Managing Stress and an Eating Disorder

By Casey Shamy, LSW

The Relationship Between Stress & Eating Disorders 

Everyone experiences stress. It is a natural human response to demands, pressure, challenges and threats. When individuals are stressed, they might engage in impulsive behaviors because they are overwhelmed. This can manifest in a myriad of ways, but for those living with an eating disorder, stressors can cause individuals to engage in disordered eating behaviors. Individuals with anorexia nervosa may find themselves restricting because they’re too anxious to eat, while those with bulimia nervosa or binge eating disorder may start emotionally eating, leading to binging or purging.  

Sources of Stress 

In today’s world, there are many possible sources of stress, but some of the largest contributors are related to big life changes or circumstances where you feel as though you have little control over your life, including: 

  • Financial trouble or job loss 

  • Death, injury or terminal illness of a loved one 

  • Caretaking for an elderly or sick family member 

  • Traumatic events, such as a natural disaster, theft or violence 

  • Bullying, harassment or discrimination 

  • Job dissatisfaction, heavy workload or working long hours 

  • Poor academic performance, standardized testing or college enrollment 

While these are some of the biggest sources of stress, they’re far from the only ones. Even positive life events, like a new marriage or a new baby, can be sources of stress. Smaller things, like an upcoming test or going on a first date, can be stressors too.  

Acute vs. Chronic Stress 

Short bursts of stress, acute stress, can be positive and productive in cases where you want to avoid danger or meet a deadline. They can also help you grow and be encouraging, like when you’re in the last mile of a marathon or about to give a presentation in front of a large audience. Acute stress can also be negative, like when you have a fight with a loved one or get stuck in traffic. Acute stress typically subsides quickly and doesn’t have lasting effects. 

However, when stress lasts for a prolonged period, it can become chronic and have a negative impact on your health. Not only can high levels of stress hormones, like cortisol and adrenalin, lead to changes in eating behaviors, but those with eating disorders have a higher risk of experiencing chronic stress. Chronic stress can leave you stuck in a permanent stage of fight or flight, making it difficult for you to relax or stay focused. 

Signs of Stress 

Chronic stress can cause a variety of health problems due to long-term activation of the stress response and excessive exposure to stress hormones, including: 

  • Anxiety 

  • Depression 

  • Digestive problems 

  • Headaches 

  • Muscle tension and pain 

  • Heart disease, heart attack, high blood pressure and stroke 

  • Difficulty sleeping 

  • Difficulty focusing or memory problems 

Since eating disorders, depression and anxiety are frequently co-occurring diagnoses, an increase in depression or anxiety symptoms may exacerbate disordered eating behaviors.  

Coping with Stress 

The way you respond to stress can make a big difference to your overall wellbeing. Evaluating the source of your stress and utilizing active coping mechanisms rather than passive ones can help you manage your stress more effectively. 

Coping Styles 

There are two major coping styles, active coping and passive (or avoidant) coping: 

  • Active coping: An adaptive coping response when a person works to find productive, problem-focused solutions to stress and is aware of their stressor and problem-solves to reduce unwanted outcomes. 

  • Passive (avoidant) coping: A coping response where individuals use maladaptive strategies when faced with stressful situations. This may include avoidance, denial or withdrawal. 

Studies of college students have shown that individuals with an avoidant coping style are at a higher risk of disordered eating. Rather than avoiding, denying or withdrawing from your sources of stress, facing stress head-on is the first step to effectively managing it.  

Actively Coping with Stress 

To actively cope with your stress, you need to acknowledge the stress, identify your stressors and evaluate your circumstances. 

Acknowledge the Stress 

The first step is to realize that stress is causing serious problems in your life. You need to make the connection between your emotional or physical symptoms and the pressure or challenges you’ve been dealing with. Don’t ignore the signs of stress or deny that they are impacting your life. 

Identify Your Stressors 

Try to identify the underlying causes of your stress. Take time to examine the sources of stress in your life and organize them into buckets: stressors with a practical solution, stressors that will get better with time and stressors that are out of your control. Accepting and letting go of the sources of stress that will resolve themselves with time or that you have no control over will allow you to focus your energy on stressors that can be addressed. 

Evaluate your Circumstances 

Once you have identified stressors with practical solutions, you need to evaluate your circumstances. Have you been taking on too much responsibility? Are there things you can delegate or ways to alter your process to make it easier? You may need to redetermine your priorities and reorganize your life so that you can manage your responsibilities and commitments more effectively. This is also the perfect time to reevaluate your boundaries and see if you’re living true to your values – a lack of which could also be contributing to your stress load.  

Outlets for Stress 

Part of controlling stress is finding ways that you can channel stress productively, like trying therapy or counseling, meditation, journaling, purposeful movement or art. 

Therapy & Counseling 

Coping with stress might not come naturally to you or maybe you don’t know where to start. In this case, it might be helpful to seek out stress management counseling. Guidance from a trained professional can help you learn, practice and develop effective coping skills. 

Nurturing Relationships 

It can be tempting to withdraw from others during times of stress. Opening up about the stress you’re experiencing with a loved one can help alleviate your emotional burden. It can also be a way to get an outside perspective or to start a dialogue about how your relationship might be a source of stress. 


Meditation can help you stay grounded and connect with yourself while instilling calm and balance that can counteract stress. Meditation can be done any time of day and anywhere. It can be for just a few minutes or over an hour.  

Meditation can also provide an opportunity to reflect. Self-reflective meditation is a valuable tool that allows you to examine your thoughts, feelings and emotions and can help determine the source of your stress. 


Expressing yourself through journaling can help you organize your thoughts and feelings during high-anxiety moments. It can also be valuable for reflection to understand your stressors and determine how you can address them. 

Purposeful Movement 

Purposeful movement, like hiking or yoga, can be a great way to relieve stress. Exercise is a great way to combat many of the issues associated with chronic stress, like increasing alertness, elevating mood and improving sleep. Exercise also reduces the production of stress hormones and increases production of endorphins, which can help you relax 


Art is a fantastic way to manage and express your emotions. Music, writing, drawing, sewing and painting can be cathartic activities or offer a reprieve from stressful thoughts. When you create, you enter a creative flow that can be restorative and energizing. Flexing your creative muscles can also inspire you to come up with creative solutions and perspectives on how to manage your stress. 

Stress is an unavoidable part of life. While many of those struggling with eating disorders find it more difficult to cope with stress, directly addressing your stressors rather than running away from them can help keep your stress in check and help sustain your recovery.


  • MacNeil, L., Esposito‐Smythers, C., Mehlenbeck, R., & Weismoore, J. (2012). The effects of avoidance coping and coping self-efficacy on eating disorder attitudes and behaviors: A stress-diathesis model. Eating Behaviors, 13(4), 293–296. 

  • Nielsen, M. B., & Knardahl, S. (2014). Coping strategies: A prospective study of patterns, stability, and relationships with psychological distress. Scandinavian Journal of Psychology (Print), 55(2), 142–150. 

  • Stress symptoms: Effects on your body and behavior. (2023, August 10). Mayo Clinic. 

  • Wood, S. K., & Bhatnagar, S. (2015). Resilience to the effects of social stress: Evidence from clinical and preclinical studies on the role of coping strategies. Neurobiology of Stress, 1, 164–173. 

  • Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T. P., & Sahebkar, A. (2017). The impact of stress on body function: A review. PubMed, 16, 1057–1072. 


Written by

Casey Shamy, LSW

Casey Shamy serves as Director of Marketing of ACUTE Center for Eating Disorders and Severe Malnutrition, bringing an essential fusion of clinical and behavioral health marketing experience to her…

ACUTE Earns Prestigious Center of Excellence Designation from Anthem
In 2018, the ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health was honored by Anthem Health as a Center of Excellence for Medical Treatment of Severe and Extreme Eating Disorders. ACUTE is the first medical unit ever to achieve this designation in the field of eating disorders. It comes after a rigorous review process.

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