Unfortunately, a parent who has a child who has an eating disorder must also look for possible childhood trauma. Childhood trauma is incredibly common and is often a factor, even a cause of eating disorders. When childhood trauma has occurred, it needs to be treated.
What is the Adverse Childhood Experiences Study?
The Adverse Childhood Experiences Study (ACE Study) was conducted by Kaiser Permanente and the Centers for Disease Control and Prevention. It 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
Significant health, social, and behavioral problems are associated with a higher ACEs score.
Childhood trauma is common
The study found that adverse childhood experiences are very common. Sixty-seven percent of people have at least one ACE. Forty percent 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). They are likely even more common among less-protected (marginalized) populations.
Emotional Regulation Worksheets
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Health impact of childhood trauma
The science is clear: early adversity dramatically affects a person’s health across their lifetime. The ACEs results show that adverse childhood experiences contribute to health problems decades later. These include chronic diseases such as heart disease, cancer, stroke, and diabetes. These are are the most common causes of death and disability in the United States.
Behavioral impact of childhood trauma
The number of ACEs is strongly associated with adulthood high-risk health behaviors. These include smoking, alcohol and drug abuse, and more. ACEs are correlated with mental health conditions including depression, heart disease, cancer, chronic lung disease and shortened lifespan.
Four adverse childhood experiences is 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.
Childhood trauma and eating disorders
Several clinical studies link childhood trauma and eating disorders. For example, one study found a history of sexual abuse is common among individuals who exhibit disordered eating (Gustafson & Sarwer, 2004). Women in larger bodies were 27% more likely to report a history of childhood physical or sexual abuse (Alvarez, Pavao, Baumrind, & Kimerling, 2007).
There are numerous studies linking sexual trauma, in particular, to the development of eating disorders. Women with a history of childhood sexual abuse had a higher prevalence of problematic eating and eating disorders. (Fuemmeler, et. al., J Trauma Stress 2009 “Adverse childhood events are associated with obesity and disordered eating”)
While most people assume the term “eating disorder” means anorexia, the most common eating disorder is binge eating disorder. Binge eating has been directly linked to ACEs. Binge eating may be a method for soothing anxiety, fear, anger or depression caused by ACEs.
Those who have bulimia may use the binge-purge process to self-soothe. Those with a diagnosis of anorexia may find restriction to be the most soothing behavior. This is why ACEs trauma must be treated to heal from an eating disorder.
Childhood trauma leads to chronic stress
The link between ACEs and poor health outcomes and negative chronic behavior is likely because exposure to early adversity:
- Affects the nucleus accumbens
- Inhibits the prefrontal cortex
- Causes measurable differences in the amygdala
Childhood trauma causes brains and bodies to undergo physical changes. Adrenaline and cortisol response rates are altered, and the body lives in a chronic fight/flight response, under tremendous chronic stress. This chronic stress impacts the immune system, hormonal system, and even the epigenetic code. This can increase the likelihood of developing an eating disorder.
ACEs can drive maladaptive coping mechanisms. These behaviors, such as eating disorders, can be a way to self-soothe when faced with anxiety and negative arousal. It makes sense to reach for a self-soothing behavior to feel better. 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, parents must open the door to the possibility of childhood trauma. The purpose of this is not to accuse a parent of neglect or mistreatment. It is to help the child heal.
Parents will feel pain and regret about what happened to their child. But they cannot stay stuck in that place. It’s important to 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 or coaching 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. It also impacted you. If your partner sexually or physically abused your child, it also impacted you.
Take care of your own need to heal for the trauma. This will free you up to help your child.
Help your child process the pain
Take your time to heal. Once you feel ready, offer to help your child process the pain. When you approach this without defensiveness, you can help.
You want to help your child learn emotional regulation. 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.
When a person has emotional regulation skills they can actively process past events without becoming stuck in them.
The negative outcomes shown in the ACE Study are based on people who did not receive care and intervention for their traumatic experiences. But people who get treatment and process past pain are able to reverse much of the damage inflicted by adverse childhood experiences. Your child’s psychology interacts with their eating disorder. So please get help if you need it!
TED Talk: Childhood Trauma
Ginny Jones is on a mission to change the conversation about eating disorders and empower people to recover. She’s the founder of More-Love.org, an online resource supporting parents who have kids with eating disorders, and a Parent Coach who helps parents supercharge their kid’s eating disorder recovery.
Ginny has been researching and writing about eating disorders since 2016. She incorporates the principles of neurobiology and attachment parenting with a non-diet, Health At Every Size® approach to health and recovery.
Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.
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.
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.
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