A Toxic Relationship: Eating Disorders and Violence

By Hattie Rowe

West Virginia University

*Trigger Warning. Discussions of Intimate Partner Violence, Sexual Assault, and Eating Disorders*

You may have heard of the nature vs. nurture debate. Some people say that our genetics and biology are what make us who we are. Others say that our environment shapes us to create the person we are. Researchers have applied this theory to the development of eating disorders.

The roots and causes of eating disorders are a widely debated and researched subject. While there is evidence that a person’s genes can predispose them to an eating disorder, there is also evidence that shows how disordered eating problems could occur as a response to sexual abuse (Chen, et al., 2010).   

What is sexual violence? And what does it have to do with eating disorders?

Sexual violence means that “someone forces or manipulates someone else into unwanted sexual activity without their consent,” as defined by The Rape, Abuse & Incest National Network (RAINN) (rainn.org).

Studies have shown a relationship of eating disorders forming as a result of sexual violence. Sexual violence can happen to anyone, but most frequently occurs to women between the ages of 18 to 34 (rainn.org). This is a similar age bracket to the average population of people with eating disorders, which typically affects women in their early teens into young adulthood (National Institute of Mental Health, 2016).

What is Intimate Partner Violence (IPV)?

Intimate partner violence (IPV), sometimes known as domestic violence, is a common

threat to men and women. The Centers for Disease Control and Prevention in the United States defines Intimate Partner Violence as: “abuse or aggression that occurs in a close relationship.” An intimate partner refers to both current and former spouses and dating partners (CDC, 2019). IPV can vary in how often it happens and how severe it is. “It can range from one episode of violence that could have lasting impact to chronic and severe episodes over multiple years.” (CDC, 2019)

Crimes committed by intimate partners often go unreported. As for the information that has been contributed to our base of knowledge over the years, the statistics offer alarming insights. Over half of reported female rape victims said that an intimate partner was responsible (CDC, 2011). Nine percent of homicides are committed by intimate partners (NCRJS, 2018). The psychological and behavioral consequences of these experiences are numerous. One of these consequences is that victims of IPV have reported experiencing disordered eating patterns (Wong et al., 2016).

Eating Disorder Effects

Use of food is a common coping mechanism used by victims of sexual violence. Strictly managing food intake is a way that a victim can feel in control over their body. Or possibly bingeing on large amounts of food falsely eases psychological burdens for a brief moment. Obsessions with food and body become a problem that impedes on the everyday life of a victim. 

Victims of sexual violence often undergo a process of healing physically and mentally. Due to the physical toll that eating disorders take on the body, eating disorders may cause a disruption in the healing process. 

Physical consequences of eating disorders include, but are not limited to:

  • Tooth decay
  • Sore throat
  • Sleep problems
  • Lowered sex hormones
  • Dropped body temperature
  • Constipation
  • Stomach rupture
  • Esophagus rupture
  • Bone loss
  • Decrease in white blood cell count 

The mental effects of sexual violence and IPV can include:

  • Eating disorders
  • Trauma
  • Depression
  • Dissociation 
  • Sleep disorders 
  • And more 

Getting professional care for the psychological effects of abuse is just as important as

healing from physical abuse. This can help prevent the onset of eating disorders and other mental health problems that occur as a result of sexual abuse. Seeking helpful services can include receiving trauma informed care/practice and becoming aware of resources for eating disorders, IPV, and sexual violence available in your area.

Pregnancy and Abuse

A 2015 study found that women who have eating disorders are at an increased risk for IPV during pregnancy (Kothari, 2015). Further research is needed on this subject, but it is important to note that rates of perinatal IPV range from 3.7% to 9% and are associated with mental and physical problems for both the parent and child (Hahn, Gilmore, Aguayo, and Rheingold, 2019). Sometimes pregnancy may occur from reproductive coercion. For instance, if one partner wants to have a child and the other does not. Pregnancy can also occur as a result of sexual assault.

Whether it was an isolated event, or if your partner is currently or has a history of being abusive, it is important to have a plan moving forward. Making a plan for maintaining good physical and mental health during pregnancy is crucial. The changes happening to the body and healing after sexual violence are a lot to handle at once. Preparing helps keep you focused on your goals throughout and after your pregnancy and also can help keep you and your baby safe. 

Visit https://www.thehotline.org/is-this-abuse/pregnancy-abuse/ for detailed information on safety plans during pregnancy.

Resources for help: 

  • National Sexual Assault Hotline: 1 (800) 656-HOPE (4673)
  • National Domestic Violence Hotline: 1 (800) 799-7233
  • National Eating Disorder Helpline: 1 (800) 931-2237


Black, M. C., Basile, K. C., Breiding, M. J., Smith, S .G., Walters, M. L., Merrick, M. T., Stevens, M.

  1. (2011). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 

summary report. Retrieved from the Centers for Disease Control and Prevention, 

National Center for Injury Prevention and Control:


Brewerton, T.D., Alexander, J., Schaefer, J. (2018). Trauma-informed care and practice for eating disorders: Personal and professional perspectives of lived experiences. Eating and Weight Disorders, epub ahead of print.


Chen, L.P., Murad, H., Paras, M.L., Colbenson, K.M., Sattler, A.L., Goranson, E.N., … Zirakzadeh, A. (2010). Sexual abuse and lifetime diagnosis of psychiatric disorders: Systematic review and meta-analysis. Mayo Clinic Proceedings, 85(7), 618-629. 

Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, National Crime

Victimization Survey, 2018 (2019).


Christine K Hahn, Amanda K. Gilmore, Rosaura Orengo Aguayo, Alyssa A. Rheingold. (2018). 

Perinatal Intimate Partner Violence. Obstetrics and Gynecology Clinics of North America,

45(3): 535–547. doi: 10.1016/j.ogc.2018.04.008