The Impact of Childhood Trauma on Developing Eating Disorders

When it comes to mental health, there’s rarely one clear cause behind the struggles we face and eating disorders are no exception. While genetics and personality traits play a role, one area that continues to stand out in research is the impact of childhood trauma.

We examine how early life experiences can shape our relationship with food and why those early wounds may quietly fuel a difficult and distressing relationship with eating for some.

What are eating disorders?

Eating disorders are complex mental health conditions that involve disturbed eating behaviours and often a distorted relationship with food, weight or body image. They’re not simply about a poor relationship with food; they’re often ways to cope with painful emotions or to regain a sense of control.

Here are some of the most common types:

• Anorexia nervosa: Characterised by extreme food restriction, intense fear of gaining weight and a distorted body image.
• Bulimia nervosa: Involves cycles of binge eating followed by behaviours like vomiting, fasting or over-exercising to compensate.
• Binge eating disorder: Marked by recurrent episodes of eating large quantities of food, often quickly and to the point of discomfort, without purging.
• Avoidant/restrictive food intake disorder (ARFID): Involves limited eating not driven by body image concerns but by sensitivity to textures, fears around food or lack of interest in eating.
• Other specified feeding or eating disorders (OSFED): Symptoms of a disordered relationship with food that doesn’t neatly fit into the other categories but still causes significant distress or impairment.

What is classed as childhood trauma?

Before we can understand how childhood trauma connects to eating disorders, we need to look at what trauma actually is. It’s not always about dramatic events. Sometimes, it’s the quieter, long-lasting moments that leave the deepest marks.

Trauma is highly individual. What one person moves on from easily, another might carry for years. In childhood, trauma can stem from any experience that felt emotionally unsafe, and it’s often only in adulthood that its effects become fully recognised.

Here are some of the more common forms of childhood trauma:

• Physical abuse: Experiencing violence, such as being hit or threatened, can lead to a lasting sense of fear, shame or powerlessness.
• Emotional neglect: When emotional needs are ignored or dismissed, a child may grow up feeling invisible, or undeserving of love and care.
• Sexual abuse: Any unwanted sexual contact or exposure can deeply affect a child’s relationship with their body, safety and trust.
• Bullying or peer rejection: Constant teasing, humiliation or exclusion during childhood can erode confidence and fuel ongoing insecurity.
• Parental divorce or abandonment: When a parent leaves or becomes emotionally distant, it can create a lasting fear of being unwanted or alone.
• Unstable or chaotic home environments: Growing up around addiction, mental illness, or ongoing instability can make the world feel unpredictable and unsafe.

Exploring the link between eating disorders and childhood trauma

Over the years, researchers have explored the link between childhood trauma and the development of eating disorders. While individual experiences can vary, many studies have found a clear connection between early emotional wounds and later difficulties with food, body image and self-worth.

A systematic review examined whether a connection exists between childhood trauma and eating disorders and what factors might help explain it. After reviewing hundreds of studies, researchers narrowed it down to 18 high-quality articles that met strict criteria. These studies looked at both clinical populations (people already diagnosed with an eating disorder) and non-clinical populations (those at risk).

The findings revealed a consistent pattern: people who had experienced childhood trauma were more likely to develop eating disorders later in life. However, the research is especially insightful in exploring the mediating factors, such as how and why this link might occur.

Some of the key mediating factors identified included:

In short, the research strongly supports a link between childhood trauma and eating disorders. While the relationship is rarely simple, there are clear psychological pathways connecting unresolved trauma to harmful eating behaviours. Recognising these links is an important step in helping people understand their relationship with food and, ultimately, begin healing.

What is treated first – the eating disorder, the trauma or both?

When someone is diagnosed with both an eating disorder and a history of childhood trauma, it’s natural to wonder what should be treated first. Is the focus on the eating disorder symptoms? Or should therapy begin by addressing the underlying trauma?

A recent meta-review of existing studies set out to explore this very question. Despite the clear emotional weight that trauma and PTSD can carry, the findings revealed something important: individuals with a trauma history can still respond well to eating-disorder-specific treatment.

Two standout studies in the review found that people with PTSD or a history of childhood abuse showed a steeper rate of improvement in eating disorder symptoms. For example:

One study tracked the return of menstruation in individuals with a history of trauma and found that while this biological marker improved, it might not reflect full recovery. Trauma may cause a different healing timeline and improvements in the body don’t always mean emotional wounds have healed.

Another study showed larger reductions in global eating disorder symptoms for individuals with PTSD. However, this may be partly because they began treatment with more severe symptoms, meaning improvements looked more dramatic due to a statistical effect known as regression to the mean.

What does this mean for treatment?

While more research is necessary, this study suggests that starting with eating disorder-focused therapy can be beneficial, even for those with a trauma history. Stabilising eating patterns and addressing the psychological components of the eating disorder can create a safer, more balanced foundation. From there, trauma-focused work can be introduced when the individual is ready.

In many cases, both the eating disorder and the trauma will need to be treated but not always at the same time. The key is a flexible, individualised approach that considers where someone is emotionally, physically and psychologically at the start of treatment.

How can I find help for eating disorders and childhood trauma?

Every person’s journey is different; what works for one individual may not feel right for another. That’s why, if you suspect that both an eating disorder and unresolved trauma are present, whether in yourself or someone you care about, the best step is to speak to someone who can help you navigate it.

At UKAT, we’re here to offer that support. Our dedicated programmes are designed to treat eating disorders and we also provide care for trauma-based conditions like PTSD. You don’t need to have all the answers before reaching out. We’re just a phone call away, ready to talk through what comes next with care and understanding.