The Guide to Eating Disorders and Substance Abuse

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Medically Reviewed By:

Dr. Patricia Sullivan MD MPH on 8/16/2021

Article Overview

Addiction is not limited to drugs or alcohol. We know that many people suffer from eating disorders, putting their health at serious risk. However, there may be a link between eating disorders and substance abuse. Throughout this post, we will look at the evidence that shows there are very similar factors at work for both kinds of addictions. If you or a loved one has either an eating disorder or an addiction to drugs or alcohol, we can give you information about facilities in your area that can help. Don’t hesitate to get in touch with us today at (888) 906-0952 for more information!

To “Just Stop” Isn’t an Option for Eating Disorders
Bulimia and Other Eating Disorders
Eating Disorders and Substance Abuse: Two Addictions At Once?
A Deadly Combination
The Link Between Eating Disorders and Addiction
Find Healing: Rehab Considers All Factors

To “Just Stop” Isn’t an Option for Eating Disorders

Many people think that individuals with eating disorders can stop whenever they want to. That is not the case at all. A person with an eating disorder has a disease. People suffering from an eating disorder can’t “just stop” without the proper treatment for the disease.

Eating disorders are serious illnesses that can often be fatal. Eating disorders cause severe disturbances in people’s eating habits, thoughts, and emotions. There is more going on here than just feeling hungry or not feeling hungry. Preoccupation with food, body weight, and shape may also be a sign of an eating disorder. While each case is different, we will look at the three most common kinds of eating disorders: anorexia nervosa, bulimia nervosa, and binge-eating disorder.

The Mind Games of Anorexia

People with anorexia nervosa may see themselves as overweight, even when they are dangerously underweight. These patients typically weigh themselves repeatedly, severely restrict the amount of food they eat, often exercise excessively. They may even force themselves to vomit or use laxatives to lose weight.

Symptoms of this disorder include:

Extremely restricted eating
Extreme thinness
A relentless pursuit of thinness
Unwillingness to maintain a healthy weight

Patients suffering from anorexia nervosa focus heavily on perceptions of body weight and shape. They cannot see themselves as they truly are. Individuals with anorexia think they are “fat” when they have normal body weight. Over time, other symptoms can develop, including thinning the bones (osteopenia or osteoporosis), mild anemia, brittle hair and nails, dry and yellowish skin, severe constipation, and low blood pressure. They can even suffer heart or brain damage. Anorexia nervosa has the highest mortality rate of any mental disorder. Sadly, many celebrities suffer from this disorder, and many have lost their lives because of it.

Bulimia and Other Eating Disorders

Patients who suffer from bulimia nervosa have episodes of eating unusually large amounts of food and lacking control. Behavior to compensate for overeating typically follows binge-eating. This behavior can include forced vomiting, excessive use of laxatives, fasting, excessive exercise, or a combination of all of these behaviors. It is not easy to determine if someone has this disorder just by looking at them.

People with bulimia nervosa may be slightly underweight, normal weight, or very overweight. Symptoms of bulimia nervosa include:

An inflamed and sore throat
Swollen salivary glands in the neck and jaw area
Sensitive or decaying teeth as a result of exposure to stomach acid
Acid reflux disorder and other gastrointestinal problems

They may also suffer severe dehydration from purging fluids or an electrolyte imbalance (too low or too high levels of sodium, calcium, potassium, and other minerals) which can lead to stroke or heart attack. Bulimia nervosa has also plagued many celebrities, which can encourage young girls to follow suit.

Binge-Eating Disorder

Binge-eating disorder is the most common eating disorder in the U.S. It takes place when people lose control over their eating. Unlike bulimia nervosa, these periods of binge-eating are not followed by purging or fasting. As a result, people with binge-eating disorders often are overweight or obese. Another symptom is eating unusually large amounts of food in a relatively short time. People with binge-eating disorders can find themselves eating even when they are full or not hungry, eating very quickly, or eating alone to avoid embarrassment. People with binge-eating disorders can feel distressed or guilty about eating and may frequently go on diets without success.

Binge-eating disorder can affect both sexes. However, womenshealth.gov reports a little more than half of the people with binge-eating disorder are women. The website states, “studies suggest that people with binge eating disorder may use overeating as a way to deal with anger, sadness, boredom, anxiety, or stress.”

Eating Disorders and Substance Abuse: Two Addictions at Once?

Studies have indicated that the same people who have eating disorders are also prone to substance abuse disorders. According to the Substance Abuse and Mental Health Services Administration, Hudson and colleagues found that men and women with eating disorders had high rates of co-occurring substance abuse disorders.

A report by Piran and Robinson looked at patients that had both eating disorders and substance abuse disorders. They found that as eating disorders became more severe, the number of different substances being abused increased. Severe binge eating disorders were consistently associated with alcohol use. Attempts to lose weight by purging were associated with stimulant/ amphetamine abuse and abusing sleeping pills.

While researchers aren’t sure what causes eating disorders, several factors seem to contribute to the diseases. People often use food and substances to help them cope. According to the SAMHSA website, “A person in recovery from an eating disorder often uses substances to cope with the stresses of recovery. Similarly, a person in recovery from a substance abuse disorder may use disordered eating to cope with or to compensate for the lack of chemical reinforcement.”

When substance abuse disorders and eating disorders occur simultaneously, the consequences, treatment, and recovery are more complicated than for either disorder alone. A 2010 review found that studies report high co-occurrence of eating disorders among women with substance abuse disorders. A study by Gadalla and Piran found that women with either a substance abuse disorder or eating disorder “were more than four times as likely to develop the other disorder as were women who had neither disorder.”

A Deadly Combination

Eating disorders and addiction can be a deadly combination. According to the medical journal QJM, “Eating-disorder patients are already at an increased risk for morbidity and mortality.

Alcohol and drug use pose additional dangers for these patients.” The personality trait impulsivity has been linked to both bulimia nervosa and substance abuse.

Some researchers believe that there is an addictive personality. Additionally, they believe there may be an underlying trait predisposing individuals to eating disorders and alcohol abuse.

However, there is little evidence to support the existence of that trait. Doctors or mental health providers can diagnose alcohol and substance abuse disorders after interviewing the patient.

The physician must keep a clear head and be non-judgmental when assessing for substance abuse disorders among those with eating disorders.

The journal notes that studies “have reported high rates of chemical dependency and clinical depression among adult bulimics. Both eating-disordered individuals and substance-abusing individuals may be self-medicating their clinical depression.”

These individuals may simply be self-medicating with two techniques: overeating and substance abuse. It’s significant to note that guilt is often associated with both eating disorders and alcohol abuse.

The journal also notes that both those suffering from substance abuse and eating disorders have high rates of social anxiety. “Substance use may provide relief from anxiety, depression, and other psycho-social problems to which bulimics appear susceptible.”

Family dysfunction may also be an underlying cause of both problems occurring at once. Often, a parent with eating disorders and substance abuse issues will have a high risk of passing along those disorders to her children through her dysfunctional behavior.

The Link Between Eating Disorders and Addiction

Is there a specific personality more prone to addiction? The QJM journal notes that the personality trait of impulsivity link to both bulimia nervosa and substance abuse. “Many researchers have proposed that an addictive personality is an underlying trait that predisposes individuals to both eating disorders and alcohol abuse.”

Eating disorders and alcoholism are both addictive disorders, and in that sense, they share similar traits. Those who develop an addiction to one substance may also develop patterns of behavior that help them become addicted to another substance.

As such, treatment for eating disorders and substance abuse can be similar in many ways. “However,” the site notes, “empirical evidence about the existence of an addictive personality is inconclusive.” However, there is some strong evidence that suggests eating disorders and substance use disorders tend to occur simultaneously.

According to the National Center for Biotechnology Information, “the prevalence of drug and alcohol abuse is approximately 50% in individuals with an eating disorder, (compared) with a prevalence of approximately 9% in the general population.

Similarly, among individuals with substance abuse disorders, over 35% report having an eating disorder compared with a 1–3% prevalence of eating disorders in the general population.”

According to the NCBI, these results highlight a need to consider alcohol and drug abuse when treating individuals with anorexia nervosa. Their findings support research that individuals with lifetime diagnoses of both (anorexia nervosa and bulimia nervosa)… report more alcohol and drug abuse than those who only engage in restricting behaviors.

Prior research indicates that individuals presenting both an eating disorder and substance abuse disorder may be at a higher risk for physical health complications.

Find Healing: Rehab Considers All Factors

We’ve seen some great similarities between those who suffer from eating disorders and those who suffer from substance abuse disorders. While there may not be one specific type of person who will suffer from both, it’s clear that both problems can co-exist. Eating disorders don’t necessarily lead to substance abuse (or vice versa), but the symptoms of each problem are similar in many ways. They’re so similar that it pays to ensure that a person suffering from substance abuse doesn’t also have an eating disorder.
The professionals who work in rehabilitation (rehab) facilities look at the whole person when creating a treatment program. They understand the common denominators of eating disorders and substance abuse. They know that addiction has underlying causes that don’t necessarily link to the addictive substance. If you or a loved one suffers from either an eating disorder or a substance abuse disorder, the people who work in rehab centers around the country can help you. Contact us at (888) 906-0952 to learn more about how rehab can help you change your life.