disorders
There are currently no combined treatments for PTSD and eating disorders. However, there are effective treatments for both conditions, and learning how to better manage symptoms of PTSD may reduce a person's reliance on unhealthy behaviors, such as those found in bulimia nervosa.
If you have an eating disorder, it is important to seek out treatment immediately. Eating disorders are serious conditions and can result in death. The About.com Guide for Eating Disorders, Matthew Tiemeyer, provides some excellent information on treatments for eating disorders.
Sources:
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders, 4th ed. Washington, DC: Author.
Brewerton, T.D. (2007). Eating disorders, trauma, and comorbidity: Focus on PTSD. Eating Disorders: The Journal of Treatment & Prevention, 15, 285-304.
Swinbourne, J.M., & Touyz, S.W. (2007). The comorbidity of eating disorders and anxiety disorders: A review. European Eating Disorders Review, 15, 253-274.
Stice, E., Burton, E.M., & Shaw, H. (2004). Prospective relations between bulimic pathology, depression, and substance abuse: Unpacking comorbidity in adolescent girls. Journal of Consulting and Clinical Psychology, 72, 62-71.
