Eating disorders as a repercussion of sexual assault, a consequence to consider

Abstract Purpose This study aims at clarifying the links between sexual violence and eating disorders (EDs). Methods In a sample of 12638 victims of sexual violence, we analyzed the situation of 546 victims that declared having developed ED. We assessed the characteristics of the assault (age, type of aggression) and the medical consequences (PTSD, depression, suicide attempts, anxiety disorders …). Results ED prevalence was 4.3% in the victim sample. The age of the first assault in ED victims was significantly lower than that of the whole population (12y vs 16 y for median; p<0.001). A much higher prevalence of sexual assault consequences was present in victims developing ED with odd ratios (OR) for: self-mutilation (OR = 11.5 [8.29-15.95], p<0.001); depression (OR=5.7 [4.81-6.86], p<0.001); self-medication (OR = 5.3 [3.86-7.19], p<0.001); suicide attempts (OR =4.5 [3.59-5.67], p<0.001); Post-traumatic stress disorder (OR = 3.8 [2.99-4.78], p<0.001) ; anxiety troubles (OR = 5.2 [4.11-6.47], p<0.001); alcoholism (OR =4.0 [2.81-5.58], p<0.001). Conclusion This study confirms the link between ED and sexual violence, especially in childhood, leading to severe psychological consequences. In this context, ED should be envisaged as a coping strategy accompanying emotional dysregulation due to traumatic events, and be treated as such.