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Borderline Personality Disorder comorbid Eating Disorders

Tanvi Bansal

Today, we live in a society that is plagued by the obsession with food. On one hand, there are self-proclaimed gourmets who enjoy eating exotic meals and aesthetic desserts. Whereas, on the other side are those fitness freaks with extreme consciousness for body images, living by nuts, berries and leaves. In this regard, most of us are aware of the direct correlation between the food we eat and the body structures we have. However, we fail to recognize the interaction between the eating patterns and personality of an individual. Therefore, this paper deals with discussing the co-occurrence of Borderline Personality Disorder and Eating Disorders. 

To begin with, borderline personality disorder (BPD) is the instability in interpersonal relationships and problems with a sense of self-image (2004). Individuals with this disorder are very conscious about themselves; they undergo repeated suicidal thoughts along with a tendency to cause self-harm. Whereas, while understanding the eating disorders there is a common misconception of this disorder being a lifestyle choice. Instead, eating disorders are fatal illnesses that affect a persons physical and mental functioning (Weltzin 2004). People often tend to either excessively eat more (Bulimia Nervosa and binge eating) or starve for food (Anorexia Nervosa) in fear of gaining weight or being extra thin respectively. Therefore, a study found that 53.8% of the patients with BPD conjointly had eating disorders (Pednwault 2019). Typically, this is not to say that all people with eating disorders had borderline personality disorder.

Firstly, eating disorders can function as behaviors through which individuals can cope up with their personality disorder. In this regard, chronic impulsivity, urges to self-harm or self-injury can lead to behaviors of binge eating (Pednwault 2019). Patients can use ‘food’ as a platform to suppress feelings of emptiness and combat emotional surges of anger. The consumption of food causes distraction from emotional distress and binging and purging on good food can make you feel happier. Also, the body of the patient gets used to eating food according to emotional hunger and not the internal cues for physical hunger. In this sense, according to mood like anger, irritability, sadness, fear, etc.- can either lead an individual to eat more or suppress the appetite by decreased food intake. Thus, food can temporarily change the mood of a person or fill the void in an individual’s life undergoing BPD, but repeated impulsive eating behaviors may lead to developing eating disorders overtime.

Secondly, eating disordered behavior can lead to stress experiences (e.g., severe shame, hospitalization, family disruption) that can trigger BPD in people with genetic vulnerability for the disorder (Pednwault 2019). Moreover, patients with anorexia nervosa have a strong desire to maintain their body images and fear of gaining weight. In this regard, the condition is associated with a number of personality traits including perfectionism, rigid thinking patterns and obsessive- compulsive behavior and thoughts (Phillipou et al. 2015). Due to these emotions, some individuals may believe that being thinner will make them look more attractive because of which they can maintain their relationships in a better way. Therefore, for having a sense of control on relationships, individuals with eating disorder comorbid with BPD. As, not being able to maintain their relations might lead to detachment of ‘self’ and developing of BPD as a result.

Clinically, eating high fat and sugary food items can trigger the release of dopamine, the feel good neurotransmitters in the brain as well as endorphin release. (Rana 2018). On the other hand, restricting and starving of food has its own effect that is the cognitive processes of the brain are slowed down and impulsive thoughts are reduced. Also, allowing for a state of emotional disconnect providing a form of inner calm and relief (Pezzente 2019).  Therefore, a study by Dr. Mary Zanarini states that 21.7% of the patients with BPD met with the criteria for anorexia nervosa and 24.1% of Bulimia Nervosa (Pednwault 2019).

Additionally, both the disorders mainly stem from the same risk factors that is childhood trauma such as physical, sexual and emotional abuse (Pednwault 2019). The association of both the disorders together can put you at greater risk for emotional deregulation, physical and mental problems. Also, eating disorders can be diagnosed at an early childhood age but BPD can typically be diagnosed by the age of 20 years, early adulthood (Pezzente 2019). By this, it can be said that people with eating disorders in their childhood could go undiagnosed of BPD. For this very reason, patients with eating disorders should be considered for diagnosis of BPD too, for early treatment and prevention. 

Lastly, treatments for both the disorders are available. Either both the disorders could be treated at the same time or one after the other, considering the severity of the problem (Pednwault 2019). 


References

Lieb, K., Zanarini, M. C., Schmahl, C., Linehan, M. M., & Bohus, M. (2004, July 30). Borderline personality disorder. Retrieved from https://www.sciencedirect.com/science/article/pii/S0140673604167706.

Phillipou, A., Gurvich, C., Castle, D. J., & Rossell, S. L. (2015). Are personality disturbances in anorexia nervosa related to emotion processing or eating disorder symptomatology?. Journal of eating disorders, 3(1), 34.

Rana, S. (2018, May 10). Why Do We Eat A Lot When Sad Or Depressed; Science Has An Answer. Retrieved from https://food.ndtv.com/health/why-do-we-eat-a-lot-when-sad-or-depressed-science-has-an-answer-1850315.

Salters-Pedneault, K. (2019, September 17). How Eating Disorders Are Treated When You Have BPD. Retrieved from https://www.verywellmind.com/eating-disorders-and-borderline-personality-425424.

Weltzin, T. (2004). Eating Disorders. GPSolo, 21(7), 42-43. Retrieved from www.jstor.org/stable/23672841

Pezzente, A. (2019). Can Borderline Personality Disorder Cause an Eating Disorder?: BC Centres for Excellence in Eating Disorders. Retrieved January 17, 2019, from https://cfe.keltyeatingdisorders.ca/news/can-borderline-personality-disorder-cause-eating-disorder.

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