Medical Trauma and the Roots of Eating Disorders

Migraines, irritable bowel syndrome, and polycystic ovarian syndrome (PCOS) are not just medical conditions. For many, they mark the beginning of a fractured relationship with the healthcare system, one defined by dismissal, invalidation, and years of unanswered questions. These experiences of being unheard or misdiagnosed can leave lasting emotional imprints, shaping how people relate to their bodies and, in some cases, to food itself.

Medical Trauma

Medical trauma can occur when encounters with the healthcare system leave a lasting imprint of fear, shame, or helplessness. This could follow a frightening or painful procedure, but it can commonly come after a misdiagnosis or years of being dismissed by professionals who minimize symptoms. For women and people of color in particular, whose pain is often questioned or attributed to stress, these experiences can erode trust in one’s own body and the people meant to care for it.

I’ve seen this pattern repeatedly among people with eating disorders. When medicine fails to provide relief, and the body feels like an enemy, food becomes the one variable still under personal control. Eating “clean,” cutting out allergens, or fasting can feel like a way to manage what doctors could not fix. Sometimes, dietary changes are prescriptions that come from doctors themselves. Over time, those strategies can solidify into rigid, rule-bound behaviors that mirror the physiological and emotional vigilance of trauma itself.

Research increasingly supports this link. Individuals with histories of medical trauma report higher levels of body mistrust, anxiety, and perfectionism. These are traits that are strongly associated with restrictive eating patterns.

For some, medical trauma leads to a heightened attunement to internal sensations, where every digestive cramp or increase in heart rate feels like a potential warning. For others, the opposite occurs, resulting in a numbing or disconnection from bodily cues. This may have developed as a way to avoid the distress that came with being in a body that is in pain, or being misunderstood or invalidated. Both responses make it difficult to interpret hunger, fullness, and fatigue, laying the groundwork for disordered eating behaviors that feel protective, even rational, in the aftermath of medical harm.

The overlap is also biological. Trauma and stress activate the body’s threat systems, elevating cortisol and disrupting digestion, appetite regulation, and hormonal balance. These same changes can intensify gastrointestinal symptoms or menstrual irregularities, which then prompt additional medical interventions, restarting the cycle of anxiety and control.

Recovery

Recovery can begin when the cycle is named. Recognizing medical trauma as part of a person’s story reframes the eating disorder as an adaptive effort to feel safe in a body that has been medicalized, doubted, or ignored. Healing requires rebuilding trust—not only with one’s own physical signals, but often with the healthcare system itself.

Clinicians can play a pivotal role. Asking about past medical experiences and current symptoms, validating fears of being dismissed, and providing collaborative, transparent care can transform future encounters from retraumatizing to reparative. Integrating trauma-informed principles such as predictability, choice, and empathy helps patients reconnect with their bodies as sources of information rather than danger. When providers approach care through this lens, they can help restore someone’s sense of safety in the medical setting and support the broader goal of rebuilding trust in both the body and the treatment process.