Eating Disorders and Sexual Abuse

• A history of sexual abuse has been linked to the development of eating disorders. It is believed that 30% of individuals with an eating disorder have been sexually abused.
• An experience of abuse might result in low self-esteem, guilt or self-blame, the development of periods of dissociation (being "outside one's body) or difficulty with relationships.
• Characteristics of abuse that are believed to influence the development of an eating disorder include, a younger age at first abuse, the abuser being a member of one's family, and the use of physical force.
• Physical violence in the home has also been found to be a contributing factor in the development of an eating disorder.
• For some, an eating disorder might be a re-enactment of the violation and intrusion experienced by the body as a result of abuse. Attempts to punish or control the body are thus symbolically and literally 'acted out' on the body.
• A history of abuse may result in disturbed perceptions of one's body and may include a fears regarding loss of bodily control, mutilation, and feelings of disgust about one's body, femaleness and sexuality. Survivors of sexual abuse often feel their bodies betrayed them and attribute responsibility or blame to their bodies.
• A lower rate of sexual abuse has been reported among people with anorexia nervosa relative to individuals with bulimia.
• The binge/purge cycle may serve a protective purpose; in particular, these behaviours seem to reduce the intensity and awareness of intolerable emotional and cognitive states, and provide an outlet for the following:
  • expression of anger
  • regaining sense of self
  • ensuring predictability
  • cleansing oneself of the abusive experience
  • relieving stress and tension
  • establishing control
  • developing a sense of personal space
  • an opportunity to refocus

• People with bulimia and a history of sexual abuse tend to report a variety of impulsive behaviours, including drug abuse, alcohol abuse, self-mutilation, and stealing. Such behaviours often appear to serve the function of reducing self-awareness and decreasing the intensity of feelings.
• For a person who has been abused, an existing eating disorder may be difficult to treat due to the protective function it serves, and treatment may not be beneficial if the underlying issues of abuse are not addressed.
• Positive responses to disclosure about abuse, and high levels of family support are thought to be important factors in encouraging the successful outcome of an eating disorder.
• Counseling for people who have been abused may include cognitive-behavioural interventions, individual or group psychotherapy, family therapy, feminist psychotherapy and expressive art therapies.

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