PTSD and Eating Disorders in Veterans
By Christopher Clark, Executive Director, The National Association for Males with Eating Disorders, Inc. (N.A.M.E.D.)
NAPLES, FL - Eating Disorders resulting from Posttraumatic Stress Disorder (PTSD) may be more common than one might expect. The person with PTSD is just as likely to turn to an unhealthy behavior, like drinking or drugs, as one is to turn to an eating disorder.
Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that results from exposure to a traumatic event. The horrible event was so scary that the person feared for his or her safety or life, or actually witnessed others being killed or injured. PTSD develops when the individual persistently feels the negative emotions of anger, guilt, and fear associated with the event even after the traumatic situation has passed. The trauma may be replayed in one’s mind (perhaps through nightmares or after hearing sounds that remind the person of the scene).
Eating disorders are illnesses that develop out of underlying negative emotions and conflicts that get expressed through eating disordered behaviors. For example, a veteran may turn to anorexia nervosa (restrictive food intake) as a means of desperately wanting to feel in control over all of life’s situations. The feeling of being able to strictly control food intake may give the false sense of security of being in control. Or one may turn to bulimia nervosa as a way to purge or cleanse oneself from the negative emotions one experiences. Or one may binge as a means of seeking comfort in food and to “stuff down” negative feelings.
Dr. Timothy D. Brewerton, MD, clinical professor of psychiatry and behavioral sciences at the Medical University of South Carolina in Charleston explains that many studies point to the connection between eating disorders and anxiety disorders and traumatic experiences. However, very little has been written on the connection between eating disorders and PTSD, and existing studies get their samples usually from women who were sexually assaulted or abused, rather than from veterans (mostly men). Dr. Jessica Hamblen, PhD, Deputy for Education at the National Center for PTSD is not aware of anyone currently studying eating disorders in PTSD patients.
Dr. Brewerton explains that it has been hypothesized that eating disordered behaviors, particular purging, may be used as an avoidance mechanism by the individual to numb painful feelings, and to block or forget painful memories. Of course, these coping mechanisms are not consciously chosen. Rather, these unhealthy coping behaviors are the body’s sub-conscious way of trying to soothe itself.
Dr. Matthew Tull, PhD conducts research on anxiety disorders with a focus on PTSD and substance abuse. Dr. Tull explains that eating disorders can co-occur with PTSD, just as other psychiatric disorders can co-occur with it. Trauma sometimes causes an eating disorder. Dr. Tull reports that those with PTSD are approximately three times more likely to develop bulimia than those who do not have PTSD.
People with PTSD experience very strong, distressing emotions, such as fear, guilt, and anger. They may turn to unhealthy behaviors in an attempt to numb the intensity of emotional pain. A person with PTSD could just as likely turn to alcohol, drug, and/or sexual addictions, as to an eating disorder to cope with emotional pain.
According to Dr. Brewerton, based on his experience, Cognitive Behavior Therapy (CBT) is the foundational therapy for eating disorders, trauma, and anxiety disorders, including PTSD.
With so many veterans experiencing PTSD from their military service, it is vital that those who treat them understand the implications of how an eating disorder could manifest itself from PTSD. Health care providers need to realize that men are just as vulnerable to eating disorders as women.
In the “macho” culture of the military, eating disorders are perceived as a femine disease that simply does not affect men. We need to come beyond viewing eating disorders as a one gender – female – disease.
Men who are veterans with eating disorders must set aside their shame about admitting to their problems with food, so that they can get the professional help they need, in order to live a healthy and happy life.
The National Association for Males with Eating Disorders, Inc. (N.A.M.E.D.) can provide veterans with eating disorders support, information, and referrals to treatment. Contact N.A.M.E.D.’s executive director at Chris@NAMEDinc.org or call the toll-free helpline at 1-877-780-0080.
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