<p>Exposure to Adverse Childhood Experiences (ACEs) is linked with disordered eating behaviors among adolescents. Emotional regulation problems, lack of self-compassion, and body image issues may explain this connection; however, these have been primarily examined in either community samples or eating disorder specialty settings. Thus, the current study examined emotion regulation difficulties, self-compassion, and body image dissatisfaction as potential mechanisms in the relationship between prior exposure to ACEs and current disordered eating behaviors among high-risk, psychiatrically-hospitalized adolescents. Participants included 160 adolescents (<i>M</i>_age = 14.92; SD = 1.72; ages 11–18; 65.7% female; 62.3% White; 48.7% sexual or gender minority) recruited from a psychiatric inpatient unit. Constructs of interest were assessed using self-report measures and results showed that emotion regulation, self-compassion, and body image dissatisfaction mediated the relationship between exposure to ACEs and disordered eating behaviors. Treatment aimed at bolstering emotion regulation strategies and self-compassion—particularly in response to negative thoughts regarding one’s body—may help reduce the risk of eating disorders among high-risk youth.</p>