The Connection Between Bulimia and Self-Injury

Contributor: Kelly Kee, MA, LPC, Eating Disorder Specialist, Timberline Knolls Residential Treatment Center

Eating disorders seldom occur independently of other psychiatric symptoms or disorders.

Unfortunately, it is not uncommon for those struggling with an eating disorder to simultaneously engage in other forms of self-destruction.

Connection Between Eating Disorders and Self-Injury

Research has demonstrated a correlation between non-suicidal self-injury (NSSI) and eating disorders, particularly bulimia nervosa. Cutting is the most common form of NNSI, though other behaviors include scratching, burning, hair-pulling, or the consumption of harmful substances or objects.

Self-harming behaviors in the case of bulimia in include self-induced vomiting, laxative or diuretic misuse, excessive exercise, restricting following a binge, or eating until the point of discomfort or pain.

When trying to understand the meaning or connections between someone’s destructive behaviors, determining the function of the symptom becomes essential. Self-harm and eating disorder behaviors serve a purpose for an individual who is experiencing internal conflict. Frequently, they explain that the physical pain inflicted by self-injurious or eating disorder behaviors helps to distract from or numb the emotional pain they may be experiencing.

Underlying Meaning of Self-Harm Behaviors

Others may engage in self-harm behaviors as a way to punish the self in response to feelings of guilt or shame. With this, the individual struggling can often become trapped in a vicious cycle of self-destruction.

For instance, an individual may be experiencing anxiety, and may believe the only method to cope is through binging, which provides a temporary relief. Following the binge and after the instant gratification dissipates, the person may experience immense feelings of guilt and shame as a result of the binging behavior and calories consumed. In another effort to cope with the uncomfortable feelings, the individual may turn to cutting as a temporary escape or manifestation of self-hatred.

Essentially, maladaptive behaviors are utilized as a way to express, change, or suppress unwanted or overwhelming emotions. Those with both bulimia nervosa and NSSI tend to display an inability to verbalize and process emotions, leading them to utilize their bodies as a form of expression.

Along with problems with emotion regulation, those who struggle with bulimia and NSSI commonly display tendencies towards body dissatisfaction, impulsivity, low self-esteem, feelings of emptiness, and cognitive distortions or self-criticism. Other similar underlying conditions include feelings of shame, desire to be perfect or unique, and/or having a lack of trust in the self or others.

Relinquishing the attachment to self-harm or the addictive connections to pain and suffering can be extremely challenging. A comprehensive treatment plan that addresses the co-occurring diagnoses is critical to restoring a healthy mind and body. Different forms of psychotherapy that may be particularly helpful in addressing eating disorders and NSSI simultaneously include individual therapy, dialectical behavior therapy (DBT), and family or group therapy.

A holistic approach to treatment offers tremendous benefits to restoring physical, emotional, and spiritual health.

Community Discussion – Share Your Thoughts Here!

If you have struggled with bulimia and self-harm, what resources were helpful for your recovery?

About the author: Kelly earned her Bachelor of Arts degree in Psychology from North Central College and was awarded her Master of Arts degree in Counseling from Northwestern University in Evanston, Illinois. Kelly spent her practicum year seeing clients at The Family Institute at Northwestern University and went on to complete her internship year at Timberline Knolls with the Eating Disorder Specialist Team. Kelly now works as an Eating Disorder Specialist at Timberline Knolls..

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 January 17, 2017
Published on EatingDisorderHope.com