When you or a loved one receives any diagnosis, it’s natural to wonder why. Our brains crave clear answers. But often, healthcare providers can’t always give us the clarity we want. There are so many variables and factors that contribute to our health–both physical and mental. On The Alliance’s blog, we’ve often shared how these mental health conditions develop due to a combination of genetic, biological, social, and environmental factors. Here, we’re taking a closer look at one of these influences. 

Research has unveiled a pattern that people who have experienced trauma are more frequently diagnosed with eating disorders than those who haven’t. Though this pattern exists, it’s not always cut and dry. There are plenty of people living with eating disorders who haven’t experienced trauma. However, research shows enough of a relationship that the question is worth exploring. Can trauma trigger an eating disorder?  

How Trauma Affects the Brain

Before we expand on the research surrounding trauma and eating disorders, let’s start with the foundations: the neurobiology of trauma. Psychological trauma is our body and brain’s response to a distressing event. It’s a broad term that includes interpersonal trauma (e.g., physical abuse, emotional abuse, sexual abuse, exposure to war, etc…) and noninterpersonal trauma (e.g., life-threatening injury or illness, natural disasters, accidents, etc…). Someone may experience trauma due to a single acute event or as a result of chronic exposure to multiple events. 

Parts of the Brain Impacted by Trauma

When someone experiences trauma, their brain reacts in a few different ways.

1. The Prefrontal Cortex: The prefrontal cortex is responsible for decision-making and rational thinking, and it usually helps respond effectively to a given situation. During a traumatic event, however, something called “Fear Circuitry” kicks in, and the prefrontal cortex becomes less effective.
2. The Amygdala: When your prefrontal cortex isn’t on board, the amygdala takes over. This area of your brain is responsible for emotional processing. During a traumatic event, it goes into overdrive, signalling a fight, flight, freeze, or fawn response.  
3. The Hippocampus: The hippocampus controls memory and becomes less active when someone experiences trauma. As a result, someone’s memory of a traumatic event may be spotty. For example, they may remember a particular smell but not what the room looked like during the event. The impact on the hippocampus also makes it challenging to distinguish between the past and present. 

This impact on memory is a key piece of how we experience trauma. When someone is “triggered” by something that reminds them of their trauma, their brain experiences the trauma response again. Their brain can’t tell the difference between memories of the event and the event itself. This impact on mental health may cause someone to develop post-traumatic stress disorder (PTSD). 

The Neurobiology of Trauma and Eating Disorders

So, how do these changes in brain chemistry increase someone’s risk of developing an eating disorder? At a neurobiological level, there are a couple things going on that tie trauma to eating behaviors. 

As we shared earlier, trauma essentially disrupts the body’s central stress response system. This system is called the hypothalamic-pituitary-adrenal (HPA) axis. This system manages the release and regulation of the stress hormone, cortisol. Trauma causes this system to “stay online” for a prolonged time. The resulting abnormal cortisol levels can affect appetite, digestion, sleep, and energy levels. 

Research also highlights the relationship between trauma and interoception (the ability to perceive and interpret internal body signals, like hunger, fullness, or emotional tension). Trauma survivors often experience disrupted interoceptive awareness, which may lead to feeling detached from bodily needs or misinterpreting physical sensations as dangerous. 

These impacts can create a disconnect or distance between someone and their body. Without being able to trust their body’s natural cues, this dysregulation may contribute to disordered eating patterns or disruptions in hunger and satiety cues.

Trauma rewires the brain. But these connections aren’t irreversible. Neuroplasticity allows us to be able to form new connections and reinforce the prefrontal cortex. We’ll touch more on this when we cover treatments, but it’s important to note that trauma isn’t a one-way street. 

What Happens When Trauma is Triggered?

Trauma presents an ongoing challenge. We’ve covered what happens in that initial experience and how that can disrupt someone’s stress response system, and we’ve mentioned how trauma’s impact on memory can affect how someone experiences the past and present. When we look at the connection between eating disorders and trauma, we also look at an individual’s response when their underlying trauma is triggered. A “trauma response” is the body’s way of reacting to danger, even when the threat is no longer present. In these moments, people may turn to different coping mechanisms.

Coping mechanisms are the strategies we use, consciously or not, to deal with distress. They aren’t exclusive to trauma. Some of them are supportive and grounding, like talking to a trusted friend, journaling, or practicing deep breathing. Others can potentially cause harm, like substance use, self-harm, dissociation, or disordered eating behaviors.

But here’s the most important thing to understand: all coping mechanisms serve a purpose. Even the ones that seem harmful are not a sign of weakness or failure. They’re the brain and body’s attempt to manage overwhelming feelings. When someone turns to disordered eating, they may not be trying to change their body or control their food; they may be trying to survive.

Understanding this opens the door to more compassionate conversations and more effective care. Because to truly support someone, we must first understand what their behavior is helping them cope with.

Eating Disorders as Coping Mechanisms

Eating disorders may help someone feel a sense of control when other parts of their lives feel unpredictable or unsafe. The act of restricting food, bingeing, or purging may also be a mechanism to help regulate emotions when a distressing feeling is triggered. For other people, eating disorders may be a method to suppress bodily awareness or dissociate from themselves. This may help create distance between their present self and painful memories. Overall, eating disorders may serve different purposes as coping mechanisms for trauma and provide a sense of “safety.”

Correlation Between Trauma and Eating Disorders

Though we can’t say for sure that trauma directly causes someone to develop an eating disorder, there is data to back up the correlation between the two. Research shows that individuals with post-traumatic stress disorder (PTSD) experience a higher prevalence of eating disorder diagnoses. A study of over 36,000 adults found that individuals diagnosed with an eating disorder were twice as likely to report a traumatic experience as those without an ED. 

In a study that compared different types of trauma and their association with different eating disorder diagnoses, researchers found that sexual trauma was most highly correlated with anorexia nervosa and binge eating disorder. 

The Role of Genetic and Environmental Factors

Trauma alone doesn’t explain why some people develop eating disorders and others don’t. We know that eating disorders arise from a mix of factors, including genetics, biology, and environment. And many of the same themes show up in research on trauma-related disorders. For example, while nearly 90% of people experience a traumatic event in their lifetime, only about 5–10% develop PTSD. Why? Genetics likely plays a pretty significant role. A twin study estimated that genetics accounts for about 30–40% of the risk of developing PTSD.

The same goes for eating disorders. Research shows that anorexia nervosa, bulimia nervosa, binge eating disorder, and Avoidant Restrictive Food Intake Disorder (ARFID) are all influenced by heritable traits. But genes aren’t destiny. Environmental stressors can interact with someone’s biology in a way that makes disordered eating more likely. This is the role that diet culture or adverse childhood experiences may influence how someone’s genes are expressed. 

While the cause of an eating disorder can’t be clearly defined for everyone, research on genetics, social influences, and trauma helps us understand the conditions that may predispose someone to these mental illnesses. This knowledge can both help clinicians better tailor treatment to each individual and undermine the harmful stigma that eating disorders are a choice.

Why Trauma-Informed Treatment Matters

When trauma underlies an eating disorder, healing requires more than nutritional support or behavior change; it requires safety. It requires being seen and understood in the full context of one’s story. That’s where trauma-informed care comes in.

Trauma-informed care recognizes that disordered eating may be rooted in past experiences of harm. It creates space for those experiences to be acknowledged and integrated, without shame or re-traumatization. Additionally, when care is trauma-informed, providers may focus on identifying and addressing the mediating factors that commonly connect trauma and eating disorders. When factors – like difficulty regulating emotions, high rates of self-criticism, and body image concerns –  are addressed early, care teams can help prevent more severe eating disorder symptoms from developing in adulthood.

Eating Disorder Treatment: Modalities That Can Help

Many care providers are integrating trauma-informed practices that honor the full complexity of a person’s experience. Here are some types of psychotherapy interventions that have shown promise in addressing trauma alongside eating disorder recovery:

• Eye Movement Desensitization and Reprocessing (EMDR): EMDR is a structured therapy developed to help individuals process distressing memories. It uses guided eye movements or other forms of bilateral stimulation to reduce the emotional charge of traumatic experiences. EMDR has been shown to significantly reduce symptoms of PTSD and may be helpful for individuals with eating disorders rooted in early life trauma or abuse.
• Somatic Therapies: Somatic therapies help individuals reconnect with their bodies and regulate their nervous systems. For eating disorder patients who have learned to disconnect from their bodies as a form of self-protection, these approaches offer gentle pathways back to emotional regulation and embodiment.
• Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): Trauma-focused CBT integrates traditional cognitive-behavioral techniques with a trauma-sensitive lens. TF-CBT has a strong evidence base for both children and adults and may be a valuable tool for those with PTSD and eating disorders.
• Internal Family Systems (IFS): IFS is a therapeutic modality that helps individuals explore the “parts” of themselves. In the IFS model, every part has a reason for being there. Using this technique, healing involves bringing curiosity and compassion to even the most difficult internal dynamics. This modality can be especially powerful for people whose eating disorders are rooted in developmental trauma or attachment wounds.

Finding Support with Trauma and Eating Disorders

Both PTSD and eating disorders are mental health disorders that impact someone’s ease of existence and quality of life. Though they are distinct diagnoses, the two are connected. Research shows that folks with eating disorders are more likely to have experienced trauma throughout their lives. In these cases, the eating disorder may be a coping mechanism to help them deal with distressing emotions that come up when their trauma is triggered. Based on our current understanding of how our brains process trauma and what risk factors exist for eating disorders, trauma may contribute to the development of an eating disorder in some cases. 

If you or a loved one is experiencing an eating disorder, please know that help is available. Our team at The Alliance is here to connect individuals and loved ones with resources and support. Call our toll-free helpline at +1 (866) 662-1235 to speak to licensed and specialized therapists. Support is here, and recovery is possible.