‘I used food as a reward but I’ve used it to punish myself too’ – How trauma leads to obesity
Studies link obesity and binge eating to adverse life events or trauma, and experts agree that the underlying causes of obesity must be addressed in order to promote health and wellbeing, especially amid a global pandemic, writes Jamaine Krige.
“I’m three years old and I’m crying… That’s my earliest memory of food… and I’m crying because my mom has food but she won’t give it to me because I’ve been naughty.”
For as long as she can remember, 28-year old **Crystal Harris has had a difficult relationship with food. It was about a decade ago when she worked herself up to go shopping. None of her clothes fit anymore – she thought she might have gained a size. “I gave myself this pep talk that even if I wasn’t a size 14 anymore, a 16 wouldn’t be that bad… But when I got to the stores a 16 wouldn’t fit either. I was too scared to try an 18 in case it would be too small too…” She cried all the way home. For a week she consumed nothing but rooibos tea. She gained 2kg regardless and decided to consult a dietician. Within a year she had lost 22kg.
A few months later: “Those kilos were back and they had brought their friends!” She was topping the scale at 112kg.
“I used food as a reward but I’ve used it to punish myself too. You don’t get food when you’re naughty. Unless you do,” she laughs at the contradiction. “Sometimes when I was punished I’d cry and my gran would give me sweets to make it stop.” Her mother and her grandmother raised her. The tears came often in her younger years, but eventually stopped. When the beatings became unbearable, not crying was the only control she had.
Softening the trauma
In cases of physical abuse, being overweight has a physically protective function – it cushions the blows. The punches and kicks land ‘softer’. If you’re thin, Crystal says, everything hurts more.
Physical abuse rarely comes without the emotional equivalent. Her mother would often brag about not having eaten all day. If her daughter ‘indulged’ in a soft drink at school, Crystal would be forced to run in front of a moving car to ‘work off’ the sugar she had consumed. “In my family, you can be a lot of things, but being fat is the cardinal sin. I internalised that,” she admits.
“I guess my relationship with my mother is my trauma,” she explains. “People think she’s vindictive or malicious, but she’s not. She’s just inherently self-centred. And she’s an addict,” she adds, almost as an afterthought.
When she was ten and her age 8-9 jeans no longer fit her, she was put on a diet. Bigger jeans were not an option. “At one stage I stopped listening to those external voices, but my internal voice took the same tone, saying the same things; my abusers left but I took their place.” She can recognise that voice for what it is now: “She’s my eating disorder voice and she’s a nasty bitch. She rarely shouts – she whispers but what she says is so easy to believe.”
She was first sexually abused at age nine, and again at age twelve. The perpetrators – her step-brother and later her step-father – initiated a pattern of abuse that continued throughout her teen years. Perhaps, she thought, if she was less attractive, they would show less interest.
Her journey with bulimia started in her late teens, persisting into adulthood. Yet she kept gaining weight. “It’s funny; people always think you reward yourself with food, and punish yourself by withholding, but that’s not always the case. You can punish yourself by eating as well.”
Crystal knows nobody is born with an unhealthy relationship with food. “A baby stops eating when it’s full,” she acknowledges. “Our unhealthy behaviours with food are learnt, and I realised that my body thinks that in order to be safe, I need to be fat.”
StatsSA’s Demographics and Health Survey found that nearly 70% of South African women and 31% of the country’s men are overweight obese, the highest prevalence in Sub-Saharan Africa according to the World Health Organisation.
Trinette Raats is a registered clinical dietician. “People who suffer from depression or anxiety, or who have experienced a trauma often neglect their body’s needs,” she explains. “Trauma leaves some people with no appetite, while others go on binges or develop cravings for sugar.”
According to the British Nutrition Foundation, between 20 and 30% of all obese people suffer from binge eating disorder, with women disproportionately affected. “Binge eating episodes are associated with eating more rapidly than normal, eating until you feel uncomfortably full, eating large amounts even when you’re not hungry, eating alone, feeling embarrassed about how much you’re eating, or feeling disgusted, depressed or guilty because of overeating,” Raats explains.
Raats says the link between obesity and trauma is not just a psychological one – it’s a chemical one too. Stress hormones like cortisol can increase feelings of hunger and promote weight gain and fat storage, especially in the abdominal area, while carbohydrates boost serotonin. “Serotonin is involved in the control of moods and behaviour,” she says. People with depression may develop cravings for starchy foods or sugars as their body tries to boost serotonin and dopamine levels.
“Emotional factors influence our hormones,” Raats explains. “With a permanently stressed life, the adrenal glands, which produce the stress hormones epinephrine or adrenaline, and norepinephrine or noradrenaline, and cortisol – well they get ‘exhausted’ and this can set off a chain of events that may produce weight gain.”
To combat the traumas and obesity, a holistic approach is needed. “In our first consultation, a thorough physical, medical and psychological assessment is done. High-risk patients will be referred to a psychologist,” explains Raats.
Linde Viviers is a clinical psychologist at Akeso Crescent Clinic’s Eating Disorder Unit. “The function of the binging and purging serves as a way to blunt or escape, or possibly avoid the emotions triggered by the trauma and can lead to weight gain,” she explains. Certain traumas can lead to low self-esteem or a sense of unworthiness, which in turn leads to a lack of self-nurturance and can manifest in eating disorder behaviours.
She says while many eating disorders have their root in trauma, this is more likely to be the case when it comes to binge eating or bulimia. “It may sometimes be the case with Anorexia Nervosa, however this disorder can be influenced by other factors like personality, adolescent development and family dynamics.”
Any trauma directed to the body – sexual abuse, neglect and physical abuse – can impact on eating and weight. “During sexual trauma, the victim disconnects from her or his body to survive the very act of abuse, and their body becomes the object of self-hate which needs to be punished or abused,” Viviers explains. “Carrying excess weight may function to protect the individual against further trauma, because becoming obese may be seen as ‘being less attractive on a sexual level’, protecting against future trauma.”
She says survivors of childhood sexual abuse or violence often struggle with healthy sexual intimacy in appropriate adult relationships. Being overweight becomes a way to avoid appropriate sexual relationships. The mantra: “I will be rejected because I am fat.” Viviers says a person’s excess weight becomes a ‘boundary’ that they don’t need to actively enforce. The weight “may protect us from confronting what we are trying to avoid.”
Crystal can relate to this. “I would self-sabotage,” she admits. “Theres a belief that the only way to get love is if I’m beautiful… and the only way to be beautiful is to weigh X,” she shrugs. “But if I don’t then it’s okay that nobody loves me, because I’m actually fundamentally unlovable.”
But when should you seek help? How many extra kilos are too many? According to Viviers, if your eating negatively impacts your health, social interactions and relationships, self-esteem, emotional well-being or occupational functioning, it is a cause for concern.
“An eating disorder cannot be ‘cured’ after treatment, but the individual can be empowered and supported to manage the disorder to live a healthy life,” Vivier explains. “In my opinion, weight loss won’t occur if the underlying psychological issues are not confronted and addressed, because the behaviour and the weight fulfil a function. The process of weight loss may be a healing process – a letting go of the trauma.”
Lilith Walliser is a hypnotherapist and life coach who has been helping Crystal deal with her unhealthy eating habits. She says when it comes to obesity people lose weight – but not for long. This is because they deal with the symptom, which is excess weight, but not the cause. “Until they deal with that the weight will keep coming back, and the whole cycle starts again.”
Walliser is fascinated by how powerful the associations a human mind makes can be. “It’s such an amazing thing – our brain connects the dots. The problem is these associations are not always correct,” she laughs. A person may become deathly ill and lose a lot of weight. When they recover their weight normalises and people praise this. “They say how good and healthy you look, how amazing your recovery is. You’re feeling better too and somehow your subconscious makes an error in association – it connects gaining weight to being healthy and feeling better, and losing weight to being terribly ill.”
“If your subconscious has a desire and your conscious mind has a desire and those two desires don’t align, the subconscious always wins,” Williser explains. “You might really want this, but if your subconscious thinks it’s a bad idea, for whatever reason, it won’t work.”
A changing relationship with food and herself
With Walliser’s help, Crystal is leading a healthier life. “I wish I could say that someone waved a magic wand and I was healed,” Crystal laughs. “I live under no illusions as to how I look and I’m aware that even after all this work, I’m overweight.” It irritates her when people try to placate her. “They’ll tell me I’m not but that’s like telling me I have straight hair,” she says as her hands brush the hair away from her face – a face with full lips and beautiful laughing almond eyes, framed by dark lashes and an abundance of bouncy black curls. “Yes I have curly hair, and yes I’m overweight, but it’s not a sin and it’s not a crime and it’s not all that I am; it’s just a part of me. It’s not my defining characteristic. I’m working at being happy and healthy, and that is enough.”
Her relationship with food and her body has changed. “I now see food as a way to nourish my body and reward it for all the good it has done for me. I mean, we’ve made it this far,” she laughs again. “I realise it’s not me against my body anymore and it’s not me trapped in this body that refuses to cooperate; me and my body, we’re actually a team.”
Her advice to others who want to start on this journey: it’s going to be hard; but it’s also going to be worth it. “Not because you’ll be thin; it’s worth it because you are. You are worthy of eating something without feeling like a failure. You are worthy of the effort and love. Today I can say I deserve to be loved, but more than that I deserve to love me and this body.”
Crystal stares at a spot on the wall. “I’m not the same person I was when I was four or nine or 12 years old.” Her gaze returns to the present. “And when I’m 38 I’ll hopefully not be the same person I am today. And maybe it’s time that my coping mechanisms change with me.” – Health-e News
*Not her real name