Eating disorders are complex conditions that arise from a combination of long-standing emotional, psychological, interpersonal and social issues. People with eating disorders often use food and the control of food as an attempt to deal with or compensate for feelings and emotions that may otherwise seem overwhelming.1

Sexual assault or abuse can have an effect on the victim’s perceived body image and affect their eating habits. For some victims, self-starvation, binge eating, and purging may begin as a way to cope with the trauma of the assault, to feel in control of a certain aspect of their lives. But ultimately, the damage caused by eating disorders can worsen their physical and emotional health as well as their self-esteem.1

Factors stemming from sexual abuse that may result in an eating disorder include:1

1. • Low self-esteem
   • Feelings of inadequacy or lack of control in life
   • Depression, anxiety, anger or loneliness
   • Difficulty expressing emotions and feelings

While each situation is different, there are some general guidelines to consider if you know or suspect someone you love is suffering from an eating disorder:1

1. • Set aside time to meet with your loved one to discuss your concerns openly, honestly and in a supportive way.
   • Avoid placing shame, blame or guilt on your loved one regarding his or her actions or attitude.
   • Stay away from accusatory statements; use words like “I feel,” “I wish,” “I hope.”
   • Remind your loved one that you care and want to support him or her in any way you can.

Eating disorders include:

1. • Anorexia Nervosa – a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.
     • Four primary symptoms: resistance to maintaining body weight, intense fear of weight gain, denial of the seriousness of low body weight, and loss of menstrual periods in girls/women
     • Warning signs include: dramatic weight loss, preoccupation with weight and food, refusal to eat certain foods, frequent comments about feeling “fat,” anxiety about gaining weight, denial of hunger, development of food rituals, consistent excuses to avoid mealtimes, rigid exercise regimen despite weather or fatigue, withdrawal from usual friends and activities
     • Health consequences: abnormally slow heart rate and low blood pressure, reduction of bone density (osteoporosis), muscle loss and weakness, severe dehydration, fainting, dry hair and skin
   • Binge Eating Disorder – eating disorder characterized by recurrent binge eating without the regular use of compensatory measures to counter the binge eating.
     • Four primary symptoms: frequent episodes of eating large quantities of food in short periods of time, feeling out of control over eating behavior, feeling ashamed or disgusted by the behavior, eating when not hungry and eating in secret
     • Health consequences: high blood pressure, high cholesterol levels, heart disease, diabetes mellitus, gallbladder disease
   • Bulimia Nervosa – serious, potentially life-threatening eating disorder characterized by a cycle of binge eating and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.
     • Three primary symptoms: regular intake of large amounts of food accompanied by a sense of loss of control over eating behavior; regular use of inappropriate compensatory behavior such as self-induced vomiting or laxative abuse or fasting; extreme concern with body weight and shape
     • Warning signs: disappearance of large amounts of food in short periods of time, frequent trips to the bathroom after meals, rigid exercise regimen despite weather or fatigue, unusual swelling of cheeks or jaw area, calluses on the back of the hands and knuckles, discoloration or staining of teeth, withdrawal from usual friends and activities
     • Health consequences: electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure, inflammation and possible rupture of the esophagus from frequent vomiting, tooth decay and staining from stomach acids released during vomiting, chronic irregular bowel movements and constipation as a result of laxative abuse, gastric rupture

Treatment

The most effective and long-lasting treatment for eating disorders is a form of therapy or counseling, along with attention to medical and nutritional needs. Each treatment will vary according to the patient’s particular issues, needs and strengths.1

1. • Psychological counseling – a licensed health professional addresses both the eating disorder symptoms and the underlying forces that contributed (in this case, sexual assault)
   • Outpatient therapy – support groups, nutritional counseling and/or psychiatric medications under careful supervision
   • Hospital-based care – necessary when an eating disorder has led to physical problems that may be life-threatening, or when it is associated with severe psychological or behavioral problems

Additional Resources

National Eating Disorders Association

American Dietetic Association

BodyImageHealth.org

Eating Disorders Anonymous

The Women’s Center for Healthy Living

Endnotes

1. National Eating Disorders Association. 2009. http://www.nationaleatingdisorders.org/index.php

_{Sections on this page have been adapted from: Rainn}