Understanding the Link Between PTSD and Eating Disorders

Eating disorders can develop in men, women, youth, and adults.

It’s unclear what causes an eating disorder to develop, but health authorities believe it’s a combination of genetic, biological, behavioral, psychological, and social risk factors.  

Also, there’s a correlation between post-traumatic stress disorder (PTSD) and eating disorders.

The relationship can go both ways. An eating disorder can develop after PTSD, and PTSD can develop as a result of an eating disorder. 

Fortunately, a specialized team that offers compassionate, comprehensive counseling can help manage both conditions.

Keep reading to learn more about PTSD and eating disorders and what steps you can take to manage these conditions.  

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What is PTSD?

PTSD is a mental health condition that’s caused by witnessing or experiencing a terrifying, shocking, or dangerous event.

‍Examples of trauma that can cause PTSD include: 

• Witnessing an accident. 
• Experiencing sexual or physical abuse. 
• Severe bullying. 
• Being subjected to emotional or physical neglect. 
• Having a loved one pass away unexpectedly. 
• Living with family members or loved ones with substance use disorders. 

After experiencing life-changing trauma, people may develop chronic (long-term) PTSD, which can impact their physical and mental well-being.

However, with specialized support, they can learn how to manage their mental health. 

Symptoms

PTSD symptoms typically start within three months of the traumatic event but can present later.

To be diagnosed, an adult must experience these symptoms for at least one month. 

The National Institute of Mental Health lists the following signs and symptoms of PTSD.

They’re a mix of cognitive, mood, avoidance, and reactive symptoms: 

• Flashbacks. 
• Recurring memories or dreams related to the event. 
• Experience physical signs of stress.
• Avoiding places, thoughts, or feelings related to the traumatic event. 
• Having difficulty concentrating, sleeping, 
• Feeling irritable, on edge, or tense.
• Losing interest in enjoyable activities. 
• Having negative thoughts about oneself or the world. 
• Feeling isolated. 

Children are also prone to bed-wetting, acting out during playtime, forgetting how to talk, and being clingy to their parents or caregivers. 

What are Eating Disorders?

The National Institute of Mental Health defines eating disorders as serious illnesses characterized by severe disturbances in eating behaviors and related thoughts and emotions.

Types of Eating Disorders

There are several types of eating disorders, and common ones include anorexia nervosa, bulimia nervosa, and binge-eating disorder. 

Other types include:

• Avoidant or restrictive food intake disorder (ARFID). 
• Pica. 
• Rumination.
• Other specific feeding and eating disorders include purging disorder, night eating syndrome, atypical anorexia nervosa, subthreshold bulimia nervosa and binge eating disorder, and orthorexia. 
• Unspecified feeding and eating disorders.  

Common Symptoms

Every eating disorder has characteristic symptoms, but a few behaviors can overlap.

For example, some people may be preoccupied with food and their body shape, weight, size, and appearance.

Others may be more preoccupied with how “healthy” they perceive a food or meal to be. 

A physician should assess your symptoms and overall health to diagnose an eating disorder.

Then, you can create a care plan that addresses your needs. 

How Often do PTSD and Eating Disorders Coexist?

Eating disorders and PTSD are comorbid, meaning people can have both conditions at once.

‍Research suggests that PTSD is prevalent in approximately 17-25% of people with an eating disorder, though the data varies across research platforms. 

When broken down by type, newer evidence suggests PTSD was highest in people with bulimia nervosa, followed by binge eating disorder, and then anorexia nervosa.  

Most of the research in this area is on adults, and we need more studies to determine how prevalent PTSD is in other age groups and types of eating disorders. 

What’s the Connection Between PTSD and Eating Disorders?

Several psychiatric disorders, including PTSD, can co-occur with an eating disorder.

Learning how these two conditions overlap can help you better manage your health and address triggers.  

What Research Says

Current data suggests that 50% of adults with an eating disorder admitted to residential treatments have PTSD.

They also have more severe eating disorder symptoms, more anxiety and depressive symptoms, and lower mindfulness. 

Some studies suggest PTSD symptoms increase the risk for an eating disorder and vice versa.

However, the risk varies depending on what type of PTSD symptoms you experience.

For example, if you’re more prone to flashback symptoms, you may be at higher risk of binge eating.  

Additionally, traumatic experiences in childhood may contribute to developing an eating disorder in teenage years or adulthood. 

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Impact of PTSD on Body Image

Some forms of trauma may affect a person’s body experience and image. 

For example, research suggests that women who experience early childhood trauma had lower self-perceived scores on physical health and sexual attractiveness.

These perceptions may contribute to an eating disorder characterized by a preoccupation with body shape, weight, and size; however, every person is different. 

PTSD and Eating Habits

Reliving moments of trauma is undeniably distressing and anxiety-provoking, which could alter your eating habits. 

Some research suggests people who experience PTSD flashbacks are more likely to binge eat.  

However, others may purge or fast. 

People's triggers and eating habits are highly individualized, so it’s challenging to predict how PTSD can impact eating behaviors.

Working with a specialized counselor is recommended to determine how it could affect your nutrition and eating habits. 

Treatment Options for PTSD and Eating Disorders 

Helpful, personalized treatment begins with a thorough assessment.

Your healthcare provider should review the details of your eating disorder and ask for a history of traumatic events. 

Understanding your personal and medical background will help them build a customized treatment plan. 

After completing your intake, your care team will triage your health and address high-risk concerns first, such as low nutritional intake (the point of starvation), electrolyte imbalances, cardiac arrhythmia, suicidality, and other self-harming behaviors. 

When you’re stable (which could take some time), your team will incorporate psychoeducation into your treatment plan. 

Psychoeducation usually involves counseling and sometimes group therapy for eating disorders.

Many practitioners use cognitive processing therapy to support patients who have an eating disorder and PTSD. 

Additionally, your psychiatrist may recommend medications to manage PTSD symptoms and aid recovery. 

Healing and Recovery

Nutrition rehabilitation is vital for your healing and recovery journey.

If you’ve been undereating, your brain can’t learn new behaviors.

Without proper nourishment, the eating disorder voice can feel loud and dominant, and in these moments, it’s much harder to change the narrative. 

Your dietitian and team will build a plan to ensure you get enough nutrition.

Your plan will include a mix of energy-rich foods that will help your brain and body heal. 

Tips for Managing Your Eating 

Here are some anecdotal tips to help you manage an eating disorder and PTSD. 

• Journal your triggers and write down what coping skills are helpful. 
• Learn how to practice mindfulness, which can help regulate anxiety. 
• Regularly remind yourself that food is fuel for your body. 
• Lean on reliable, caring friends and loved ones for support. 
• Reach out to your healthcare team when you need help. 
• Following a routine can help foster a sense of stability. 

Other Methods for Managing PTSD and an Eating Disorder

Other trauma-focused treatments that may help include: 

• Prolonged exposure. 
• Eye movement desensitization reprocessing (EMDR). 
• Imaging rescripting. 
• Written exposure therapy. 
• Narrative exposure therapy. 
• Compassion-focused therapy. 
• Trauma-focused cognitive behavioral therapy. 

Your healthcare provider will recommend an approach after assessing you. 

Meet You Care Team 

As both PTSD and eating disorders are mental health conditions, your care team should include mental health specialists. You may work with:  

• Psychiatrists. 
• Psychologists. 
• Family physician and other specialists. 
• Registered social workers. 

When you’re ready to address nutrition and eating behaviors, registered dietitians specializing in eating disorders should also be part of your care team. 

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Takeaway

PTSD and eating disorders are two separate mental health conditions that can co-occur.

They’re very serious and can impact your overall health if left unaddressed. 

Working with specialists in each area can help you recover.

Treatment options may include a mix of individualized counseling sessions and group therapies. 

These two conditions have distinct pathophysiologies that require personalized attention.

Your support team will work with you at a comfortable pace to help you recover. 

How a Dietitian Can Help

A registered dietitian is a nutrition expert and licensed healthcare professional.

They work alongside your medical team to coordinate high-quality care that can help you recover from an eating disorder.  

At Nourish, all appointments are remote and covered by major insurance providers.

During the session, you’ll review your current nutritional intake and lifestyle behaviors and establish health goals to work on between visits. 

After every visit, you should feel more supported and confident that you have the skills to manage your overall health and well-being. 

Find a dietitian who accepts insurance through Nourish.