Eating Disorders

New Book! Jade Miller’s “Attachment and Dissociation: A Survivor’s Analysis” in e-book form. About intergenerational dysfunctional attachments and Jade’s healing process. (Jade is the author of “Dear Little Ones.”)


Now for eating disorders. This is a huge subject and I will break it up with posts on a couple of other topics. (Like, say, Mothers’ Day, which doesn’t bother me a bit. Yeah.) Think of this post as the introduction; there is nothing about alters, ritual abuse, or healing in this section, so be patient. And there won’t be lots of statistics in the other sections.

I was at the International Society for the Study of Trauma and Dissociation (ISSTD) conference the beginning of April this year and went to two very good workshops on eating disorders. One was “The Body Remembers: The Brain Reacts: Clinical Applications of Current Research on the Underlying Connections between Eating Disorders and Trauma” by Norman H. Kim, National Director of the Center for Change and Director of Reasons Eating Disorder Center. The other was “Trauma, Dissociation, and Eating Disorders: When No Body is Home” by Debbie Cohen, who is on the Faculty of ISSTD. Much of the material in this post comes from those workshops.

Let’s start with some definitions. Anorexia is limiting the intake of food to the point of significantly low body weight, along with the fear of becoming fat and the distortion of body image to seem heavier than one is in actuality. Bulimia is the periodic out-of-control eating of large amounts of food followed by attempts to prevent weight gain by vomiting, using laxatives, or excessive exercising. Anorexia can be followed by periods of binge eating, or bulimia may occur alone. Binge Eating Disorder is the periodic out-of-control eating of large amounts of food, but without attempts to prevent weight gain. It is accompanied by shame, embarrassment, and attempts to hide episodes from other people. Steadily eating large amounts of food isn’t currently labelled an eating disorder, even though it probably should be.

There are a lot of misconceptions about eating disorders. A big one is that they are caused by society and the media, with all the hype about weight, dieting, and the desirability of thinness. The emphasis on weight makes people dissatisfied with their bodies: 42% of girls in first to third grades want to be thinner; 81% of ten-year-old girls are afraid of being fat; and half of ten-year-old girls have dieted. But the rate of eating disorders has not changed. We are more miserable and pour billions of dollars into the diet industry but the prevalence of eating disorders has not changed.

Another misconception is that it’s an illness of rich white girls. However, that’s who gets studied and therefore that’s who gets the attention. The rates are the same for Afro-American and Latina girls.

Men, too, suffer from eating disorders. Of all people with eating disorders, about 25% of anorexics  and 36% of bulimics are male. Men tend to get overlooked because eating disorders, like depression, are seen as a women’s problem. There now are some in-patient and out-patient treatment programs specifically for men and hopefully there will be more resources in the future.

Family and twin studies suggest a genetic component to anorexia and bulimia. Anorexia is seen in 0.3% to 0.7% and bulimia in 1.7% to 2.5% of women in the general population. Yet they are 7 to 12 times more likely in relatives of those with eating disorders, even if relatives do not share a common environment. Twin studies show that genetic factors seem to “kick in” at adolescence and that there seems to be something in the environment that triggers the onset of eating disorders.

So if you have an eating disorder, and lots of your blood relatives do, too, it may be genetic. Not your fault, just plain bad luck. Of course, if it wasn’t genetic, it still wouldn’t be your fault.

Eating disorders, especially anorexia, are very, very serious. In females 15 – 24 years old, the mortality rate from eating disorders is 12 times higher than the mortality rates from all other causes of death combined. And, if you have an eating disorder, it is reported that your chances of dying from this illness at some point in your life range from 5% to 20%, depending on the study.

The environmental trigger typically seems to be a trauma, such as sexual abuse or bullying. A study described in “Anorexia Nervosa and Bulimic Disorders: Current Perspectives,” edited by G.I. Szmukler, P. D. Slade, and P. Harris, pp. 357-61 showed that almost two-thirds of women patients who entered a London eating disorders clinic between 1982 and 1984 reported sexual trauma in childhood or adolescence. This did not, of course, include anybody who had amnesia for the abuse.

One last bit of information: there have been two surveys (that I know of) looking at the prevalence of eating disorders in survivors of ritual abuse and other forms of extreme childhood trauma. Both were self-reporting and open to any survivor who wished to participate. One was conducted by Survivorship and the other by the Extreme Abuse Survey. 60% to 65% percent of survivors said that they had an eating disorder, while less than 20% reported that they were alcoholic and/or drug-addicted.

I’d like to end this post by pointing out that eating disorders are hard to treat, the effects of sexual abuse are hard to treat, and the two together are even harder to treat. Or to live with, for that matter!!! Add in amnesia, dissociation, ritual abuse, and/or mind control … well, nobody said it was going to be easy.