Understanding Self-Harm and Eating Disorders in Adolescents

By Deborah Etienne-Ward

An eating disorder is often seen as an indirect form of self-harm. Commonly however, people with eating disorders will also report to engage in more direct forms of self-harm such as cutting, burning, aggressive behaviour (e.g., punching the wall), and self-poisoning (e.g., medication overdose). Eating disorder and self-harm behaviours are often started for the first time during adolescence. This article aims to provide insight into the relationship between eating disorders and self-harm as well as some of the common purposes that they serve.

Why do adolescents engage in self-harming behaviour?pic

There are a number of reasons why people may engage in self-harm, and each individual is different. Some common functions of eating disorders and self-harm are listed below.

  1. Control

Adolescents commonly report that whilst they are trying to develop a sense of independence they feel that their life is out of their control. This might occur for a number of reasons including difficult relationships at home or school, or feeling that other people such as parents, teachers, and coaches plan every minute of their day without giving them the freedom that they would like. As a result adolescents may turn to self-harm or food restriction to have some control in their life.

  1. Punishment

Self-harm due to punishment is most common in adolescents that set high expectations for themselves. It is also common among those who have grown up in an environment where they have been taught that they ‘deserve’ to be punished. Additionally, people with eating disorders often have a punishing theme behind their food restriction. For example they may report that they do not ‘deserve’ to eat or that losing weight makes them feel closer to disappearing altogether.

  1. To appear ‘ugly’

This is a common reason for self-harm among people who have experienced the trauma of sexual abuse. People with a history of sexual abuse may self-harm, restrict their food intake, or eat excessively with an aim to be less sexually attractive and protect themselves from future sexual abuse.

  1. To manage overwhelming feelings

Sometimes people find it difficult to express their emotions and self-harm can feel like the only way to communicate and release feelings. Similarly it is not uncommon for people to use food to manage their emotions by eating large amounts of food or starving themselves. For other people, self-harm can be a way to communicate their emotional pain which may be too difficult to talk about.

  1. Nowhere else to turn

Often people report that they do not know of another way to deal with their problems.

What should I do if my daughter/son reveals that they are engaging in self-harm behaviours?

Try to give them your undivided attention and listen to them. Respond in a non-judgmental manner and trust what they are saying. It can be very difficult for people who self-harm to seek help. Furthermore, perceived failed attempts at seeking help can lead to increased self-harm and decreased help-seeking in the future. Let your adolescent know that you wish to support them. Encourage them to seek support such as by talking to their GP or seeing a psychologist.

The psychologists at BodyMatters do take clients who are experiencing difficulties with eating disorders and self-harm. Contact us for further information.


Knightsmith, P. (2015). Self-Harm and Eating Disorders in Schools. A Guide to Whole-School Strategies and Practical Support. London, UK: Jessica Kingsley Publishers.

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