How is BPD linked with Eating Disorders? All you need to know

A Quick Guide

Borderline personality disorder (BPD) and eating disorders regularly co-occur, but until recently, very little was understood about how they relate to one another. Recent studies have shed light on how frequently BPD and eating disorders co-occur, how they might be associated, and how to manage them when they do. In this article, we will discuss the link between BPD and eating disorders.

Prevalence Rates of BPD & Eating Disorders

The National Association of Anorexia Nervosa and Associated Eating Disorders reports that:

In the US, there are at least 30 million individuals with eating disorders of all ages and genders. At least one person passes away as a direct consequence of an eating disorder every 62 minutes. Of all mental illnesses, eating disorders have the largest fatality rate.

Numerous studies have been conducted on personality disorders and how they may be influencing certain types of eating pathology. Individuals with borderline personality disorder (BPD) tend to have higher rates of eating disorders (EDs). Up to 53.8% of BPD patients also meet the requirements for having an eating disorder.

According to research, borderline personality is present in roughly 25% of people with anorexia nervosa and 28% of people with bulimia nervosa. Various personality disorders may be influencing comparable eating pathologies, according to research on the relationship between BPD and eating disorders.

What are Eating Disorders?

Psychiatric disorders known as eating disorders are characterized by severe issues with eating behavior as well as associated thoughts and feelings. Here we will be discussing 6 different types of eating disorders recognized by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the standard manual for the diagnosis of psychiatric disorders used by mental health professionals.

The following eating disorders are listed in the DSM-5:

• Anorexia nervosa: Anorexia is characterized by severely reduced food intake, an obsession with gaining weight, and abnormally low body weight.
• Avoidant/restrictive food intake disorder (ARFID): This disorder is defined by restrictive eating but not by concern about one’s appearance or weight gain.
• Binge-eating disorder: People with these condition experience episodes of uncontrollable eating, which are characterized by binge eating. These events frequently come with feelings of embarrassment or guilt as well.
• Bulimia nervosa: It is characterized by binge eating as its primary symptom, which is then followed by compensatory behaviors such as self-induced vomiting, excessive laxative usage, excessive exercise, and others.
• Rumination disorder: It is the regurgitation of previously consumed food in order to spew or re-swallow it.
• Pica: Pica entails the desire for and ingestion of items other than food.

Understanding Borderline Personality Disorder BPD

A different manner of thinking, acting, and feeling from what most people experience is referred to as a personality disorder. It goes beyond peculiarities or distinctive personality qualities. These attitudes, emotions, and types of behavior inflict damage on someone’s life.

A person with borderline personality disorder (BPD) deals with at least five of the following, according to the DSM-5, the diagnostic guide used by medical professionals:

• A series of tumultuous and intense interpersonal interactions distinguished by swings between extremes of idealization and devaluation
• Extreme dissociation or paranoia brought on by stress
• Extreme rage or trouble restraining rage
• Feelings of emptiness that persist
• Frantic, chaotic attempts to prevent actual or perceived abandonment
• Frequently displaying suicidal thoughts, actions, threats, or self-harm
• In at least two areas a person shows impulsivity. For instance, risky driving, binge eating, sex, substance misuse, and reckless spending
• Mood instability and abrupt mood changes could last a few hours to a few days
• Significantly unstable self-image or sense of self

These symptoms appear by early adulthood and affect several facets of a person’s life.

Understanding the Signs of BPD: Explaining the Symptoms

The symptoms mentioned above will be further broken down in this section. People with BPD have a severe dread of being abandoned. It’s crucial to remember that when an actual abandonment is taking place or even when a person suspects one, their fear of abandonment may be triggered. This can cause a strong reaction, including excessive crying, the inability to do tasks at work or in school, or irrational outbursts of anger. This dread can be triggered at typical times of separation, such as when their partner travels for work or between therapy sessions.

The pattern of strong connections is another important characteristic of borderline personality. There are several factors that contribute to the intensity of these partnerships. The inclination of a borderline personality to both idealize and devalue people is one of the underlying causes. It’s called idealization when someone sees another person as flawless.

This is illogical because the idealized person will inevitably make mistakes, which will diminish their value. When someone’s value is reduced and undermined, that person is devalued. This cycle of idealization and devaluation can be explained simply as seeing everything in black and white; either they are good or they are evil. A person with BPD may experience intense relationships that begin really well before falling apart as a result of being treated with disrespect.

What links exist between BPD and eating disorders?

One of the most typical co-occurring conditions for people with eating problems is borderline personality disorder. These disorders are unquestionably distinct illnesses with different signs and symptoms. Having said that, they can complement one another.

Anorexia and BPD

An extreme fear of gaining weight makes it difficult for those with anorexia to maintain a healthy weight. In an effort to lose weight, this fear motivates a number of disordered behaviors, such as deprivation or compulsive exercise. Someone’s anorexia may be aggravated in particular ways by borderline personality. There are various ways in which this could show up. For instance, a fragile sense of self was one of the BPD defining signs. Weight has a significant impact on how people with anorexia perceive themselves and their value. Their anxiety over their weight can be made worse by their identity, which is already shaky, or decreasing weight might be an attempt to create a stable identity.

BPD and bulimia

An eating disorder called bulimia is characterized by cycles of binge eating and coping mechanisms to prevent weight gain from overeating. There are many compensatory actions, including purging, using laxatives compulsively, exercising excessively, or fasting.

Similar to those who have BPD and anorexia, BPD can have a variety of effects on those who have bulimia. One example of this might be impulsively engaging in disordered eating habits as a coping mechanism for rapidly changing moods.

Binge Eating Disorder and BPD

Binge eating episodes that spiral out of control are a reality for those with binge eating disorder (BED). Eating more food than the majority of people would typically consume in the same period of time is referred to as binge eating. Like any other eating disorder, BPD and BED may coexist. One example would be bingeing after their fear of abandonment was provoked as a means of emotional relief.

Causes and Risk Factors for BPD 

According to research, a person’s risk of getting BPD might be affected by a number of distinct factors. Some of these are discussed below:

Causes and Risk Factors of Eating Disorders

Although the exact causes of eating disorders are unknown, research has revealed that they are frequently impacted by or made worse by a variety of emotional and social factors, such as:

• Abuse history, either physical or sexual
• Difficult interpersonal connections
• Extremely high standards for attractiveness in society or the family
• Feelings of powerlessness and inadequacy
• History of bullying, especially when prompted by weight or looks
• Inability to communicate feelings
• Self-esteem issues

An individual’s chance of developing an eating problem may be increased by a number of circumstances, such as:

• Activities and interests: Some professions, such as modeling, dance, and athletics, place a larger importance on maintaining a slender physique and may help to develop eating disorders.
• Age: Late teens and early 20s are when eating disorders are most prevalent.
• Family history: You are more likely to have an eating disorder if one of your parents or siblings does.
• Gender: Women are much more likely than men to suffer from an eating disorder.
• Mental health problems: People with anxiety, obsessive-compulsive disorder, or depression are more likely to have eating disorders.
• Stress: Eating disorders can be caused by stressful situations or relationships.

Here’s All You Need To Know About Disordered Eating Habits

How are BPD and Eating Disorders linked?

Why do people with BPD appear to experience eating disorders more frequently than those in the general population? One theory put out by experts is that BPD and eating disorders, particularly Bulimia Nervosa, share the same risk factor.

A history of childhood trauma, such as physical, sexual, and emotional abuse, is linked to both BPD and eating disorders. It’s possible that having experienced childhood trauma increases one’s likelihood of developing BPD and eating disorders.

Additionally, some professionals have hypothesized that BPD symptoms may increase the chance of developing an eating disorder. For instance, persistent impulsivity and urges to harm oneself may cause someone to engage in destructive eating habits, which may eventually progress to the level of an eating disorder.

On the other hand, participating in disordered eating behavior may result in stressful experiences (such as extreme shame, hospitalization, and family disturbance) that may cause BPD in someone who is genetically predisposed to the condition.

BPD and Eating Disorder Treatment

Both eating disorders and borderline personality disorders can be treated. It’s critical that anyone dealing with both of these disorders receive therapy. This can be a key relapse prevention strategy and help address the manner in which the disorders reinforce one another. Treatment for BPD and eating problems encompasses a variety of aspects.

Medication

There aren’t any drugs that are only used to treat BPD or eating disorders. These people frequently receive medication for other mental health issues or symptoms including depression or anxiety.

In order to stabilize their mood, borderline individuals may also be prescribed drugs that are generally given to those with bipolar disorder.

Therapy

For the treatment of eating disorders and borderline personality disorder BPD, there are particular therapy techniques. Dialectical behavioral therapy is one overlapping therapy approach that has a record of being successful.

DBT was initially developed to treat borderline personality disorder, but because of how powerful it can be, it is occasionally employed in the treatment of eating disorders. It emphasizes the following fundamental abilities:

• Mindfulness
• Relational skills
• Distress tolerance
• Emotional regulation

DBT can be introduced in a group context as well as in one-on-one treatment sessions. A therapist may employ a range of therapeutic modalities while treating a patient who also has an eating disorder and a borderline personality disorder. Usually, the goal of therapy is to stabilize the patient and reduce or eliminate any negative behaviors. A therapist could delve further with a patient once they are stabilized to assist them to cope with any unresolved feelings or core beliefs.

Relapse Prevention and Post-Treatment Support

Considering that BPD is characterized by impulsivity, having a strong relapse prevention strategy is essential. Even though setbacks are common, avoiding a full-blown relapse can assist someone to avoid going too far back. An action plan to prevent relapses could contain the following:

• A list of potential triggers and coping mechanisms
• List of names and contact information for people you can contact
• Warning indicators that you’re having difficulty

There are many different types of help that can be provided during aftercare. A few examples include the following:

• Engaging in routine self-care
• Going to counseling
• Joining a support group
• Making time for uplifting friends
• Taking your medicine as prescribed

It takes tremendous effort to manage an eating disorder with a borderline personality disorder. Because these disorders can be fatal and have a substantial influence on a person’s quality of life, it is crucial to seek treatment.

We hope you found this article useful in understanding more about how BPD is related to Eating disorders along with how these conditions can be treated if comorbidity does exist. Do You Get Anxiety After Eating Carbs? Here’s How To Manage