Monday, September 11, 2017

Sexual abuse creates a hole in the soul of the survivor, and food offers the illusion of filling that void...

The Link Between Childhood Sex Abuse and Food Addiction

Woman looking at pastries in refrigerator

Gabby doesn’t remember if the sexual abuse came first or the eating disorder. “In my mind,” she explains. “They began on the same day.”

Gabby was a champion swimmer who, in her freshman year of high school, began to be sexually assaulted by her long-term swim coach. Now married and a mother of three, Gabby shares, “I thought I was choosing to participate in the relationship. And I thought I was choosing to binge and purge. I realize now I was just trying to control something, since I really had so little control over what was happening to me.”

According to a 2013 study, women who had experienced physical or sexual abuse before the age of 18 were almost twice as likely to have a food addiction in middle adulthood compared with women without a history of childhood abuse. The study, done by Susan Mason, PhD, of Brigham and Women's Hospital and Harvard Medical School in Boston and her colleagues, evaluated 57,321 adult participants by comparing physical and sexual child abuse histories in 2001 and current food addiction in 2009.

In Gabby’s case, the food addiction lasted far longer than the abuse, replacing the original trauma with a lifelong battle against bulimia.

“I still struggle with it,” Gabby admitted. “Even though I have managed to create this incredible life, it feels like the minute something feels out of control, I resort back to my eating disorder. It’s become an old friend at this point, the one thing I can count on to provide me relief.”

For many food addicts, food is comfort. According to Tennie McCarty, founder and CEO of Shades of Hope, an eating disorder treatment center in Texas, “Approximately 30% of people we see have experienced sexual abuse as children, and sometimes there will be other types of abuse, it can be overt or covert sexual abuse. Sometimes it’s emotional. Anything that’s less than nurturing to the child can be a form of abuse.”

As Tennie has seen over the years of treating food addiction and in her own recovery, diet plays a vital role for children growing up in abusive homes or experiencing abusive relationships: “Food is the closet thing to mother’s love. Sexual abuse creates a hole in the soul of the survivor, and food offers the illusion of filling that void. For me, the sexual abuse started very early and so, I had become a food addict by age four. The sexual abuse creates a real emptiness in the person and the food fills it up.”

According to the 2013 Harvard Study, these issues become compounded when people have experienced multiple forms of abuse, “The likelihood of food addiction was increased even further for women who had experienced both physical and sexual abuse in childhood. The food addiction prevalence varied from six percent among women without a history of physical or sexual abuse to 16 percent among women with a history of both severe physical and sexual abuse.”

But despite the study’s focus, food addiction doesn’t only affect women. Paul was six-years old when he was first sexually assaulted by a neighbor. “Up until that point, I had just been a normal, curious kid, running around the neighborhood, enjoying life,” Paul shares.

But then the first rape occurred, and everything changed. “I didn’t get an eating disorder right away. I remember being a normal-sized kid, but then a couple of years later, that neighbor caught me again. The following year, we moved away and that’s when my relationship with food began to change. My mom would go out all night, and so I started overeating when I was home alone. She would let me get whatever sugary foods I wanted at the grocery store. I would eat whatever I wanted when I wanted. I would go to the pantry for love, and I started gaining weight."

For many food addicts, the link between their eating and the trauma they experienced in childhood isn’t a clear one. The bulk of their work at Shades of Hope is around helping people to see how their relationship with food is rooted in childhood traumas and other ongoing abuse. As Tennie explains, “One of the things we have them to do is write a very detailed history of their eating disorder, how they use food, and then alongside that, we ask them to write an autobiography. They begin to see the truth come out around the history of their eating disorder and the history of their life. It’s important for them to get the stories straight – and to see how the abuse affects them today.”

As Tennie shares, food is often the safest way for folks to self-medicate, at least when they are younger, and don’t see its consequences as starkly, “A lot of times the abuse will start early on, and had that person been using any other substance, they would be dead by now. We do a lot of work around shame, because they use the food to ease the shame. It’s important for people to be able to say out loud I am a survivor of childhood sexual abuse and I have no shame.”

Paul spent decades unaware of how his food--and later alcohol and drug -–addictions were related to the abuse and neglect of his childhood, “By the time I was 13 or 14, I went back down in weight again. Later, I found diet pills and that helped for a few years too. But then I got married, I ended up taking on a really stressful job, and [I became] a drug addict. I don’t think I was ever [cognitively aware] enough to understand my relationship with food. I knew it was stress related, but I just couldn’t change my behaviors, even after my wife left me, and even years later, after I had gotten sober from drugs and alcohol.”

As Tennie explains, food can be one of the hardest addictions to treat. “With drugs or alcohol or gambling addiction, you can put the tiger in the cage and not let him back out,” she shares. “But with food, you have to take that tiger out of the cage and walk it around your kitchen three times a day. At Shades, we see it as an addiction and we treat it as an addiction, which means like all addictions, we can recover. It doesn’t have to be a lifelong battle but it does have to be a lifelong recovery.”

For Paul, that recovery hasn’t always been easy. After recently completing a stint at a long-term food treatment program, he found himself relapsing after only a couple of weeks, “I know I’m still out of control with food. I am choosing not to go to the OA meetings, I am choosing not to see the dietician.

Right when I got back from food treatment, the PTSD and panic disorder got stirred up. In two weeks, I started eating again. It’s like I need the food so bad right now, and once I start, I can’t stop.”

After years of struggling, Tennie was finally able to get abstinent around her own food addiction, building much of the program she offers to others based on her own success, “It’s like diabetes. You will always have diabetes even after you recover, but that doesn’t mean you can’t have a long and healthy life. I’ll soon have 32 years free from compulsive eating. The working part of recovery becomes a working part of your life, just as the addiction once was. That is why it is so important to work on that core pain, at the same time [you] work on your eating disorder. Because you will always go back to the food if you don’t do both.”

According to Dr. Mason, there are ways to recognize the signs of disordered eating and trauma, and to start early treatment before someone is battling a lifelong addiction, "Women with histories of trauma who show a propensity toward uncontrolled eating could potentially be referred for prevention programs, while obese women might be screened for early trauma and addiction-like eating so that any psychological impediments to weight loss could be addressed."

Mason shares that like most disorders, prevention is always the best course. "Of course, preventing childhood abuse in the first place would be the best strategy of all, but in the absence of a perfect child abuse prevention strategy, it is important that we try to head off its negative long-term health consequences.”

Gabby can’t help but wonder what might have happened had she never been abused by her swim coach, “So much of my life has felt like before and after that time, as though my life had been whole and solid, and then at fourteen, it became broken. I have worked hard to try to fix that break, but that doesn’t mean I’m perfect at it. I’m not sure I’ll ever be.”

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