Intimate Partner Violence Among Women with Eating Disorders

Two conditions increased the risk in two studies.

Reprinted from Eating Disorders Review
January/February Volume 27, Number 1
©2016 IAEDP

The Centers for Disease Control and Prevention defines intimate partner violence, or IPV, as physical, sexual, or psychological harm by a current or former spouse or partner. IPV currently affects 44% of American women. By contrast, men are far more likely to experience violent acts from strangers or acquaintances than by an intimate partner (World Health Organization. 2002). 

Two recent studies have highlighted the increased risk among women with eating disorders during the perinatal period and among women with poor social support. 

Poor social support increased risk

Lack of social support increases the risk of IPV, according to results of a recent Penn State College of Medicine study (Int J Women’s Health. 2015. 7:919). Dana K. Schirk and colleagues examined the frequency of risk of eating disorders in adult women exposed to intimate partner violence and then assessed the effect of social support on the risk of disordered eating among these women. 

The HARK Questionnaire Have you been humiliated or emotionally abused in other ways by your partner or ex-partner? Have you ever been afraid of your partner or ex-partner? Have you ever been raped or forced to have any kind of sexual activity by your partner or ex-partner? Have you ever been kicked, hit, slapped, or otherwise physically hurt by your partner or ex-partner?

The women, who were from 18 to 64 years of age, completed a screening survey examining health, demographics, and IPV exposure, as measured by the Humiliation-Afraid-Rape-Kick (HARK) screen. This 4-question survey (see table) accurately identifies women who are experiencing IPV. For this study the survey was modified to ask about both IPV exposure in the past 12 months and lifetime exposure. 

After the screening questions were completed, women were invited to leave their contact information if they wished to participate further. To protect the participants, safety and confidentiality steps were put in place, and the women were also given referral information for services for general health, domestic violence, mental health, substance abuse, and eating disorders. Individual social support was measured with the MOS Social Support Survey, which contains 19 questions about emotional informal support, tangible support, and social interactions. Risk of ED was assessed during the Eating Disorders Screen for Primary Care (ESP), a five-question screen.

When the researchers examined the risk of eating disorders among the 302 women with lifetime IPV, 14% were found to be at high risk, 42% at moderate risk, and 44% at low risk. Among women exposed to abuse, low social support was significantly associated with an increased risk of eating disorders, suggesting that social support may help protect women dealing with IPV against developing an eating disorder, if the women take advantage of the support. 

IPV during the perinatal period

Mothers with eating disorders and their children may be especially vulnerable to negative effects from IPV, according to Dr. Radha Kothari and a team in the UK (Int J Eat Disord. 2015. 48:727). In the team’s recent study of women participating in the Avon Longitudinal Study of Parents and Children, three groups were evaluated: women with lifetime histories of eating disorders (n=174), those without pregnancy shape and weight concerns and/or purging behaviors (n=189), and women with no history of eating disorders (n=8723).

Just as they had hypothesized, women with a lifetime history of eating disorders were more likely to have experienced physical IPV during the perinatal period (but not the postnatal) period and more likely to report emotional IPV. Rates of IVP were high: physical violence affected from 9.6% to 14.0% of women, while the incidence of emotional violence was even higher, up to 28%.