Although the evidence to suggest that eating disorders (ED) have a biological basis has been described as irrefutable (e.g., Strober & Johnson, 2012), we know that the environment also plays a role in the development of an ED. One of the most prominently discussed environmental factors found in the literature—and in the therapy room—is trauma, and as EDs most often develop in late adolescence, the trauma is often experienced in childhood. Although research results have been somewhat mixed regarding the link of childhood trauma and anorexia, the link between childhood trauma and bulimia nervosa and binge eating disorders is more consistent (Caslini et al., 2016).

However, it is noteworthy that much of the research utilizes strict definitions of trauma and does not include, for example, trauma at the hands of peers such as school bullying or nonconsensual sexual advances/contact by near-same-aged adolescents (e.g., the meta-analysis by Caslini et al., 2016). Yet, even unwanted sexual attention, versus actual sexual abuse, has been shown to lead to body image problems in adulthood (Whealin & Jackson, 2002), thus with wider definitions of childhood trauma, we may see more robust correlations between childhood abuse and EDs, including anorexia. In support of this notion, the US National Comorbidity Survey Replication Study found that virtually all 5,692 participants (2,382 of which were male) with AN, BN, and BED reported a history of at least subthreshold post-traumatic stress disorder (Mitchell, Mazzeo, Schlesinger, Brewerton, & Smith, 2012). Learn more here.