Why Trauma Informed Care is Important for Eating Disorder Treatment

At the age of only four-years-old, I heard a voice in my head that said, “You’re fat. You aren’t good enough.” That voice was my eating disorder (aka “Ed”). I was 22-years-old before someone finally told me that I didn’t have to listen to that negative, self-critical voice anymore.

While my eating disorder began as negative body image thoughts, I ultimately ended up restricting food. And, in time, this led to bingeing and purging. Sometimes, it seemed like the treacherous, painful cycle would never end.

I experienced sexual assault toward the end of my eating disorder recovery, yet, like countless others, I didn’t label the experience as trauma for quite some time. Because the perpetrator was my boyfriend at the time, I didn’t think the words “sexual assault” applied. Boy, was I wrong. I am grateful that a trauma therapist finally helped me come to terms with the fact that I had been raped. It took years for me to be able to say that last word. In recovery, I learned that saying specific words, rather than avoiding, was important in breaking free.

Connection Between Trauma and Eating Disorders

The average amount of time between the onset of posttraumatic stress disorder (PTSD) symptoms and the initiation of treatment is twelve years. This was my story.

Following my trauma, PTSD symptoms emerged, which exacerbated my eating disorder. I binged more, and I purged in even more violent ways. Research indicates that people with comorbid ED-PTSD are more likely to engage in multiple forms of purging [1]. We also know that PTSD is a significant predictor of poor prognosis in eating disorder recovery, so PTSD must be addressed for complete healing [1].

It’s important to note that PTSD and eating disorders share common risk factors, including high anxiety, perfectionism, and obsessive-compulsiveness [2]. People with eating disorders, especially those characterized by binge eating or purging, have a higher lifetime rate of PTSD than the general population.

For some, PTSD might be considered the source of the infection. In other words, PTSD fuels the eating disorder. Many binge and purge to achieve relief from the debilitating symptoms of PTSD. To heal, people need to recover from both disorders. The latest research suggests that integrated treatment for trauma and eating disorders is the way to go. Research also shows that people can get better.

Trauma-Informed Care in Eating Disorder Treatment

Trauma-informed care is imperative in eating disorder treatment, which is one reason that I am so excited to work with The Meadows Ranch.

My trauma treatment has been a jigsaw puzzle with countless pieces. The first two therapies that helped me included EMDR and Somatic Experiencing, the latter, which was founded by my colleague at The Meadows, Dr. Peter Levine. Then, I worked hard in Prolonged Exposure therapy. Other therapies I utilized included ACT (Acceptance and Commitment Therapy), DBT (Dialectical Behavior Therapy), Brainspotting, mindfulness, massage, acupuncture, and yoga.

Today, I am honored to be a Senior Fellow with The Meadows and an advocate for its specialty eating disorders program, The Meadows Ranch. In my role, I get to do two of my favorite things: educate and offer hope. As an example, I truly enjoy speaking with our incredible patients on our beautiful campus in the Arizona desert.

Unlike most other eating disorder treatment centers, The Meadows Ranch integrates treatment for PTSD and eating disorders. This integration includes these components for addressing PTSD:

  • We are the only eating disorders treatment program with a Brain Center, including neurofeedback and biofeedback. Patients report over and over again that our Brain Center helps to calm their anxious minds. We are able to utilize this neurotherapy to guide patients’ readiness for trauma treatment.
  • We utilize EMDR, which is one of the evidence-based treatments for PTSD.
  • Further, patients are able to participate in our signature workshop, Survivors I.

Creating Change for the Future of PTSD Recovery

I am currently writing a book about my recovery from PTSD. Earlier, I mentioned that the average time between the onset of PTSD symptoms and the initiation of treatment is twelve years.

This needs to change.

I hope to be a small part of that change. Far too often, PTSD is missed and dismissed, sometimes misdiagnosed as depression, bipolar disorder, borderline personality disorder, or generalized anxiety disorder. I view a correct diagnosis not as a label, but as a compass pointing toward the best treatment.

To read the entire interview, visit Dr. Marianne Miller’s blog.


[1]: Timothy D. Brewerton (2007) Eating Disorders, Trauma, and Comorbidity: Focus on PTSD, Eating Disorders, 15:4, 285-304, DOI: 10.1080/10640260701454311

[2]: Becker CB, DeViva JC, Zayfert C. Eating disorder symptoms among female anxiety disorder patients in clinical practice: the importance of anxiety comorbidity assessment. J Anxiety Disord. 2004;18:255-274.

Jenni Schaefer

About Senior Fellow Jenni Schaefer

Jenni Schaefer graduated summa cum laude from Texas A&M University with a degree in biochemistry, and she knows firsthand the devastating consequences of an eating disorder. Since recovering from her own eating disorder, she has carried her message of self-acceptance and triumph over adversity to the public.

Jenni is the author of several books, including Life Without Ed: How One Woman Declared Independence from Her Eating Disorder and How You Can Too, and she has contributed to anthologies like the Chicken Soup for the Soul series. A sought-after speaker on addiction and food disorders, relationships, depression, and career, Jenni has appeared on Dr. Phil, Dr. Oz, the TODAY show and Entertainment Tonight, as well as in print coverage from Cosmopolitan and The New York Times. She is also a blogger for The Huffington Post, and her work has appeared in Publisher’s Weekly, The Chicago Tribune, Glamour, Shape, The Washington Times, Woman’s World, Seventeen, and more.