What is the connection between sexual abuse and developing an eating disorder? Why does bingeing, purging, starving and chronic dieting become a “solution” for the abuse?

Abuse shatters the sacred innocence of a child and often becomes a primary trigger for an eating disorder. The survivor of sexual abuse becomes plagued with confusion, guilt, shame, fear, anxiety, self-punishment, and rage. She (or he) seeks the soothing comfort, protection, and anesthesia that food offers. Food, after all, is the most available, legal, socially sanctioned, cheapest mood altering drug on the market! And emotional eating is a mood altering behavior that can help detour, divert, and distract a person from inner pain.

Barbara (all names changed for confidentiality) describes, “My father’s best friend molested me in our garage starting when I was seven. I was filled with such anxiety that I began gorging on everything that wasn’t tied down. I gained 30 pounds by the time I was 11 which my mother attributed to my eating too much pizza at the school cafeteria.”

Amber was abused by an older cousin who said it was a game of doctor. “Overeating and laxatives became my way to rid myself of the pain and confusion. I realized I was trying to evacuate my cousin out of my body through those laxatives.”

Donald described shamefully, “After my parents divorced, my mother would get drunk and dance around the house in her nightgown. She scared me, but the worst part was I got turned on. To try and get control, I began starving myself and developed anorexia. Through therapy, I now understand how I was trying to starve out my horrible feelings about myself. And my shame also made me feel I didn’t even deserve to eat.”

Abuse violates the boundaries of the self so dramatically that one’s inner sensations of hunger, fatigue, or sexuality often become difficult to identify. People who have been sexually abused turn to food to relieve a wide range of different tension states that have nothing to do with hunger because the betrayal they experienced has made them disoriented, mistrustful, and in turmoil about their inner perceptions. For many survivors, trusting food is safer than trusting people. Food never abuses you, never hurts you, never rejects you, never dies. You get to say when, where, and how much. No other relationship complies with your needs so absolutely.

As they reach their teen or adult years, survivors often try to de-sexualize themselves. They may work to make themselves very fat or very thin in an attempt to render themselves unattractive. They hope their armor of fat or thinness will protect them from sexual advances or even to wipe out their own sexual feelings which feel too threatening to deal with. Survivors may not be fully aware of how they manipulate their food or bodies to make themselves feel safer. Much of this behavior occurs unconsciously, behind the scenes, until therapy or a self-help program increases the person’s awareness. And, of course, attempting to manipulate your body shape is a pseudo-solution to inner problems.

Some survivors who live in larger bodies actually fear losing weight because it will make them feel smaller and childlike, ushering in earlier memories of feeling defenseless that are difficult to cope with from when they were younger. Paul became anxious as he started to resolve his binge eating disorder in therapy. “Even though I’ve only lost 20 pounds, its triggering flashbacks of abuse with my uncle because I feel small, like the little boy I was.” Paul explained. Although I realize this is a distortion on my part, it helps me understand why I packed on the pounds in the first place to make myself feel bigger and stronger.”

Other survivors obsessively diet, starve, or purge to try to make their bodies perfect. Striving for a perfect body is their attempt to feel more powerful, invulnerable, and in control so as not to re-experience the powerlessness they felt as children.

In addition to falling prey to eating disorders, all survivors of sexual abuse are vulnerable to depression, substance abuse, post traumatic stress disorder, and a profound mistrust of intimacy.

Sexual abuse and emotional eating contain one central element in common: secrecy. Many eating disorder patients feel guilty about the sexual abuse in their childhoods, believing they could have prevented it but chose not to because of some defect in themselves. They repress their secret and push it underground, and then distract and anesthetize themselves by secretive emotional eating.

Secrecy is intertwined with shame. Anyone who is an emotional eater as well a survivor of sexual abuse is no stranger to shame about how insatiable for food and love you can feel at your core, shame about what lengths you have gone to sneak food, and shame for the secret gorging rampages or forceful purges or self-destructive starvation that can override reason.

Coming out of hiding involves reaching out to others. You cannot heal your shame/secrecy/abuse/eating disorders alone. Just as hurtful relationships were the cause of isolating with food in the first place, so supportive and loving relationships will be the medium of healing. Connecting with other people who can validate your pain and accept you for who are is key. Through a support group and/or therapy, you create a second chance family.

Another cornerstone of recovery is the ability to achieve sexual intimacy with a partner. Sexual intimacy is the opposite of emotional eating. Intimacy is about surrendering, relaxing, sharing, and letting go while emotional eating is about controlling, rigidity, fear, and isolation. Our goal as therapists with eating disordered and sexually abused clients is to help them re-contact their inner vigor and vitality and sink their teeth into LIFE, not into their relationship with food!