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What is the link between domestic abuse and eating disorders?

I work in domestic abuse perpetrator services within FearLess, though my other passion is working with people struggling with food and body image. In this blog, I wanted to share how these two worlds (domestic abuse and eating disorders) intersect, from my experience. These views are my own.

What is disordered eating?

Disordered eating can refer to eating problems that lie outside of diagnosed eating disorders, which can include a vast array of eating/body distress such as restricting, calorie counting, binging, yo-yo dieting, over-exercising, and more. Eating disorders NHS services are over-stretched, and it can be difficult for many to get a diagnosis. Many people also face social and cultural barriers, and stigma and shame, and minoritized groups often face the most barriers. Weight stigma influences who get treatment, highlighted by Hope Virgo with her “Dump the Scales” campaign, pushing back against the “not thin enough” narrative sadly heard by many people struggling with eating. As Hope says in this article, only 6% of people with an eating disorder are underweight. Counter to the stereotype of the thin teenage girl with anorexia, most people with eating disorders are at higher weights (Duncan et al, 2017). This has a tremendous impact on how we as a society view eating disorders, and there is currently a huge amount of unmet need for help.

Whether people gain a diagnosis or not, disordered eating and body image concerns have a huge impact on mental health and everyday life, and those struggling are very much deserving of help irrelevant of size or shape.

What is weight stigma?

Weight stigma stems from the biases people hold toward those at higher weights, and the discrimination subsequently experienced by those people. It also impacts those who are not in larger bodies as it reinforces a fear of fatness, sometimes called fatphobia.

The quest for weight loss due to the idea that being thinner is healthier is widespread in our society. Food is labelled “good” and “bad” and in turn, we as humans can be too – moral value is placed on ourselves if we eat something “bad”, so it turns into “I am bad”, which has a huge impact on self-esteem. When people say we live in a “diet culture” it usually means that we’ve normalised dieting and restriction of food, in fact… not only normalised but celebrated. However, there is very little evidence to show that diets lead to lasting weight loss or health benefits (Mann et al, 2007). Weight stigma has shown to be a stressful experience which impacts mental and physical health, and can shorten life expectancy (Sutin et al, 2005). In short, weight stigma is a big part of the issue.

Although not all disordered eating stems from a drive to lose weight, the idealization of thinness is the best-known environmental contributor to the development of eating disorders (NEDA, Culbert et al, 2015). There are many other contributing factors to disordered eating and body image problems, including trauma, abuse, poverty, discrimination, and there are genetic factors too. A factor which can also play a part in the development of disordered eating is domestic abuse.

Coping strategies

Disordered eating and body image problems can be a form of coping, to try and regain control when other aspects of life feel out of control and there is a need to feel safe. There is a metaphor used by Dr Anita Johnston which tells the story of falling into a fast-flowing river and grabbing onto a log. The log is saving your life so you cling to it, but then you reach calmer waters and there are people on the riverbed who want to help you get out. But you can’t let go of the log, because it’s your lifesaver, even though a part of you really wants to let go. This can often resonate with people in what it feels like to experience disordered eating, when one part of them wants to break free of it, but the other is clinging for dear life. This could also describe the difficulty of wanting to leave an abusive relationship, but it being so scary to do so.

The abusive voice

Many people with eating disorders speak of the “anorexic voice” or “eating disorder voice”; the critical thoughts that shame them and tell them what to eat/what not to eat. This voice, many say, is like an abusive partner (or parent) in their heads. This part can’t just be switched off because it may be deeply rooted in narratives and patterns of behaviour stemming back for a long time. Shame plays a big part in both disordered eating and domestic abuse. Take a basic binge and restrict cycle for example:

(copyright Mel Ciavucco, 2023)

A person who is trying to reduce their food intake (calorie counting, dieting etc) may, for example, tell themselves that they are not allowed chocolate. This in turn may make them want chocolate even more, and have cravings, then evitably give in and eat all the chocolate in the house and be hit by a wall of guilt and shame. Then comes the “diet starts Monday” mentality, and it happens all over again. And people always blame themselves, never the diet (which is of course how diet companies make their money!) This shame cycle can be similar to how perpetrators feel when they relapse when going through a perpetrator programme, and it may be similar to the feeling of trying to leave an abusive relationship. It’s a tough cycle to break, but this is where domestic abuse services, perpetrator programmes, counselling and other forms of support come in. We help people to start breaking free from these cycles.

If you struggle with eating or body image, the first thing to know is that you deserve help. It’s not silly or too minor, if it’s causing you any anxiety or distress at all, you’re worthy of help. Looking at how the disordered eating is serving you, where and when it developed, and developing new ways of coping will all be part of helping and supporting you to take steps towards recovery from disordered eating.

Find help for disordered eating

BEAT Helpline: 0808 801 0677 https://www.beateatingdisorders.org.uk/

First Steps ED: https://firststepsed.co.uk/services-and-support/ (counselling, befriending, groups, workshops and more)

www.melciavucco.com – Counselling and Training

Online Events training in disordered eating and body image: https://www.eventbrite.co.uk/e/introduction-to-body-image-and-disordered-eating-mel-ciavucco-tickets-681435851977?aff=ebdssbdestsearch&from=03d9311c2ca211eeb42a86b5ef95b1e1


Duncan, A. E. et al. (2017). The Prevalence of Past 12-Month and Lifetime DSM-IV Eating Disorders by BMI Category in US Men and Women. European eating disorders review: the journal of the Eating Disorders Association, 25(3), 165–171. https://doi.org/10.1002/erv.2503

Guardian (2021) Hope Virgo: the woman who survived anorexia – and began Dump the Scales, Zoe Williams, https://www.theguardian.com/society/2021/jul/07/hope-virgo-the-woman-who-survived-anorexia-and-began-dump-the-scales

Mann, T., Tomiyama, A. J., Westling, E., Lew, A.-M., Samuels, B., & Chatman, J. (2007). Medicare’s search for effective obesity treatments: Diets are not the answer. American Psychologist, 62(3), 220–233. https://doi.org/10.1037/0003-066X.62.3.220

NEDA, Statistics & Research on Eating Disorders, https://www.nationaleatingdisorders.org/statistics-research-eating-disorders

Sutin, A. R., Stephan, Y., & Terracciano, A. (2015). Weight Discrimination and Risk of Mortality. Psychological science, 26(11), 1803–1811. https://doi.org/10.1177/0956797615601103

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