Exploring the Connection Between Self-Harm & Eating Disorders
by Emily Costa
Eating disorders and self-harm are both complex mental health issues that sadly affect a significant percentage of the global population. According to one report, 9% of the U.S. population, or 28.8 million Americans, will have an eating disorder in their lifetime, while self-harm affects in 17.2% of people, most commonly amongst those aged 15-19 years. These figures reveal the stark reality of the struggles many individuals face daily.
In this blog we will take a look at the intricate relationship between eating disorders and self-harm, understanding the nuances that intertwine these two behaviors. We will explore the underlying factors contributing to how they often coexist in the same individuals, and the importance of comprehensive treatment that addresses both issues simultaneously.
Read on to learn more about:
What eating disorders are
What self-harm is
What the connection is between eating disorders and self-harm
Understanding the shame and guilt in these behaviors
Treatment options for eating disorder recovery and self-harm
The ultimate goal in treatment
How to help a loved one or seeking support for yourself
What are Eating Disorders?
Eating disorders are mental health conditions characterized by unhealthy relationships with food, body weight, and shape, often accompanied by severe disturbances in eating behaviors.
The most common types include Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. Anorexia Nervosa involves intense fear of gaining weight and a distorted body image, leading to a restriction of intake. Bulimia Nervosa encompasses cycles of binge eating followed by compensatory behaviors such as self-induced vomiting or over-exercising. Binge Eating Disorder is characterized by out-of-control eating but without the compensatory behaviors seen in bulimia.
Genetic, environmental, and psychological factors contribute to the development of these disorders. Eating disorders can have a significant impact both physically and psychologically. Physically, disordered eating habits can lead to malnutrition, heart conditions, gastrointestinal issues and more. Psychologically, individuals may struggle with co-occuring issues such as depression and anxiety, and an overall decrease in the quality of life.
A prominent influence in developing an eating disorder is often societal pressure to conform to idealized beauty standards, which frequently promote thinness as the epitome of attractiveness. This pressure can lead to body dissatisfaction and distorted self-perception, triggering unhealthy eating behaviors in an attempt to attain the 'ideal' body. Concurrently, individuals may use these disordered eating behaviors as maladaptive coping mechanisms to manage stress, anxiety, or feelings of inadequacy. This is because the temporary control over food and body can offer a false sense of relief from underlying psychological distress.
Understanding Self-Harm
Self-harm, also known as self-injury, is a behavior where an individual intentionally inflicts harm on themselves, often as a way to cope with overwhelming emotions or distressing situations. This behavior can manifest in several forms such as cutting, burning, scratching oneself, or engaging in other harmful activities.
It’s essential to shed light on the fact that self-harm is not a mental disorder in itself, but a symptom reflecting mental discomfort or turmoil. It is often associated with various mental health conditions, including depression, anxiety disorders, borderline personality disorder, and eating disorders. Causes are complex and multi-faceted, often rooted in emotional distress, feelings of emptiness or numbness, a desire for control, or self-punishment.
The symptoms of self-harm can be both physical and emotional. Physical signs include unexplained injuries like cuts, burns or bruises, often found on the wrists, arms, thighs, or chest. Individuals may also wear long sleeves or pants even in hot weather to conceal their injuries. Emotional symptoms can include isolation, irritability, difficulty in handling feelings, and drastic mood changes.
The consequences of self-harm are severe and far-reaching. Physically, it can lead to unintended severe injuries, infections, or even be life-threatening. Emotional and psychological consequences include a heightened sense of guilt and shame, increased feelings of worthlessness, and a vicious cycle of self-harm that can be hard to break. Furthermore, self-harm is a significant risk factor for suicidal ideation and attempts.
The Connection between Eating Disorders and Self-Harm
Eating disorders and self-harm behaviors are often co-occurring. According to a 2018 study published 25-55% of patients with eating disorders engage in non-suicidal self-injury.
The common thread between the two maladaptive behaviors is the underlying psychological distress and the struggle to manage overwhelming emotions. Both eating disorders and self-harm are coping mechanisms, albeit unhealthy ones.
For individuals dealing with eating disorders, controlling food, weight, and body shape becomes a way to manage emotional pain, feelings of worthlessness, and anxiety. Similarly, self-harm is a misguided attempt to gain relief from emotional distress or regain control.
Risk factors for developing both behaviors include a history of trauma, abuse, or neglect, co-existing mental health conditions such as depression or anxiety, and certain personality traits, including perfectionism or impulsivity. There's also an interplay of genetic factors, suggesting that individuals may have a predisposition to these behaviors.
Psychologically, both eating disorders and self-harm result from an inability to effectively regulate or express emotions — a process known as alexithymia. These individuals struggle to identify or describe their feelings, leading to an internal build-up of stress and emotional discomfort. As a result, the individual resorts to harmful behaviors — such as restrictive eating, bingeing, purging, or self-harm — as a misguided attempt to exert control over their emotional state or to express their inner turmoil.
Understanding the connection between eating disorders and self-harm is vital as it indicates the need for comprehensive treatment that addresses both issues simultaneously, helping individuals develop healthier coping mechanisms and improve emotional regulation.
The Role of Guilt and Shame
Eating disorders and self-harm significantly impact an individual's mental health, often creating a destructive cycle of shame, guilt, and secrecy that further exacerbates the psychological distress. An individual may feel shame about their behaviors, whether it's binge eating, purging, or self-inflicted injuries, leading to a deepening sense of worthlessness and self-loathing.
The guilt associated with these behaviors can be equally damaging. With each episode of disordered eating or self-harm, the guilt intensifies, heightening feelings of despair and leading to further suffering. This guilt is not only about the act itself but also about the inability to stop the behavior, which may lead to feelings of failure.
Moreover, the persistent secrecy surrounding these behaviors often leads to increased anxiety and paranoia about being discovered, which can cause significant emotional distress. This secretiveness also traps the individual in their destructive behaviors as it prevents them from seeking help or support due to fear of judgment or stigma. The intertwining of eating disorders and self-harm with cycles of shame, guilt, and secrecy significantly deteriorates mental well-being.
Treatment Options for Self-Harm and Eating Disorders
When dealing with co-occurring self-harm and eating disorders, a comprehensive treatment approach that addresses both issues simultaneously is crucial. Clinicians and treatment programs with expertise in both areas can provide the most effective care leading to lasting recovery.
Dialectical Behavior Therapy (DBT) is specifically designed to help individuals regulate emotions and manage distress without resorting to harmful behaviors. It emphasizes mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
Eye Movement Desensitization and Reprocessing (EMDR) can be particularly helpful for individuals who have a history of trauma, as it aids in processing and integrating traumatic memories.
In treatment, professionals will aid clients in decreasing and eventually eliminating self-harm and disordered behaviors. Together, finding the underlying purpose of these behaviors can help discover the necessary skills to live a life without these destructive habits.
The Ultimate Goal of Treatment
The ultimate goal of treatment is to help individuals learn to regulate emotions in a healthier manner, replace self-harming and disordered eating behaviors with productive coping mechanisms, and cultivate a life that aligns with their values and doesn't feel overwhelming. This could involve learning stress management techniques, improving interpersonal skills, building self-esteem, and identifying and working towards personal life goals.
It's important to remember that recovery is a journey with ups and downs, but with the right support and therapeutic interventions, it is entirely achievable. Choosing a comprehensive treatment program that understands the intertwined nature of self-harm and eating disorders is the first step towards a healthier, happier life.
Helping a Loved One
Supporting a loved one struggling with an eating disorder and self-harm can be challenging yet crucial. Begin with educating yourself on these issues to better understand their struggle, just as you have with reading this blog. Approach them with compassion, patience, and non-judgmental curiosity, expressing your concerns and willingness to help. Avoid focusing on food or weight or the self-harm behavior itself. Instead, try to encourage them to express their feelings and fears. Remember, professional help is paramount. Encourage them to seek professional help. You can even offer to attend a therapy session together if they're comfortable.
Remember, healing is a journey, and your consistent emotional support can make a tremendous difference while they navigate recovery.
Reaching Out For Help
Reaching out for help when you or a loved one are struggling with self-harm and disordered eating can feel overwhelming, but remember, you are not alone in this journey.
‘Ai Pono Hawaii eating disorder treatment programs provide specialized, holistic care, focusing on healing the body, mind, and spirit. Our programs are designed to provide a safe and nurturing environment where you can explore the root causes of your behaviors, develop healthier coping mechanisms, and work towards recovery. The road may seem challenging, but you don't have to walk it alone. With the right support and treatment, recovery is within your reach.
Learn more about our treatment philosophy and reach out today.
Emily Costa
Having struggled with an eating disorder herself, Emily is passionate about spreading awareness, education and the possibility of recovery with others. Emily previously volunteered as a Crisis Text Line counselor and with the eating disorder non-profit Project HEAL where she served as their blog manager, their NYC Chapter Leader & a recovery mentor in their Communities of HEALing pilot program completing training by the Carolyn Costin Institute. Emily now enjoys working with various treatment centers, clinicians and non-profits in the eating disorder community providing marketing and design services. In her free time she enjoys spending time with friends, hanging with her dogs, and reading a book at the beach.