Childhood trauma and sexual abuse frequently underlie eating disorders. Parents must help children process trauma to heal.

Childhood trauma and eating disorders

No parent wants to open this door, but if you have a child who has an eating disorder, then I implore you to throw it open, and find out whether your child is suffering from childhood trauma. Doing so will save yourself and your child years of ineffective eating disorder treatment, because until we dig down to the root of childhood trauma (if it exists), we are unlikely to achieve full recovery from an eating disorder. – Ginny Jones đź’•

Unfortunately, a parent who has a child who has an eating disorder must look deeply for root causes beyond body and food. Childhood trauma is incredibly common and is often an underlying factor driving in eating disorders. If childhood trauma is part of your child’s disorder, then often she or he can only recover when the trauma is treated.

What is the Adverse Childhood Experiences Study?

The Adverse Childhood Experiences Study (ACE Study), conducted by Kaiser Permanente and the Centers for Disease Control and Prevention, tracked long-term health outcomes and found a strong connection between adverse childhood experiences (ACEs) and lifetime health problems.

“Adverse childhood experiences are the single greatest public health threat facing our nation today” – Dr. Nadine Burke Harris

The ACE Study shows that a person’s cumulative ACEs score has a strong and direct relationship to a large number of health, social, and behavioral problems throughout their lifespan.

Childhood trauma is common

The study found that adverse childhood experiences are very common. Sixty-seven percent of people have at least one ACE, 40% of people have two or more ACEs, and 20% of people have four or more ACEs. ACEs tend to occur in clusters: 87% of individuals who reported one ACE reported at least one additional ACE. Twenty-eight percent of participants reported physical abuse and 21% reported sexual abuse.

The top 10 Adverse Childhood Experiences are:

  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Physical neglect
  • Emotional neglect
  • Mother treated violently
  • Household substance abuse
  • Household mental illness
  • Parental separation or divorce
  • Incarcerated household member

It is important to note that the ACE Study spans a broad socio-economic population. Adverse Childhood Experiences are common among the best-protected populations (white, college-educated), and are likely even more common among less-protected (minority) populations.

Health impact of childhood trauma

The science is clear: early adversity dramatically affects a person’s health across their lifetime. The ACE results show that adverse childhood experiences contribute to health problems decades later. These include chronic diseases such as heart disease, cancer, stroke, and diabetes, which are the most common causes of death and disability in the United States.

Behavioral impact of childhood trauma

The number of ACEs was strongly associated with adulthood high-risk health behaviors such as smoking, alcohol and drug abuse, promiscuity, and severe obesity, and correlated with ill-health including depression, heart disease, cancer, chronic lung disease and shortened lifespan.

Compared to an ACE score of zero, having four adverse childhood experiences was associated with a seven-fold (700%) increase in alcoholism, a doubling of risk of being diagnosed with cancer, and a four-fold increase in emphysema; an ACE score above six was associated with a 30-fold (3000%) increase in attempted suicide.

Eating disorders and childhood trauma

Several clinical studies suggest a history of sexual abuse is common among individuals who exhibit disordered eating (). Obese women, many of whom are diagnosed or qualify for an eating disorder diagnosis, were 27% more likely to report a history of childhood physical or sexual abuse ().

There are numerous studies linking sexual trauma, in particular, to the development of eating disorders. For example, women with a history of childhood sexual abuse had a higher prevalence of self-reported problematic eating and possible eating disorder history. (Fuemmeler, et. al., J Trauma Stress 2009 “Adverse childhood events are associated with obesity and disordered eating”)

The majority of people who have eating disorders struggle with over-eating, and over-eating and obesity have both been directly linked to ACEs. It is believed that over-eating becomes a method for soothing anxiety, fear, anger or depression caused by ACEs.

Those who have bulimia find the binge-purge process to serve the same purpose, and those with a diagnosis of anorexia find restriction to be the most soothing behavior. Regardless of how we soothe our emotions, if we experienced ACEs, our trauma must be treated in order to fully heal from our eating disorder.

Childhood trauma leads to chronic stress

The link between ACEs and poor health outcomes and negative chronic behavior is likely that exposure to early adversity affects the nucleus accumbens, inhibits the prefrontal cortex, and causes measurable differences in the amygdala.

When we experience childhood trauma, our brains and bodies undergo physical changes. Our adrenaline and cortisol response rates are altered, and we live in a chronic fight/flight response, under tremendous chronic stress. This chronic stress impacts our immune system, hormonal system, and even our epigenetic code, all of which can impact our likelihood to develop an eating disorder.

Many of us who have eating disorders adopt the behavior as a maladaptive coping mechanism. We tend to feel we are “overreactive” or “overly sensitive” to anxiety and negative arousal, and we reach for our eating disorder as a self-soothing mechanism. This hypersensitivity may be physiologically driven based on adverse childhood experiences.

What we can do if our children experienced trauma

“This is treatable. This is beatable. The single most important thing we need today is to look this problem in the face and say this is real, and this is all of us.” – Dr. Nadine Burke Harris

When a child has an eating disorder, we must open the door to the possibility of childhood trauma. The purpose of this is not to accuse a parent of neglect or mistreatment, but instead to help the child heal. Parents will feel pain and regret about what happened to their child, but we cannot stay stuck in that place. We must move forward and help the child process the trauma in an adaptive manner. When a child (or adult) processes trauma, often that is the beginning of full recovery.

Try to take the focus off you as the parent, and focus instead on your child’s experience. Get therapy for yourself if you need to process your own trauma around the trauma. For example, if you were in a relationship and were hurt by your partner, this impacted your child, and it also impacted you. If you were in a relationship with someone who sexually or physically abused your child, this impacted your child, and it also impacted you.

Take care of your own need to heal, because you will not be able to help your child navigate trauma if you bring your own trauma to the table.

Once you are able to show up for your child’s trauma without bringing defensiveness to the situation, work with your child to process the pain. You want to help your child learn resilience. This is a learned behavior that can be developed in anyone. The path to resilience involves being brave enough to go through, not around, the pain. It will be difficult emotionally for everyone, but the end result will be an ability to begin the important repair process physically and emotionally.

As your child develops resilience, he or she will learn to think about past events as something that happened to them, but those events do not need to define who they are as a person. Those events also don’t mean that they are destined to a lifetime of eating disorders, addiction, and poor health.

The negative outcomes shown in the ACE Study are based on people who did not receive care and intervention for their traumatic experiences. Those of us who learn resilience are able to reverse much of the damage inflicted by adverse childhood experiences.

TED Talk: Childhood Trauma

Comments 3

  1. I read this as conflating & using DE & ED interchangeably. They are not the same. No mention is made of the strong genetic component to EDs. Nor any mention of the trauma of digging for underlying causes that don’t exist for many. Evaluate and do not expect.

    My daughter is among a large population of many with low to zero ACE scores and eating disorders. They’ve been treated and taken into recovery with evidence-based treatment prioritizing nutritional rehabilitation and high enough body weight. This should be the first step for all. If more exists that’s the time to deal with it and let’s stop traumatizing people who started out with no trauma – because that’s what it does.

    To those with trauma and co-morbid conditions we need to utilize evidenced based practices for them as well.

    1. Since research has shown that anywhere from 68%-98% of people who attend eating disorder treatment programs report histories of sexual, and other, abuse or trauma, this is an extremely important topic. I’m so glad that your child did not experience ACE. I send you both love and healing.

  2. Pingback: The terrors of middle school body harassment, and how to help your child navigate body shaming

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