When Trauma and Eating Disorders Overlap: Understanding C-PTSD and Disordered Eating

By: Megan Samuels, MSW, LCSW-C, Eating Disorder and Trauma Therapist

Content Warning: This blog post discusses trauma, dissociation, and eating disorders.  Please take care of yourself in whatever way feels right for you. Here are a few ideas for ways to ground yourself in the present.

Living with C-PTSD and an Eating Disorder

Living with complex PTSD (C-PTSD) and an eating disorder can feel deeply overwhelming. You may find yourself navigating intense mental health symptoms that affect your relationships, daily functioning, and overall sense of safety. Flashbacks, emotional numbness, hypervigilance, obsessive thoughts around food, restriction, or compulsive exercise can become constant companions. And despite trying different approaches to feel better, nothing may seem to stick.

If this resonates with you, you’re not alone—and there is hope.

What Is C-PTSD?

C-PTSD stands for complex post-traumatic stress disorder. While it’s not yet formally recognized in the DSM-5 (the diagnostic manual used by mental health professionals), it is a valid and real condition. C-PTSD typically results from prolonged or repeated trauma—often starting in childhood—such as chronic abuse or neglect.

Common symptoms of C-PTSD include:

• Dissociation (feeling disconnected from yourself or your surroundings)
• Difficulty forming or maintaining relationships
• Persistent feelings of shame, guilt, or worthlessness
• Emotional dysregulation
• Co-occurring conditions like eating disorders, substance use, or chronic health issues
  
  

Unlike PTSD, which often stems from a single traumatic event, C-PTSD develops from long-term, repeated trauma. That said, anyone who has experienced trauma—regardless of whether they meet formal criteria for a diagnosis—deserves support.
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You don’t need a label to seek help. Trauma-focused therapy can be beneficial even if you’re unsure what you’re experiencing has a name.

What Is an Eating Disorder?

An eating disorder involves a disordered relationship with food, body image, or both. These behaviors often develop as a way to cope with difficult emotions, trauma, or distress—and they can significantly affect a person’s quality of life.

Common eating disorder behaviors include:

• Restriction: severely limiting food intake
• Binge eating: consuming large quantities of food in a short time
• Purging: using methods like vomiting, laxatives, or compulsive exercise to get rid of food
  
  

There are several types of eating disorders, including:

• Anorexia Nervosa
• Bulimia Nervosa
• Binge Eating Disorder
• Orthorexia Nervosa
• Avoidant/Restrictive Food Intake Disorder (ARFID)
• Other Specified Feeding or Eating Disorder (OSFED)
• Compulsive Exercise
  
  

Eating disorders often occur alongside other conditions such as anxiety, OCD, or trauma. This overlap can complicate recovery and highlights the importance of specialized, integrated treatment.

How Are C-PTSD and Eating Disorders Connected?

​Eating disorders are not choices. They are complex mental health conditions, and for many individuals with trauma histories, disordered eating behaviors serve as a way to cope.

When trauma makes the world—and your body—feel unsafe, eating disorder behaviors can provide a temporary sense of control or relief. But while behaviors like restricting, bingeing, purging, or overexercising might seem to ease distress in the moment, they often deepen it in the long run.

Both C-PTSD and eating disorders frequently involve dissociation, or a feeling of disconnection from your body, emotions, or environment.

Research has shown that individuals with eating disorders often have higher dissociation scores on screening tools, such as the Dissociative Experiences Scale (DES).

In Healing the Fragmented Selves of Trauma Survivors, trauma expert Janina Fisher explores this connection in depth. She writes:

• “Bulimia, in both the binging and purging phases, causes a reduction in hyperarousal and decreased pain sensitivity via activation of the dorsal vagal system.”

• (Fisher, 2017, p. 131)

Fisher also explains:

• “In anorexia, restricting food intake results in (temporary) numbing of emotion and sensation. Overeating also results in numbing accompanied by relaxation, increased parasympathetic hypoarousal, disconnection from the body, spaciness or drowsiness.”
• (Fisher, 2017, p. 131)

In essence, disordered eating can be a way the nervous system tries to regulate itself—a survival strategy that becomes harmful over time.

What Does Treatment for PTSD and an Eating Disorder Look Like

Healing from both trauma and an eating disorder requires specialized care from clinicians trained in this intersection. Effective treatment for PTSD and an eating disorder may include:

• Relational Therapy
• Ego State Therapy (parts work)
• EMDR Therapy (Eye Movement Desensitization and Reprocessing)
• Sandtray Therapy
• Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT) informed interventions
  
  

Because of the complex interplay between trauma and eating disorder symptoms, a concurrent treatment approach—addressing both conditions at the same time—is often most effective. That said, treatment plans should always be tailored to the individual.

The journey of healing from trauma and an eating disorder can feel isolating—but it doesn't have to be. With the right support, recovery is possible.

If you're ready to take the first step, we’re here to help. We offer online therapy for trauma and eating disorders in Maryland and Virginia. We also provide trauma therapy in person in Rockville, Maryland.

You don’t have to keep living this way. Let us support you in finding your path to healing.

Reach out today to schedule a free 15-minute consultation with one of our trauma-informed eating disorder therapists.

You’re Not Alone - And Recovery Is Possible

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Schedule a FREE 15-minute consultation to explore how eating disorder therapy or recovery coaching can help you to find freedom.​
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🌟 Available in MD, VA, DC, PA, NY, FL, and CA for eating disorder therapy
🌍 Offering recovery coaching worldwide

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The Eating Disorder Center is a premier outpatient eating disorder therapy center founded by Jennifer Rollin. We specialize in helping children, teens, and adults struggling with anorexia, binge eating disorder, bulimia, OSFED, and body image issues. We provide eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, North Potomac, Bethesda, Olney, Silver Spring, Germantown, and Washington, D.C. We also provide eating disorder therapy in Arlington, Virginia and virtually throughout Virginia. Additionally, we offer eating disorder therapy virtually in New York (NYC), Florida, Pennsylvania, and California. We provide eating disorder and EMDR trauma therapy in Rockville, Maryland and virtually throughout Maryland and Virginia. We provide eating disorder recovery coaching via Zoom to people worldwide. Connect with us through our website at www.theeatingdisordercenter.com 

References:
Fisher, J. (2017). Healing the fragmented selves of trauma survivors: Overcoming internal self-alienation. Routledge/Taylor & Francis Group.