The Link Between Eating Disorders and Attachment: Understanding the Connection
Watching your teen struggle with an eating disorder can leave you feeling helpless. Diets, food, and body image often get the limelight when talking about disordered eating. However, the roots usually run much deeper and can often be tied to the emotional bonds formed in our early years.
Research studies highlight a strong link between eating disorders (ED) and attachment trauma. And this isn’t surprising, especially when you understand that insecure attachments or disrupted connections in childhood can shape the ways that adolescents cope with their emotions and self-worth.
Seeking professional support is always the best approach when dealing with these complex disorders. However, this article can also help by exploring
- The impact of attachment on mental health
- Eating disorders and attachment trauma link
- How attachment styles are connected with specific disordered eating patterns
- Mental health support for eating disorder teens with attachment issues
- Residential treatment options for eating disorders
- Where to find professional support
Understanding Attachment and Its Impact on Mental Health
Children within the first few years of life develop templates for how the world works and their place in it based on early relationships with caregivers. These templates typically dictate whether they can trust others, how relationships should look, and how they manage their emotions.1
Attachment theory suggests that when caregivers are supportive and available to meet a child’s needs during times of distress, a secure attachment style develops. However, if caregivers are inconsistent in their support or don’t meet an infant’s needs, they may develop one of three insecure attachment styles: anxious, avoidant, or disorganized.2
The following information covers how attachment styles can impact emotions and the risk of developing an eating disorder.
Attachment Styles and Emotional Development
Attachment styles act as a blueprint for relationships in life, especially the relationship we have with ourselves. For instance, people with insecure attachments are more likely to experience difficulties with emotional regulation. They may also have low self-esteem, believe they are “unlovable” or “worthless”, or use unhealthy coping mechanisms to manage emotions when they feel overwhelmed.3
This is because early experiences with parents or caregivers taught them that emotions were either unsafe, ignored, or inconsistently met. They then learned how to manage their emotions based on this. As a result, self-soothing may not come naturally. Their feelings may become intense, as though their emotions are “too much” to stand. Alternatively, they may completely suppress their feelings and “shut down”, believing their emotions aren’t important.
Insecure Attachment as a Risk Factor for Eating Disorders
Insecure attachment styles can increase the probability of developing an eating disorder. This is because people with them usually have difficulties managing negative emotions and experience a low sense of self-worth. These issues can lead someone to develop unhealthy coping strategies to deal with or avoid uncomfortable feelings.
Research confirms this link, finding that those with eating disorders often have insecure attachments.4,5 Studies explain this link to some degree, showing the relationship between insecure attachment styles and poor self-concept, lower body acceptance, and an impaired recognition of hunger.5
The following section explores the connection between attachment trauma and disordered eating in more detail.
Attachment Trauma and Disordered Eating
Attachment trauma is the term used to describe the emotional and psychological distress that comes from disruptions to the early bonding process between a child and their caregiver. At a vital time when an infant needs safety and comfort, they may instead receive inconsistent caregiving, neglect, or abuse, resulting in the creation of insecure attachments.
As discussed, attachments provide an infant with a template of how they fit into the world around them. Children with insecure attachments may develop a core belief that they aren’t worthy of support and love, or that others cannot be trusted to fulfill their needs. This is especially true when neglect or abuse takes place.
An unhealthy coping strategy can present itself through food restriction. For example, research notes the link between those with anorexia nervosa (AN) and emotional avoidance. Therefore, a preoccupation with food, eating, weight, or body image may allow someone to avoid thinking about other emotionally intense feelings and stress. In this sense, disordered eating can become a way to avoid negative feelings and induce emotional numbness.6,7
How Attachment Styles Present in Different Eating Disorders
In the U.S, it is estimated that up to one in ten young women has an eating disorder, according to the American Academy of Child & Adolescent Psychiatry (AACAP).8 Additionally, the prevalence of eating disorders in young males is also significant, although typically less than half in comparison to females.9
Knowing that there is an element of emotional regulation in eating disorders, it can be useful to understand the role that different attachment types play in contributing to ED. The information below can help.
Attachment Issues and Anorexia in Teens
Anorexia nervosa, also known as anorexia, occurs when a person reduces their food intake significantly and persistently, resulting in an extremely low body weight.9
There is a link between having an avoidant attachment style and anorexia. Adolescents with avoidant attachments typically grow up believing they cannot trust others and must be completely independent and self-reliant. This means they may put up emotional barriers to protect themselves from rejection or abandonment, or strive for perfection at all costs to remain independent.
The National Alliance for Eating Disorders (NAED) suggests that it is the combination of these coping mechanisms that can be a risk factor for anorexia. Avoidant aspects of the attachment style may spread to relationships with food and body image in order to manage emotions. These, together with a cultural obsession with being thin, can be a very dangerous mix.10
Attachment Theory and Bulimia Recovery
According to AACAP, bulimia is a condition in which someone binges on large quantities of food, then purges their body by inducing vomiting, using laxatives, or exercising excessively.9
According to the NAED, anxious attachment can be a risk factor for bulimia.10 Teens with an anxious attachment often crave approval from others, have a negative self-concept, and may compare themselves to others more than those with a secure attachment. Sometimes, seeking comfort in food can help to soothe emotional distress. However, emotional eating can turn to bingeing, and the negative self-view and comparison to others can compel them to purge themselves.
Binge Eating Disorder and Insecure Attachment
Binge eating disorder (BED) typically involves eating large quantities of food until the person feels uncomfortably full.3
There is less research into the specific attachment styles associated with BED. However, studies have found links between insecure attachment, more specifically anxious and disorganized styles, and BED.11-13 This is due to emotional dysregulation and using food as a way to manage or “numb” uncomfortable feelings.
Recognizing the link between attachment styles and eating disorders can help you navigate the therapeutic approaches available when treating attachment issues in those with bulimia, BED, or anorexia.
Therapy for Eating Disorders in Adolescents With Attachment Trauma
Hopefully, you have found the information on this page helpful so far, but remember that it doesn’t replace professional treatment. While there are specific programs for disorders such as anorexia or BED, healing attachment wounds in eating disorder recovery can ensure that the emotional roots of the issue are addressed. This can provide a more holistic approach, allowing the deeper attachment trauma to be dealt with as well as the more visible eating disorder symptoms.
You can find more information about the therapies used to treat attachment trauma below:
Attachment-Based Therapy for Disordered Eating
When attachment style is a factor in eating disorders, it’s important to heal the emotional bonds that may have been disrupted during childhood. This is where attachment-based therapies can be useful. Attachment-based family therapy is a structured approach based on attachment theory. The work during these sessions tends to focus on repairing the connections within the family unit by building trust, encouraging open communication, creating a sense of safety, and reforming connections.14,15
CBT and DBT for Eating Disorders and Attachment
Dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT) are two therapeutic approaches that can bring relief to those with attachment trauma.16,17
CBT is a structured therapy that teaches teenagers how to recognize and rewrite any negative or unhelpful thought and behavior patterns they may have. They can learn healthier coping skills with the help of their therapist, and gain a deeper understanding of themselves and their feelings, including how to regulate and self-soothe.
DBT is a therapy that teaches adolescents how to manage their emotions, which is an area that those with insecure attachment often struggle with. They can learn healthy coping strategies to help them deal with distress and anxiety, and to improve their relationships.
The following section explores the connection between attachment trauma and disordered eating in more detail.
Residential Treatment for Eating Disorders and Trauma
Outpatient therapy sometimes isn’t enough to provide the amount of support needed for a teenager struggling with disordered eating and attachment trauma. When this is the case, teen eating disorder programs with trauma focus can offer the intensive care that’s required for long-term healing and recovery.
Residential programs provide a safe, structured, and compassionate space where adolescents can begin to heal from their struggles. Through individualized therapy, peer support, and skill-building, teens can learn to understand their thoughts, feelings, and behaviors, so as to develop healthier coping skills and better connections. Family involvement is important in residential recovery, especially when it comes to healing emotional bonds. Family sessions and regular communication can keep parents involved in the process, so that the whole family can recover together.
Start Your Recovery With Mission Prep
If you think your teen is struggling with a mental health issue, the best thing to do is reach out to a mental health professional for support. You don’t have to figure it out alone when we are here to help you.
Mission Prep are experts in helping teenagers recover from trauma and other mental health challenges. We use evidence-based therapy and personalized treatment plans to ensure your teen heals in the best possible way.
Whether you’re looking for some gentle support or a more intensive approach, we have you covered. We offer a variety of options, including:
- Individual therapy, both in-person and online
- Family therapy
- Support groups
- Intensive outpatient programs
- Residential recovery programs
Reach out to us today to explore the treatment options available to you and your teen. We’ll take the first step on the road to recovery, together.
References
- McGarvie, S., PhD. (2025, March 27). Attachment Theory, Bowlby’s Stages & Attachment Styles. PositivePsychology.com. https://positivepsychology.com/attachment-theory/
- Ainsworth, M. D. S., & Bell, S. M. (1970). Attachment, exploration, and separation: Illustrated by the behavior of one-year-olds in a strange situation. Child Development, 41(1), 49–67. https://doi.org/10.2307/1127388
- Jewell, T., Apostolidou, E., Sadikovic, K., Tahta-Wraith, K., Liston, S., Simic, M., Eisler, I., Fonagy, P., & Yorke, I. (2023). Attachment in individuals with eating disorders compared to community controls: A systematic review and meta-analysis. International Journal of Eating Disorders, 56(5), 888-908. https://doi.org/10.1002/eat.23922
- Tasca, G. A., & Balfour, L. (2014). Attachment and eating disorders: A review of current research. International Journal of Eating Disorders, 47(7), 710–717. https://doi.org/10.1002/eat.22302
- Gander, M., Sevecke, K., & Buchheim, A. (2015). Eating disorders in adolescence: attachment issues from a developmental perspective. Frontiers in Psychology, 6. https://doi.org/10.3389/fpsyg.2015.01136
- Wildes, J. E., Ringham, R. M., & Marcus, M. D. (2009). Emotion avoidance in patients with anorexia nervosa: Initial test of a functional model. International Journal of Eating Disorders, 43(5), 398–404. https://doi.org/10.1002/eat.20730
- Espeset, E. M. S., Gulliksen, K. S., Nordbø, R. H. S., Skårderud, F., & Holte, A. (2012). The Link Between Negative Emotions and Eating Disorder Behaviour in Patients with Anorexia Nervosa. European Eating Disorders Review, 20(6), 451–460. https://doi.org/10.1002/erv.2183
- Aacap. (n.d.). Eating disorders in teens. Retrieved August 13, 2025, from https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Teenagers-With-Eating-Disorders-002.aspx
- National Institute of Mental Health (NIMH). (n.d.). Eating disorders. Retrieved August 13, 2025, from https://www.nimh.nih.gov/health/statistics/eating-disorders
- National Alliance for Eating Disorders. (2024, July 30). The connection between insecure attachment styles and eating disorders. https://www.allianceforeatingdisorders.com/the-connection-between-insecure-attachment-styles-and-eating-disorders/
- Keating, L., Mills, J. S., & Rawana, J. S. (2018). Momentary predictors of binge eating: An attachment perspective. Eating Behaviors, 32, 44–52. https://doi.org/10.1016/j.eatbeh.2018.12.003
- Faber, A., Dubé, L., & Knäuper, B. (2017). Attachment and eating: A meta-analytic review of the relevance of attachment for unhealthy and healthy eating behaviors in the general population. Appetite, 123, 410–438. https://doi.org/10.1016/j.appet.2017.10.043
- Maxwell, H., Tasca, G. A., Grenon, R., Ritchie, K., Bissada, H., & Balfour, L. (2017). Change in attachment states of mind of women with binge‐eating disorder. Clinical Psychology & Psychotherapy, 24(6), 1292–1303. https://doi.org/10.1002/cpp.2095
- Ewing, E. S. K., Diamond, G., & Levy, S. (2015). Attachment-based family therapy for depressed and suicidal adolescents: theory, clinical model and empirical support. Attachment & Human Development, 17(2), 136–156. https://doi.org/10.1080/14616734.2015.1006384
- Diamond, G., Siqueland, L., & Diamond, G. M. (2003). Attachment-based family therapy for depressed adolescents: programmatic treatment development. Clinical Child and Family Psychology Review, 6(2), 107–127. https://doi.org/10.1023/a:1023782510786
- De Arellano, M. a. R., Lyman, D. R., Jobe-Shields, L., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Huang, L., & Delphin-Rittmon, M. E. (2014). Trauma-Focused Cognitive-Behavioral therapy for Children and Adolescents: Assessing the evidence. Psychiatric Services, 65(5), 591–602. https://doi.org/10.1176/appi.ps.201300255
- Geddes, K., Dziurawiec, S., & Lee, C. W. (2013). Dialectical Behaviour Therapy for the Treatment of Emotion Dysregulation and Trauma Symptoms in Self-Injurious and Suicidal Adolescent Females: A Pilot Programme within a Community-Based Child and Adolescent Mental Health Service. Psychiatry Journal, 2013, 1–10. https://doi.org/10.1155/2013/145219
