Eating disorders wreak havoc on the mind and the body, so it’s no surprise that people who struggle with these conditions may consider taking their own lives. In fact, studies show that, overall, up to 20% (1 in 5) of those with anorexia attempt suicide. Individual group studies have found up to 60% of those with eating behaviors engage in suicidal thoughts and behaviors. The rate of suicidal thinking, attempts, and completion are much higher for people with bulimia nervosa and those with anorexia who purge, than for those who simply restrict the amount of food they eat. However, there are still cases of suicide and suicidal thinking and attempts among those who don’t engage in purging behavior. Those who unsuccessfully attempt suicide are also at high risk of future attempts.

The death rate by suicide among people with eating disorders is not only higher than average, higher than in those with depression, schizophrenia, or any other mental health disorder. Many factors can contribute to an increased risk of suicide or attempted suicide among people with eating disorders. These include suffering from multiple forms of mental illness, family issues and conflicts, social isolation, a sense of being a burden to others, a history of previous suicide attempts, a disregard for the dangerous consequences of their behavior, tolerance for high-risk, impulsive behaviors, and a sense of fearlessness when it comes to death.

Recognize These 6 Warning Signs of Suicidal Thinking

Regardless of the reason, people who are considering suicide often show similar signs and behave in similar ways. Some of those signs are more obvious than others. People with eating disorders who are experiencing suicidal thoughts may:

  1. Talk about having no reason to live, or feeling hopeless and guilty about being a burden to others because of their disorder. 
  2. Increase their use of alcohol or drugs, or engage in other reckless behaviors. 
  3. Experience mood swings, display increased anxiety or anger, or suddenly display a sense of relief or improvement in symptoms
  4. Begin to withdraw from social activities, isolate themselves from others or start to give away their possessions. 
  5. Express thoughts about death or dying or not being around in the future, even going so far as to say goodbye to family and friends. 
  6. Start to create a plan by searching online and elsewhere for ways to end their lives.
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Self-Harm and Eating Disorders: Risky Behaviors Increase the Risk of Death

In addition to suicide attempts, up to 40% or more of people with eating disorders engage in deliberate, non-suicidal, self-harming behaviors. These behaviors can include self-cutting or burning their skin, poisoning, swallowing objects to cause choking or other actions that cause great discomfort or pain. Self-harm behaviors are thought to be an attempt to use physical pain as a distraction from deep psychological pain. 

Self-harming behaviors in people with eating disorders are closely linked to suicide. People who practice self-harm behaviors do not necessarily have the intention of committing suicide; they may, at most, be apathetic towards death, but they are at increased risk of accidental death due to the extent of the injury and may go on to develop suicidal thoughts.

Getting Help for Yourself or Someone Else

If you have a friend or family member with an eating disorder who is showing signs of suicidal thinking and behavior, you can help by showing them support. If you’re not sure what to do or say, call the confidential National Suicide Prevention Lifeline (below) for help. Suicide is preventable and some form of help is always available.

There is often a fear that talking about suicide will make someone suicidal, but this is a myth. Asking someone if they are thinking about suicide does not put the thought in their head, so don’t be afraid to specifically ask them whether they’re planning on hurting themselves or committing suicide. Ask the direct question: Are you planning to kill yourself? Remain calm and speak in a non-judgmental way. Tell the person you care about them, that their life is meaningful, and that you are willing to help them find a professional to work with. Stay with the person as long as you can but, for your own safety, do not try to negotiate with someone who has a weapon. If necessary, and when possible, call 911 or accompany the person to the nearest hospital emergency room.

If you ever have suicidal thoughts, it helps to develop a written crisis plan for the future, a reminder list that includes such guidance as engaging in coping behaviors that improve your mood, calling a hotline or a friend, or calling 911 to get yourself to the hospital.

Once the initial threat of suicide has been addressed, it’s important to connect to long-term eating disorder treatment that includes help for suicidal ideation, and other related issues such as depression or substance abuse. Start by speaking with your primary care physician or mental health professional who can refer you to specialized inpatient or outpatient programs, if necessary. Getting the right help is vital for someone with an eating disorder to stabilize both their physical and mental health.

If you are having suicidal thoughts, never hesitate to reach out to someone for help. The National Suicide Prevention Lifeline at 1-800-273-TALK (8255), is free and available 24/7. 

The National Eating Disorders Association also has a hotline at 1-800-931-2237. Call them if you need help and cannot get it from your immediate support circle. They will talk to you and can connect you with resources and treatment options to help you get started with your recovery.

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Last Updated: Sep 4, 2019