Sexual Abuse and Eating Disorders

While some research suggests a link between having a history of sexual abuse and developing an eating disorder, the nature and strength of this association is not yet known. For example, some believe sexual [Page 685]abuse is a risk factor of eating disorders, while others assert that sexual abuse is a risk factor of general psychopathology. The role that sexual abuse plays in the development of eating disorders is complicated and a casual link cannot be established; however, various results of research on this topic are discussed.

The prevalence of reported sexual abuse in individuals with eating disorders varies widely. Sexual abuse is a difficult subject of study because traumatic experiences such as sexual abuse are often unreported. According to a review of the literature on sexual abuse and eating disorders conducted by Connors and Morse, roughly 30 percent of eating disorder patients report having experienced sexual abuse as a child. However, conclusions regarding the relationship between sexual abuse and eating disorders are difficult to determine because of the variability in findings of the prevalence of such a history in noneating disorder populations.

Some research reports similar findings of sexual abuse in the overall population compared to that found by Connors and Morse, while other research reports smaller findings. Preti and colleagues took an interesting approach to researching this topic and examined the sexual abuse history and eating disorder symptoms in a community sample of women aged 18–30. They found that the 20 percent of women who reported having experienced sexual abuse were also more likely to report symptoms of eating disorders compared to those who did not endorse experiencing such abuse. They also found that women who were sexually abused before age 12 were more likely to endorse eating disorder symptoms. While this specific study looked at eating disorder symptoms as opposed to eating disorder diagnosis, these findings are valuable considering the relationship between disordered eating habits and the development of an eating disorder.

Recent research suggests a relationship between purging behaviors, such as vomiting, and a history of sexual abuse. Specifically, Gerko et al. conducted a study on women diagnosed with restrictive subtype anorexia nervosa, bulimia nervosa, and binge-eating disorder and found that overall almost 30 percent of these women reported a history of childhood sexual abuse. History of sexual abuse, however, varied based on eating disorder diagnosis. Specifically, out of the women who did not engage in purging behaviors, that is, those who were diagnosed with restricting type anorexia or binge-eating disorder, about 17 percent reported childhood sexual abuse. However, 34 percent of women who engaged in any purging behavior, which included vomiting and laxative and diuretic use, endorsed suffering sexual abuse as a child.

Treuer et al. reported similar findings in their study of abuse in individuals diagnosed with anorexia or bulimia. They found that 29 percent of individuals diagnosed with anorexia or bulimia had a history of sexual abuse, with the most individuals having a diagnosis of anorexia, binge/purge subtype (38 percent). Interestingly, in contrast with Gerko's findings, Treuer and colleagues reported higher rates of sexual abuse in individuals with anorexia, restrictive subtype compared to individuals diagnosed with bulimia. Carter et al. found that 48 percent of individuals diagnosed with anorexia reported a history of childhood sexual abuse. Of these individuals, 65 percent were diagnosed with binge/purge subtype anorexia, whereas only 37 percent were diagnosed with restricting subtype anorexia.

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