Eating Disorders and Suicide: A Connection We Can’t Overlook
Trigger Warning: This article discusses sensitive topics, including suicidal thoughts and eating disorders. These topics can be deeply triggering or distressing. Please take care of yourself while reading.
If you are in crisis and live in the U.S., call or text 988, or access the chat function via the 988 Suicide & Crisis Lifeline. Deaf or hard-of-hearing options are available as well. You can also reach the Crisis Text Line by sending “HOME” to 741741. LGBTQIA+ folks can connect with a trained, queer-affirming counselor via The Trevor Project’s virtual hotline, too. All of these resources are free, confidential, and available 24-7. You can also look through this extensive list of hotline options.
We can’t overlook the fact that the mortality rate of eating disorders is significantly higher compared to most other mental health disorders. This is largely due to the serious medical complications that can result from eating disorders, such as weak immune function, severe malnutrition, and, in extreme cases, heart and organ failure.
But there’s another equally dangerous—and frequently overlooked—threat contributing to those increased mortality rates: the connection between eating disorders and suicide.
According to the Journal of Eating Disorders, suicide is one of the leading causes of death in folks with these illnesses. Around 60 percent of bulimia-related fatalities are from suicide, while nearly 35 percent of anorexia-related fatalities are from suicide.
That risk escalates even further in those with co-occurring mental health concerns, like depression or anxiety, and those from marginalized communities.
For example, suicide attempts are about 75 percent more frequent in transgender folks with eating disorders than their cisgender peers.
If either you or someone you know has an eating disorder, it’s crucial to be aware of this overlap and the behavioral signs to look for.
Lethal-means intervention and crisis-informed therapeutic care can mean the difference between life and death. So, let’s explore the intersection of eating disorders and suicide, along with actions to take if suicidality is present.
What to Know About the Increased Risk of Suicide in Eating Disorder Patients
Research from the International Journal of Eating Disorders shows that almost 65 percent of folks with eating disorders also report encountering suicidal ideation at some point in their lives.
Additionally, more than 30 percent have attempted to act on their suicidal thoughts at least once. As alarming as these numbers are, it’s hard to meaningfully intervene with helpful resources and care models until we can parse out the roots of this correlation.
Common Traits
Eating disorders and suicidal behaviors share many traits in common. Both issues are often characterized by low self-esteem, perfectionism, trauma, impulsivity, isolation, depression, anxiety, intrusive thoughts, and emotional dysregulation.
These risk factors can exacerbate feelings of distress or overwhelm, which in turn, can increase the urge to harm oneself. Since eating disorders and suicidality are extreme forms of self-harm, they can feed off each other, creating a “perfect storm” situation.
Suicide as a Means to Escape
Folks with eating disorders often experience their lives as unbearable, with no way out of the mental, emotional, and physical turmoil these illnesses cause. This existential hopelessness and belief that healing is out of reach can influence a person to view suicide as the only alternative to their suffering.
Under these circumstances, suicidal thoughts or behaviors are not necessarily the result of a desire not to live, but a means to escape the constant, relentless pain of an eating disorder.
Suicide, Eating Disorders, and Minorities
It’s also important to recognize that minorities face an even higher risk of suicidality, the SSM Population Health Journal indicates. This is due to systemic injustices like discrimination, stress, socioeconomic impacts, elevated trauma or bias, mental health stigma, and treatment access barriers.
We can’t talk about this connection between eating disorders and suicide without also calling out the societal disparities that affect some folks more than others.
Red Flags for Suicidal Thoughts and Behaviors
While not a comprehensive list, here are the main red flags associated with potential suicidal thoughts and behaviors, according to the Substance Abuse and Mental Health Services Administration (SAMHSA):
Uncharacteristic agitated, reckless, irritable, anxious, or hostile behavior
Sleep disturbances—either sleeping too much or not enough
Feeling hopeless or questioning whether there’s a reason to live
Elevated use of substances (alcohol, medications, recreational drugs)
Loneliness or withdrawal from social connections and situations
Extreme mood swings or emotional outbursts that seem to come out of nowhere
Loss of interest in activities, relationships, or normal daily routines
Increase in physical issues like chronic headaches, nausea, and fatigue
Overwhelming emotional distress or feeling stuck in a cycle of unbearable pain
Belief that your presence and existence is a burden to others
Talking about suicide—or making plans to carry out a suicide attempt
Recovery Is Possible—From Both Eating Disorders and Suicidality
Just as eating disorders and suicide overlap, healing from these mental illnesses must also take place in tandem. Urgent crisis intervention or suicide prevention measures might be necessary to re-stabilize a person, but these actions alone are not enough.
It’s also important for folks to access comprehensive care modes that treat the intersectional roots of both eating disorders and suicidality, while taking someone’s unique, holistic needs into account. Here are four critical steps to nurture long-term recovery outcomes.
Create and Regularly Evaluate a Personalized Written Safety Plan
Research shows that safety planning interventions can lower the risk of suicide attempts by 43 percent. With the help of a licensed mental health clinician, write a safety plan tailored to your own experiences.
List out the thoughts, behaviors, and symptoms to look for, then identify the coping mechanisms, crisis hotlines, trusted contacts, and steps for de-escalation to reach for in moments of emotional distress or overwhelm.
You can also revisit this plan on a regular basis to modify the level of care, as you progress in treatment.
Look for Trauma-Informed, Weight-Inclusive, Identity-Affirming Care
Unresolved trauma often causes mental, physical, or emotional detachment from oneself, which can fuel both eating disorders and suicidal behaviors, the Journal of Clinical Medicine explains. Trauma-informed mental healthcare helps cultivate safety, trust, empowerment, and autonomy to reduce shame and minimize the risk of retraumatization in treatment settings.
Meanwhile, weight-inclusive, identity-affirming care models help combat harmful stigmas, which can worsen mental health outcomes and exacerbate suicidal behaviors.
Integrate Lethal-Means Protocols Into Your Eating Disorder Treatment
If you are in imminent danger of a suicidal attempt, lethal-means counseling is a critical first step that could save your life. Lethal-means counseling refers to the practice of limiting access to medications, firearms, and other tangible objects or environmental factors that can increase the potential for suicidality.
A consistent, structured protocol for lethal-means counseling can lower the frequency of suicidal attempts in folks across the entire spectrum of mental illnesses, the American College of Preventative Medicine Journal points out.
Surround Yourself with a Safe, Accountable, Nurturing Support Network
Social isolation can also heighten the risk of eating disorder symptoms and suicidal behaviors. But leaning into trusted clinicians, mentors, friends, or family members can help you feel safe enough to take steps forward in the healing journey.
A robust support network can also hold you accountable during setbacks and pay attention to certain blind spots that might not be as evident to you. At Project HEAL, we offer resources to connect with others who will come alongside you in this process, such as free meal support and community care programs.
Ready to Start Your Healing Journey? We’re Here to Support You
The connection between eating disorders and suicide is rampant—but healing is possible. If you have been suffering in isolation, silence, or shame, please know that you don’t have to walk through this alone.
Project HEAL is on a mission to dismantle financial and societal barriers to treatment, so you can recover with the help of a clinician who will affirm your unique identities and establish a care plan that centers around your own specific needs. Learn more about our treatment access programs today.
