Medical Presentations of Covert Sexual Abuse in Eating Disorder Patients
This chapter discusses some patients with eating disorders who presented with unusual medical complaints. In all cases, medical intervention was not helpful until the patients’ sexual abuse histories were diagnosed and effectively treated. A subpopulation of patients with eating disorders has also experienced sexual abuse. Sexually abused patients with bulimia and anorexia nervosa frequently present with medical symptoms that may be difficult to explain. The victim of sexual abuse who has a concomitant eating disorder will frequently complain of predominantly physical ailments. It may be unclear to the physician or therapist whether the patient is suffering from a physical or psychiatric disorder. If the vomiting occurs during or soon after a meal and relieves abdominal pain, peptic disease should be considered. Alternatively, if the vomiting is delayed at least one hour after eating, gastric obstruction or a gastric motility disorder is likely. A distinct subpopulation of eating disorder patients has been sexually abused.