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How adverse childhood experiences influence eating disorders


People who have eating disorders frequently have a history of adverse childhood experiences and trauma. Childhood trauma is incredibly common and is often a contributing factor to the development of eating disorders.

This is why almost anyone who treats eating disorders will ask about childhood trauma. Some parents feel attacked or blamed when this happens, so it’s important to take a look at what adverse childhood experiences are, how they impact eating disorder development, and what parents can do to help kids who have both trauma and eating disorders.

What are adverse childhood experiences?

Adverse childhood experiences are most often called childhood trauma. There are different types of experiences that can be traumatic for a child. They include physical abuse, emotional abuse, and neglect. Additionally, witnessing a parent’s abuse and parental separation and divorce can be traumatic.

Not every child who experiences an adverse childhood event will develop trauma, but a significant portion will do so. For example, divorce or separation is considered an adverse childhood experience, but it doesn’t always result in trauma. Some children may be severely impacted by their parents’ divorce, while others will not.

In addition to an individual child’s experience and reaction to the experience, the number of adverse experiences matters. The more adverse experiences a child has, the greater their risk for mental and physical health issues. The impact of trauma ranges from suicidality, substance abuse, and eating disorders to heart disease and cancer.

It’s important to know that adverse childhood experiences are common. About 67% of people have at least one. And 47% of people have two or more. About 20% of people have four or more. Since risk increases with the number of experiences, this is important.

The link to eating disorders

Numerous clinical studies have found a connection between childhood adverse experiences and eating disorders. People who have eating disorders have a higher rate of childhood trauma compared to the general population.

Childhood trauma, specifically physical abuse, is most strongly linked to bulimia and binge eating disorder. Eating disorders frequently co-occur with other psychiatric disorders linked to adverse childhood events.

For example, mood disorders, post-traumatic stress disorders, substance use disorders, and clinical behaviors such as suicidal behavior, impulsivity, and aggressiveness are all associated with both trauma and eating disorders.

Sexual trauma seems to be particularly linked to eating disorders. One study found that women who have a history of childhood sexual abuse are more likely to have problematic eating behaviors and eating disorders.

Experts have suggested that people who have adverse childhood experiences may develop eating disorders as a way to cope with their trauma. Eating disorders can be powerful self-soothing and coping mechanisms.

What parents should know about ACES and eating disorders

Many parents feel instantly guilty when they find out their child has an eating disorder. The eating disorder diagnosis carries a heavy stigma, and many parents worry they did something to cause it.

So the first thing we need to say is that parents cannot cause an eating disorder. Eating disorders are biopsychosocial. This means they arise from a combination of biological, psychological, and social factors. When we look for the causes of an eating disorder the answer is rarely one single thing or person, but the combination of multiple factors.

For example, if your child had an adverse childhood event, that may have contributed to their eating disorder. That would make a lot of sense. But that doesn’t mean that the experience alone “caused” the eating disorder. And in many cases, parents don’t have control over adverse childhood events. In other words, this isn’t your fault.

The more you’re able to release your guilt over causing the eating disorder, the better you will be able to help your child recover.

Four things parents can do to help

“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

1. Understand your child’s adverse experiences

The more you understand your child’s unique experience, the better you will be able to support them in recovery. This doesn’t mean asking a ton of questions. You don’t want to re-traumatize your child. Instead, think back on the time when the trauma occurred. How might your child have felt? What can you do to rebuild your relationship based on what happened?

2. Build emotional safety for your child

Remember that trauma isn’t always what was done to us, but the fact that we felt unsafe and unsupported when it happened. Our kids need us to be a safe harbor for them and their feelings. When they were traumatized, we may not have been able to provide a safe harbor because we didn’t know what was going on or just didn’t have the knowledge to do it. But now we can focus on building emotional safety and making sure they feel loved and protected by us.

3. Understand your child’s eating disorder

Every eating disorder is unique. Your child’s eating disorder is a form of communication, and if you listen, you will be able to hear what they need you to know. Learn about what eating disorders are, and what they are not. In short, they are not a choice, and they are not something that people just grow out of. They are serious disorders that require significant family-wide effort to address. This is time for advanced parenting!

4. Create a safe home environment

An eating-disorder-safe home is important to recovery. Most people struggle to recover into the same conditions that nurtured the eating disorder. Take a long look at your beliefs about weight, bodies, and food. Stop all efforts to control weight in the household, and get rid of your scales. This may seem drastic or unhealthy, but eating disorders are no joke, and they are encouraged when dieting and weighing is a daily practice at home.

Want to know more about eating disorders? I have a free eBook: What Kids Want Parents to Know About Eating Disorders

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