Just like self-harm behavior through cutting, eating disorders have existed in human life since ancient times. In particular, the act of self-starvation dates back to the Middle Ages and even to antiquity.
This issue—being as thin as Twiggy and spending endless hours at the gym—has become a cultural obsession over the past thirty years and has almost reached epidemic proportions.
In the United States, it is estimated that ninety percent of approximately eighty million American women suffer from anorexia, bulimia, or other pathological eating disorders. In reality, concepts such as food and weight occupy a central place in the lives of seventy percent of American women, and the same percentage engage in dieting at some point in their lives.
In studies conducted on college students, two-thirds of the participants were found to be dieting, although only twenty percent of those dieting were actually overweight.
According to findings from numerous studies, eating disorders have been identified in 35% to 80% of individuals who engage in self-harm through cutting. Although the rate varies among studies, 35% is still a remarkably significant figure. This indicates a clear connection between self-harm through cutting and eating disorders (bulimia nervosa and anorexia nervosa).
In studies conducted by Armando Favazza and Karen Centorio, it was observed that at least half of the 240 participants were anorexic or bulimic. In one of Strong’s studies, interviews with individuals who self-harmed revealed that approximately eighty percent of them reported issues such as binge eating or restrictive eating.
Self-harm through cutting has been identified in 25% to 75% of individuals with bulimia.
For example, among well-known public figures, Princess Diana is often cited as someone who struggled with both self-harm and an eating disorder. In the second half of the eighteenth century, Dr. Samuel Johnson—one of the leading figures in literature—was bulimic throughout his life and inflicted physical harm on himself through cutting and beating. Despite his literary success, he suffered from severe bouts of rage, harsh self-criticism, melancholic episodes, and suicide attempts.
His biography reveals that his mother’s strict and punitive attitudes toward sexuality and her pressure to remain “pure” subjected him to psychological torment as a child. Feelings of guilt associated with being sinful were experienced as a form of emotional torture.
Burdened by these painful thoughts and emotions, he harmed himself by cutting his legs. In addition, he engaged in various forms of bodily modification.
In eating disorders, self-harm through cutting frequently accompanies the condition, and the connection between the two is not surprising.
Eating disorders and self-harm through cutting are generally associated with childhood trauma, particularly sexual abuse.
These behaviors serve to reduce psychological tension, manage distress, control anger, loneliness, and emptiness, and prevent dissociation—similar to the dissociative symptoms seen after traumatic experiences.
Self-harm and eating disorder behaviors occur suddenly, secretly, repetitively, ritualistically, and often as a way to cope with guilt and shame. These behaviors help individuals define bodily boundaries. In both self-harm and eating disorders, body image is crucial, as it helps create a sense of bodily boundaries. A common statement among individuals with these conditions is: “Hurting myself helps me feel in control.”
In studies by Armando Favazza, he found that individuals with anorexia and bulimia nervosa frequently engaged in self-harm, often in impulsive (sudden and unplanned) ways.
Behaviors identified included cutting, burning, intermittent alcohol and substance use, kleptomania, and various repetitive forms of self-injury.
Treating individuals with eating disorders can be extremely challenging. The treatment of severe anorexic cases is particularly difficult.
Twenty percent of untreated severe eating disorder cases result in death. Approximately half of these deaths are due to suicide, heart attacks, or other medical complications.
Another shared mechanism between self-harm and eating disorders is that the brain numbs itself in response to external threats. Eating disorders and cutting behaviors induce this numbness.
When individuals recall traumatic memories, they experience fear, sadness, anxiety, and other intense emotions. Cutting, vomiting, or similar behaviors delay the re-experiencing of these memories by creating a sense of numbness under the individual’s control. If individuals can express these emotions in a safe and supportive environment, the trauma can be processed and resolved.
If not expressed, these emotions become suppressed and may manifest as cutting, hitting oneself, carving the body, or burning.
Through behaviors like starvation, cutting, and bodily mutilation, individuals create temporary numbness, distancing themselves from memories—a form of psychological escape.
Sometimes, these behaviors may paradoxically break dissociative states and bring the person back to reality.
The compulsive nature of eating disorders may also have a biological basis. Some experts believe that vomiting and the use of laxatives in bulimia trigger the release of natural opiates in the body, potentially creating biological dependence—thus reinforcing the bulimic cycle.
Based on all of this, one can see that individuals attempt to protect themselves from dissociation and reconnect with reality.
There is little difference between a bulimic patient stabilizing their sense of bodily boundaries through vomiting and an individual creating boundaries by cutting their skin. Losing these boundaries is experienced as the dissolution of the self. These behaviors represent attempts to avoid psychological fragmentation, numb emotional pain, and create distance from traumatic memories.
Although biological factors may partly explain the repetitive nature of these behaviors—such as opiates released after vomiting—the core experience still involves both psychological and physical numbing.
Source
Strong, Marilee A. A Bright Red Scream: Self-Mutilation and the Language of Pain, 1998
