The Link Between Trauma and Binge Eating

From the WebMD Archives

It’s normal for past experiences to affect the way you act or feel. What you've done, seen, or lived through can even impact your eating habits -- in both good and bad ways. For example, you might happily host a weekly Sunday dinner because that’s what your mom did. Or, you might often overeat because you grew up watching other family members do so.

Sometimes, a very bad (traumatic) past event causes a person to get an eating disorder, like binge eating. For years, scientists have been reporting a link between bingeing and post-traumatic stress disorder (PTSD), which can happen after you’ve seen or gone through a violent or life-threatening event. Examples are:

  • Physical or sexual abuse or assault
  • Life-threatening accident
  • Violent or accidental death of a loved one
  • Terrorism or war
  • Seeing a serious crime such as a murder or rape

About 1 in 4 people who binge eat have PTSD.

"People with PTSD have such a hard time focusing on the present and future because they are preoccupied with traumatic memories or trying to avoid traumatic reminders," says Rachel Yehuda, PhD. She’s the director of the traumatic stress studies division at the Icahn School of Medicine at Mount Sinai in New York. "Sometimes that means they don't plan well for future meals, and [as a result], they may get very hungry and overeat or overeat compulsively."

How PTSD Affects Binges

Scientists don't yet know exactly how PTSD and binge eating are linked in the body. Both conditions are related to problems with stress hormones and mood-boosting brain chemicals, though, research shows. Your genes might also determine whether or not you get these two disorders.

Most of the time, the trauma (which leads to PTSD) comes first and the binge eating comes later. Scientists think people binge eat to “escape” the painful memories related to the traumatic event.

"People with binge eating disorder often don't understand what they're feeling or why,” says Timothy Brewerton, MD. He's the executive medical director of The Hearth Center for Eating Disorders in Columbia, S.C. “They're too busy compulsively trying to numb the pain with food."

Continued

Many people who binge eat have negative thoughts about their bodies. This poor body image is worse if the person also has PTSD, research shows. Sometimes, these feelings are the result of a trauma, and they spark the eating disorder.

For example, a woman who's been sexually abused might think that if she gains weight by overeating, her attackers won’t hurt her in the future. (Research shows that 35% of women with binge eating disorder have been raped or sexually assaulted.)

Treatments

Binge eating and PTSD can be treated, often at the same time. Tell your doctors about all your symptoms, and let them know if you think you might have both disorders.

The main goal of binge eating treatment is to figure out why you overeat. If your overeating symptoms are due to a past trauma, your doctors need to know that so they can help you get better.

Treatments that can help someone with binge eating disorder and PTSD include:

Cognitive behavioral therapy: Research shows this is among the best treatments for PTSD and binge eating disorder when they happen separately. It could be a good option for someone who has both.

A specific type of this treatment, called prolonged exposure therapy, involves talking about the scary memories and learning to face your fears. It works well for PTSD, but your binges could get worse before they get better.

"It's possible that reliving traumatic events could temporarily increase the urge to binge," Yehuda says. Your doctors can help you fight that urge and eventually overcome it -- as long as you've told them that you binge eat.

Eye movement desensitization and reprocessing (EMDR): During this treatment, you focus on eye movements or hand taps while thinking about or discussing painful memories.

Scientists aren’t sure why this method works, but they think it mimics the way the brain acts during sleep. This could help remove a "mental blockage" that might prevent healing, says Morris Cohen, LCSW. He's a New York-based psychotherapist.

EMDR is not a direct treatment for binge eating disorder, but it might help if your binges are sparked by a trauma.

Medication: Antidepressants -- especially a type of them called selective serotonin reuptake inhibitors (SSRIs) -- help many people with PTSD. They can also help ease anxiety and depression that often go along with binge eating disorder.

WebMD Feature Reviewed by Joseph Goldberg, MD on January 24, 2015

Sources

SOURCES:

Timothy Brewerton, MD, executive medical director, The Hearth Center for Eating Disorders in Columbia, S.C.; clinical professor of psychiatry and behavioral sciences, Medical University of South Carolina.

Morris Cohen, LCSW, New York-based psychotherapist and EMDR practitioner.

Grilo, C. Journal of Psychiatric Practice, November 2012.

Litwack, S. General Hospital Psychiatry, July-August 2014.

Russell Marx, MD, chief science officer, National Eating Disorder Association.

Mitchell, K. International Journal of Eating Disorders, April 2012.

National Eating Disorders Association: "Trauma and Eating Disorders."

National Institute of Mental Health: “What is Post-traumatic Stress Disorder (PTSD)?”

U.S. Department of Veterans Affairs: "Treatment of PTSD," "DSM-5 Criteria for PTSD," "Cognitive Processing Therapy," "Prolonged Exposure Therapy."

Rachel Yehuda, PhD, professor of psychiatry and neuroscience; director, Traumatic Stress Studies Division, Icahn School of Medicine at Mount Sinai, New York.

The Center for Eating Disorders at Sheppard Pratt: “Trauma and Eating Disorders: Updates & Advances in Managing the Complex Comorbidity.”

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