Co-Occurring Self-Harm & Eating Disorders

Various forms of self-harm, such as cutting, scratching, burning, or otherwise causing injury to oneself, often co-occur with eating disorders. In fact, disordered eating is a form of self-harm in itself.

Just as there can be many contributing factors to the development of an eating disorder, there are many reasons someone might engage in self-harm. Examples include to numb, to punish oneself, or to escape. It is possible to silence these urges in recovery and instead embrace self-care.

Prevalence of Self-Harm

A 2002 meta-analysis [1] examined multiple studies on the prevalence of self-injurious behaviors among the eating disorder population.

Researchers reported that these behaviors were found in 25 percent of bulimic outpatient clients, 25 percent of bulimic inpatient clients, and 23 percent of anorexic outpatient clients.

It is vital for primary care physicians and eating disorder clinicians alike to recognize the high prevalence of self-harm among individuals with eating disorders. These behaviors serve a similar purpose to the individual, often providing temporary relief from unwanted feelings.

Health professionals can screen patients for self-harming behavior using the Self-Harm Inventory (SMI). This short, free exam screens for 22 different self-injurious behaviors and identifies whether symptoms of personality disorders might also be present.

Why Self-Harm & Eating Disorders?

Feelings of worthlessness, self-hatred, and isolation often accompany eating disorders. This mindset can trigger a downpour of unhealthy coping mechanisms, including self-harm.

There is a common misconception that self-injurious behavior comes from a desire to commit suicide. While suicide is a very real concern among the eating disorder population and self-harm can certainly be an indicator of suicidal ideation, many individuals who hurt themselves have no desire to end their lives.

Self-harm is often used as an outlet for uncomfortable feelings, similar to the reason people engage in disordered food behaviors. Individuals might hurt themselves to numb or inflict physical pain to lessen their emotional pain. It might also be a form of punishment for perceived flaws or mistakes.

Conversely, self-harm can also be implemented as a means of escaping feelings of numbness or isolation. Feeling pain or seeing the physical side effects of self-harm might help the individual feel more alive.

Treating eating disorders and self-harm concurrently is vital for long-term recovery from both. If not treated together, self-injurious behaviors might spike after eating disorder behaviors have ceased, or vice versa. Replacing one set of harmful behaviors with another is common.

Exploring the Mind-Body Connection

Eating disorders generally lead to an extreme disconnect between mind and body. This disassociation, particularly when combined with the self-hatred that accompanies eating disorders, makes acts of self-harm more common.

By embracing healthy coping tools that encourage the mind-body connection, such as yoga or meditation, individuals in recovery can gain new awareness and respect for their bodies.

A 2005 study [2] examined the difference between self-care versus self-injury in the context of non-traditional piercing, tattooing, and self-harm. Findings concluded that “…piercing and tattooing seem to reflect more self-care, and might protect some patients against more self-harm.”

This does not mean that everyone should run out and get a new tattoo tomorrow, but it is interesting that these often stigmatized acts can actually support self-care in recovery. Improved body image and self-expression might be part of the equation, though this connection needs to be studied further.

When to Seek Help

If you are engaging in disordered food behaviors or self-harm, it is important to seek help immediately. Speak with a trusted friend, counselor, parent, or medical professional.

When you are in the depths of your eating disorder, the scariest thing can be reaching out for help. This is true for a variety of reasons. Even if you know deep down that you want recovery, part of you is likely terrified to give up your disorder.

In recovery, you can develop healthy coping tools to resist urges to engage in your eating disorder or self-injurious behaviors when triggered. With newfound appreciation for your body and soul, you can fully embrace self-care.

There are also many online resources available if you feel unable to reach out to someone in your life at this time. Know that you are not alone, and that treatment options for both self-harm and eating disorders can be highly effective.

---

About the Author: Courtney Howard is the Director of Operations & Business Development at Eating Disorder Hope and Addiction Hope. She graduated summa cum laude with a B.A. from San Diego State University, holds a paralegal certificate in Family Law, and is a Certified Domestic Violence Advocate.

---

References:

[1]: Sansone, R., Levitt, J. (2002). “Self-Harm Behaviors Among Those with Eating Disorders: An Overview.” Eating Disorders: The Journal of Treatment & Prevention. Volume 10, 2002, Issue 3.

[2]: Claes, L., Vandereycken, W. and Vertommen, H. (2005). “Self-care versus self-harm: piercing, tattooing, and self-injuring in eating disorders.” Eur. Eat. Disorders Rev., 13: 11–18. doi:10.1002/erv.612

---

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on December 9, 2016
Published on EatingDisorderHope.com