This post will highlight possible ramifications and effects of a history of sexual assault, and how these relate to the possibility of an eating disorder. Though not everyone who gets sexually assaulted will develop an eating disorder, thought processes following this type of trauma often create the perfect breeding ground for one to begin.

Thoughts and Possible Following Effects

Reaction to Trauma Action to "Help"

⦁Feeling "gross" -> "Cleanse" body
⦁Wanting to crawl out of body -> Change weight ("new" body)
⦁"Disappointed" in self -> "Punish" self
⦁Fear of being appealing -> Rid self of breasts/hips/physique
⦁Sadness/Depression -> Lose appetite/will to eat

The first bullet point of feeling "gross," is a common reaction to sexual trauma. It also doubles as a common feeling for those struggling with body dysmorphia or an eating disorder. What the affected individual may then try to do is cleanse this body, or rid it of "all things bad." In turn, this can lead to using laxatives, purging, or restricting intake in various ways. The next possible effect, of wanting to crawl out of one's body, is a common segue to an eating disorder. For example, if someone was assaulted in a body at a certain weight, they may want to find home in a new weight. For some, this may mean losing weight until they feel less tied to the body that was "actually" assaulted. Unfortunately, this lends to the feeling of dread of ever being in that body ever again. For others, this may mean overeating to change their body. They, in turn, will associate that smaller body with the one that was "actually" assaulted. If one feels as though they "asked for it," or "deserved it," a common misconception pushed in media today, they may feel that they've lost the right to their old body. What's their punishment? They cannot live in that body ever again. Therefore, they will take the steps necessary to make this possible.

These body changes may also tie into another point mentioned above: appeal. A history of sexual trauma may leave the one affected wondering how they can prevent this from happening again. If they believe their body was "too appealing," which is another common misconception in media, they may try to change this. For women, this may look like trying to shrink their breasts or hips, or gaining enough weight that society deems them as unattractive. For men, this may look like gaining or losing enough fat, or losing enough muscle, that society too deems them as unattractive. The common theme here: using food and body to avoid possible harm in the future. In reality, though, these measures may often be unsuccessful in warding off future trauma, or simply unrelated.

Mechanisms of the Eating Disorder

Reaction to Trauma Action to "Help"

⦁Flashbacks/Memories -> Self-Medicate: Over/under eat
⦁Thoughts of suicide -> Subtle way of killing self
⦁"I need help" -> "I'll use my body to ask"
⦁Feeling out of control -> Eating Disorder: sense of control
⦁Blame -> "Deserve" self harm
⦁Shame -> Shame the body/self too

Many people who experience sexual trauma may experience flashbacks, intense memories, or nightmares. There are a few seemingly viable options when this is the case: continue on without change, seek counseling, use prescribed medication, use illegal substances, or use food (to name a few). For the purpose of this post, using food will be of focus here. Manipulating intake can be used as a way of self-medication. For some, food may feel like a safety net, or as a comfort. When they eat, their bad thoughts may dissipate, and they may feel a rare moment of peace. They may feel relief from their mind, encouraging them to seek this feeling over and over again. For others, the lack of food may provide for this same safety net. A starving brain is often a numb brain. This means that each hunger pang may feel like relief, or a break from overwhelming thoughts. Again, this leaves the affected craving this feeling.

Many individuals with this history may turn to suicide or self-harm. Overeating to the point of medical concern, and under eating to the point of medical concern, is a way of killing the self slowly and subtly. It is not one, defining gesture or act, but rather a decision that can be made day in and day out. Yes, this is a form of self-harm. If one blames themself for their experience, they may also turn to different forms of self-harm. They may deprive themselves of food when their body sends a hunger cue, because they don't "deserve" the luxury of food. They may purge as punishment for the food they ate that they didn't feel they deserved. They may continue to eat through stomach pains that are begging the person to stop, because this pain is what they believe they have earned.

The last two bullet points warranting extra discussion are those of needing help, and yearning for some control. Many people may realize that they do, in fact, need some help with moving forward after an assault. However, asking for help is not always easy. For many reasons, individuals may not want or be able to verbalize that they need help. What's another way to signal that you need help? Changing your body. For those with eating disorders, it's not uncommon to use the body as a form of language, or to signal to others what your needs are. People tend to notice if dramatic amounts of weight are lost or gained. For example, when people start to lose large amounts of weight from their "norm," it's common for people to become concerned. This leads them to ask you: "Is everything okay?" It may even lead them to saying, "Let's get you some help."

This method allows the one suffering to not have to verbalize their needs, but rather get others to notice and offer services or concern due to the state of their body. Another aspect of this is that it seemingly gives the control back to the one struggling. They controlled what they did to their body, and got the response from others that they desired. Someone may not feel as comfortable making a counseling appointment completely on their own due to a recent sexual trauma. However, if a family member or friend suggests counseling, as they can visibly see something is wrong, it can feel much more validating to schedule that appointment on the recommendation of others. The problem with this is: This individual just confirmed for themself that the best way to access help, is to show that you need it physically.

What Can We Do?
The biggest impact we can have, as loved ones and mental health professionals alike, is support, validate, and help the one affected feel safe. We must not bash on the actions they have taken trying to live after their traumatic experience. The steps they chose to take, they took to survive. We must validate them for this, and provide a space of no judgment. Every person will handle a seemingly "similar" sexual trauma very differently. No way of moving forward is right or wrong. However, as clinician's, we must find a new outlet for them to feel and move forward from that pain. We must find ways for them to feel in control of their body, mind, and experience again, without manipulating their intake. In a sense, too, it will take time and trust. It's almost as if exposure therapy is forced to be used. For example, a client may someday experience being in that seemingly same body that was assaulted someday. With each day that passes, and each new tool and technique implemented, that dreaded body won't feel so scary anymore. We must be there for them through this process. As professionals and loved ones, we must empower the individual. We must help them see their value, and the lack of impact their body and food has on this. Finally, we must express and show our unrelenting, and unconditional support. There is no timeline on healing, and there should be no expectation on when changes and progress should be seen.

Sexual Trauma and Eating Disorders

“Thin to Win”