The Connection between Sexual Abuse History and Bulimia
There appears to be a strong connection between a history of sexual abuse and the development of the eating disorder bulimia. For example, a study conducted by the Eating Disorders Unit of the Florida Hospital in Altamonte found that 50 percent of both anorexic and bulimic patients reported a history of sexual abuse, compared to 28 percent of control subjects without an eating disorder. According to Mary Anne Cohen, director of The New York Center for Eating Disorders, 40 to 60 percent of men and women who come to the center for treatment for an eating disorder have been sexually or physically abused.
Clinical Data Concerning Sexual Abuse and Bulimia
However, these findings are somewhat anecdotal and do not establish a clear cause and effect relationship. Other factors must be taken into consideration. Researcher Dawn Myers has reviewed a tremendous amount of data collected from various clinical studies of the connection between sexual abuse and eating disorders and has reached the following conclusions:
- The preponderance of data suggests a potential connection between sexual abuse and bulimia, but no clear connection between sexual abuse and anorexia.
- The data suggests a link between sexual abuse and bulimia but does not prove a cause and effect relationship.
- Many individuals with a history of sexual abuse do not develop bulimia, and many bulimics have no history of sexual abuse.
- Other traumatic events or situations may also contribute to bulimia.
- The relationship between any type of trauma and the development of bulimia is affected by a variety of factors, such as environment and family characteristics.
While there appears to be a strong connection between sexual abuse and bulimia, the relationship is complex.
Bulimia as a Defense Mechanism
Despite the lack of a clear clinically established cause and effect relationship between a history of sexual abuse and bulimia, it is safe to assume that sexual abuse is a contributing factor to bulimia in a person with bulimia and a history of sexual abuse.
Researchers and eating disorder treatment specialists tend to agree that bulimia in sexual abuse survivors is related to disturbed body image and perception of self-worth and is often used as a defense mechanism. Depending on the individual, bulimia can be used as a defense mechanism in a variety of ways. For instance, some may engage in binge-purge cycles in a dysfunctional attempt to attain the perfect body while others may engage in the same behavior in an attempt to become either excessively thin or fat so as to be unattractive and avoid unwanted sexual attention. Others may gain weight in order to become large and avoid feeling small and powerless.
There also appears to be a correlation between bulimia and unhealthy sexual behavior, such as promiscuity. The Florida study mentioned above found that 46 percent of bulimic women exhibited promiscuous behavior. Researchers hypothesized that these women use sex either as a measure of their own self-worth or as a means of punishing men, and researchers advised addressing issues of sexuality in bulimia treatment. Significantly, they found that although sexual abuse seems to contribute to bulimia, rape does not. They theorize that this is because rape is often disclosed early and survivors receive psychological treatment.
Cognitive behavioral therapy has a proven track record as an effective treatment for eating disorders such as bulimia. Patients address the issues contributing to bulimia and learn effective coping skills.
If you or someone you know needs treatment for bulimia, please call our toll-free, 24 hour helpline today.