PTSD, a link between abuse and future eating disorders

In my last post, a researcher found a more specific predictor of binge eating disorder (and other conditions) than most people would have assumed. In this post, the researcher is Timothy Brewerton, a psychiatrist in South Carolina, and he spoke on trauma.

It’s a truism that sexual and other forms of abuse are a strong trigger of eating disorders, but Brewerton’s research refines that point to say that women who develop post-traumatic stress syndrome as a result of abuse are more likely to develop eating disorders than those who suffer abuse but don't develop PTSD. That argues for clinicians to remain aware of PTSD as a predictor of a future eating disorder. 

Brewerton followed his trauma findings by raising the issue of food addiction, which he believed in enough to broach the subject but not enough to use the term without quote marks. As preamble, he referenced the Mark Gold/Kelly Brownell-edited book “Food and Addiction,” which came out in October, and gave a bit of history of the term, whose first appearance in medical literature came in 1956.

As one completely convinced on food addiction, I found his comments fairly measured, saying researchers should investigate which foods have the greatest addictive potential, and what increases food’s addictive nature. He pointed out that foods are being processed to increase their “reward potency,” including the rate of absorption of fat and sugar. “Just like in drugs of abuse, rapidity of absorption is a key factor in addiction,” such as in the chewing of coca leaves vs. the processed version, cocaine, he said.

Nevertheless, Brewerton was quickly assailed by the audience, which raised several objections consecutively; one questioned called it a “pseudo-addiction.” To another, Brewerton pointed out the breadth of individual differences within a diagnostic category, which “definitely goes against the doctrine that no foods are bad, all foods are good. I don’t think that’s true for everyone.”

Cynthia Bulik, of the University of North Carolina and BEDA’s chief science advisor, who moderated the panel, backed Brewerton’s take when an audience member brought up Michael Moss’s New York Times Magazine article on Big Food’s manipulation of food formulas to make them hyperpalatable. “It was a brilliant article. We’re in a similar situation with the tobacco industry when they knew quite well it was harmful and researchers were running behind. They are so far ahead of us technologically.”

After a panelist referenced cognitive-behavioral therapy as a treatment for eating disorders, Brewerton agreed wholeheartedly, but added, “We have to do CBT on ourselves and be aware of our own distortions and biases. One of the most common distortions is all-or-nothing thinking.”

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