Understanding the Connection Between Dissociation and Eating Disorders
Blog Post by Contributing Editor Megan Samuels, MSW, LCSW-C
When people think about eating disorders, they often focus on food, weight, or body image. However, for many individuals, eating disorders are deeply connected to trauma, emotional overwhelm, and dissociation. Understanding dissociation can help explain why eating disorder behaviors can feel so automatic, difficult to stop, or disconnected from conscious choice.
What is dissociation?
The Latin root of the word dissociate means “to sever” or “to separate.” Dissociation involves a disconnection from oneself, emotions, memories, bodily sensations, or the world around you.
Dissociation exists on a spectrum and is actually part of normal human experience. Many people have experienced “highway hypnosis,” where they arrive somewhere and realize they do not fully remember the drive. Others may become so absorbed in a movie or scrolling on their phone that they temporarily lose awareness of time or their surroundings.
More severe forms of dissociation can interfere with daily functioning, emotional regulation, memory, identity, and relationships. Dissociation is especially common among people who have experienced trauma, chronic stress, abuse, neglect, or emotionally overwhelming experiences.
Importantly, dissociation is not something people consciously choose to do. It is often an automatic survival response from the nervous system.
Dissociation as a Survival Response
When experiences become too overwhelming emotionally, psychologically, or physically, the brain and body may create distance from those experiences in order to survive them. Dissociation can help a person continue functioning in situations that feel unsafe or intolerable.
For example, if someone grows up in an environment where emotions feel dangerous, unpredictable, or unsupported, disconnecting from emotions may become protective. If someone experiences trauma or chronic stress, dissociation may help them separate from fear, shame, pain, or helplessness in order to cope.
In this way, dissociation is often adaptive. It develops because it helps the nervous system survive overwhelming experiences.
However, while dissociation may begin as protection, it can later create difficulties with emotional awareness, relationships, body awareness, and self-regulation.
The Connection Between Dissociation and Eating Disorders
There is a growing body of research suggesting strong links between trauma, dissociation, and eating disorders (Rabito-Alcón et al., 2021). For some individuals, eating disorder behaviors develop alongside dissociation as ways to cope with overwhelming emotions, painful memories, stress, or nervous system dysregulation.
When someone dissociates, they may disconnect from emotions, bodily sensations, hunger cues, fullness, pain, or internal awareness. Eating disorder behaviors can then become attempts to regulate what feels emotionally unbearable or disconnected.
For example:
Restriction may create numbness or emotional distance
Binge eating may temporarily soothe distress or help someone “check out” emotionally
Purging may provide a temporary sense of release or relief
Compulsive exercise may help someone avoid emotional experiences or stay disconnected from bodily sensations
Eating disorder behaviors are often misunderstood as being “just about food” or appearance. In reality, they are frequently connected to emotional regulation, nervous system survival, control, safety, and dissociation.
Disconnecting from the Body
One of the most significant overlaps between dissociation and eating disorders is disconnection from the body.
For many people with eating disorders, the body may not feel like a safe place to exist. Trauma survivors, in particular, may learn to disconnect from bodily sensations because the body became associated with fear, shame, pain, vulnerability, or overwhelm.
This disconnection can show up in several ways:
Difficulty recognizing hunger and fullness
Some individuals struggle to recognize when they are hungry, full, tired, dehydrated, or physically unwell. They may unintentionally go long periods without eating because they feel disconnected from internal body cues.
Others may eat past fullness because they are unable to stay connected to physical sensations while eating.
Ignoring pain or physical distress
Dissociation can reduce awareness of pain, fatigue, injury, or physical limitations. Someone may continue compulsive exercise despite injury or physical exhaustion because they feel disconnected from bodily sensations.
Feeling emotionally numb while engaging in behaviors
Many people describe feeling emotionally disconnected or “checked out” during eating disorder behaviors. Binge eating episodes, restriction, purging, or compulsive movement may feel automatic or trance-like.
Some individuals report losing track of time while engaging in eating disorder behaviors or feeling detached from themselves during the experience.
Distorted body awareness
Dissociation can also contribute to feeling disconnected from one’s physical self or appearance. Some individuals describe looking in the mirror and feeling unfamiliar with their body, disconnected from what they see, or unable to accurately perceive themselves.
Eating Disorders as Adaptive Survival Responses
Eating disorders are often adaptive survival responses, not simply behaviors to eliminate. While eating disorder behaviors can become dangerous and harmful over time, they frequently develop because they serve a psychological or emotional function.
For some people, the eating disorder may:
Create a (false) sense of control during chaos
Numb painful emotions
Provide predictability or structure
Help avoid traumatic memories or emotions
Reduce anxiety temporarily
Create disconnection from the body or emotional pain
Serve as a coping mechanism for overwhelming stress
Understanding the function of the eating disorder is an important part of treatment. When eating disorder behaviors are viewed only as “bad behaviors,” the deeper emotional and nervous system needs underneath them may be missed.
A therapist who specializes in both trauma and eating disorders can help uncover the role the eating disorder has played in someone’s life while also helping develop safer and more sustainable coping mechanisms.
Healing from Dissociation and Eating Disorders
Healing from dissociation and eating disorders often involves much more than changing eating behaviors alone. Recovery may also include rebuilding safety in the nervous system, increasing emotional awareness, processing trauma, and reconnecting with the body in manageable ways.
For many individuals, reconnecting with the body can feel frightening at first. If dissociation developed as protection, becoming more emotionally or physically present may initially feel uncomfortable or unsafe. Because of this, trauma-focused treatment is often an important part of eating disorder recovery.
Therapy may help individuals:
Understand the purpose dissociation and eating disorder behaviors have served
Recognize triggers for dissociation or eating disorder urges
Build emotional regulation skills
Increase awareness of bodily sensations and needs
Develop grounding techniques
Process unresolved trauma safely
Build a more compassionate relationship with themselves and their body
Recent research and specialized training have helped many therapists who treat both trauma and eating disorders better understand the complex relationship between trauma, dissociation, and eating disorders. Rather than treating these experiences separately, many therapists now approach them as interconnected parts of someone’s survival system.
The good news is that healing is possible. With support, individuals can learn new ways to regulate emotions, reconnect with their body, and feel more present in their lives and relationships. Help is available.
If you or a loved one is struggling with an eating disorder, trauma, or dissociation, help is available.
Megan Samuels, MSW, LCSW-C
About the Author: Megan Samuels, MSW, LCSW-C is an eating disorder and trauma therapist practicing in Maryland and Virginia. She offers therapy for teens and adults, focusing on the intersection of trauma (including complex trauma and dissociative disorders) and eating disorders. Megan uses EMDR therapy, DBT, relational therapy, and ego state therapy to help clients heal. She is passionate about providing compassionate and supportive care for folks struggling with an eating disorder and/or trauma.