Eating Disorders and Substance Abuse

Eating disorders are a type of mental illness that impacts the way that the people who have them eat and see their own bodies. There are multiple types of eating disorders, and some are more common than others. All of these conditions involve extreme changes in what and/or how much a person eats, usually in a way that results in a lot of stress on the body.

The National Eating Disorders Association (ANAD) estimates that over 30 million people in the United States have eating disorders. Additionally, ANAD states that someone dies directly from an eating disorder about once every hour. Contrary to common perception, eating disorders are serious illnesses that can threaten one’s life, not just an unusual lifestyle choice.

So what do eating disorders and addiction have to do with each other? In order to answer this question, we will take a closer look at what eating disorders are and how they can exist alongside addiction to create a co-occurring disorder. 

Common Eating Disorders

Eating disorders are a type of mental illness, and many specific conditions exist under this title. There are many types of eating disorders, but three stand out as the most common. These three are anorexia nervosa, bulimia, and binge-eating. Let’s take a look at these conditions:

Anorexia Nervosa

Anorexia nervosa, commonly referred to as ‘anorexia’, is a type of eating disorder that affects a person’s body image. People with this condition see themselves as overweight even when they are very underweight. ANAD states that around 1 percent of American women suffer from anorexia during the course of their life. 

People who have anorexia have an intense fear of gaining weight. They often check their weight constantly. Anorexia is labeled as an eating disorder because people who have it restrict their food intake. Signs and symptoms of anorexia include extreme weight loss, low blood pressure, and damage to bones, hair, and nails. According to ANAD, about half of people with anorexia also suffer from anxiety.

Bulimia Nervosa

Bulimia is a condition that includes extreme eating and purging behavior. People with bulimia eat very large amounts of food at a time and then follow these episodes of binging with different kinds of purging. The purging might include throwing up on purpose, exercising excessively, using laxatives, fasting, or some combination of these actions.

Unlike anorexia, people with bulimia are not generally underweight. Becoming underweight as a result of bulimia is possible, but it is also possible to keep a normal or even above average body weight.

Symptoms of bulimia include negative effects from frequent throwing up, such as sore throat, decaying teeth, and dehydration. Other symptoms are chronic digestive issues and electrolyte imbalance, both of which can lead to serious health problems.

Binge Eating

Binge eating, also known as binge-eating disorder, describes a condition wherein the affected person loses control of their food intake. Unlike people with bulimia, those who suffer from binge eating do not purge or fast after their episodes. People with this disorder are commonly very overweight or obese.

According to the National Institute of Mental Health, binge eating is the most common eating disorder in the United States. Symptoms of binge eating include eating unusually large amounts of food over a short period of time, continuing to eat when you are full, eating quickly, and eating until you are sick or very uncomfortable. Some people who binge eat may do so privately and lie about their eating habits to others.

Binge eating can result in digestive issues as well as obesity, which can, in turn, lead to serious health concerns. These health risks include heart failure, raised blood pressure, and diabetes.

What is the Link Between Eating Disorders and Addiction?

According to a 2003 study published by the Center on Addiction, people with eating disorders are up to 5 times more likely to abuse drugs and alcohol than people without eating disorders. While about 9 percent of the general population abuses drugs or alcohol, around half of people with eating disorders do so. But what makes this specific type of co-occurring disorder so common?

Shared Risk Factors

One of the reasons that many people have both eating disorders and substance use disorders is that the two types of conditions share common risk factors. This means that people who are more likely to develop one type of disorder for certain reasons may also be more likely to develop the other for the same reasons. Examples of risk factors that can increase the chances of either type of disorder include:

• Brain chemistry. Both eating disorders and substance abuse can be made more likely by certain changes in brain chemistry. One example of this is lowered dopamine levels. Dopamine is responsible for feelings of pleasure and reward. Both substance abuse and disordered eating can provide short, temporary boosts in dopamine levels. In this way, eating disorder behavior can actually be thought of as addictive.
• Family history. The connection between these conditions and family experiences is very strong. A history of abuse and neglect can make both eating disorders and substance abuse more likely. Certain traumatic experiences, either inside or outside of the family, can also make both types of conditions more likely to develop. This is because both eating disorders and addictions give people short periods of feeling in control and happy.
• Mental health conditions including depression and anxiety. It is not uncommon for someone who has an eating disorder and a substance use disorder to also suffer from mental health issues. Conditions like anxiety and depression can lead to both substance abuse and eating disorders.

Feedback Loops

As is the case with many co-occurring disorders, once a person has both an eating disorder and a substance use disorder, these issues tend to feed into each other. Oftentimes, these disorders develop as a way of coping with stressful or difficult times. 

People with eating disorders like anorexia and bulimia tend to use their relationship with food as a way of exerting control when they feel helpless. Unfortunately, this only leads to further physical and mental health problems, which continue to feed into the stress rather than resolve it. 

Those who are familiar with addiction will see how similar this pattern is to drug or alcohol abuse. People with substance use disorders tend to try to solve their problems with drugs or alcohol, but only end up making matters worse. 

When both an eating disorder and an addiction are present, the cycle is even worse. Both conditions put a strain on the body and mind, and both tend to get worse when times are tough. In this way, people with both kinds of disorders are not only at risk to develop these issues, but the issues make one another worse, as well.

Treatment for Co-occurring Eating Disorders and Addiction

Treating someone who has both of these disorders is challenging, but possible. Treatment for co-occurring disorders is most effective when it is integrated. This means that rather than looking at each problem as a separate thing and treating them that way, the person’s unique situation is addressed as a whole.

In the case of eating disorders and substance abuse, treatment must address each issue, as well as the entire situation. This means understanding what the common risk factors are that are contributing to both problems, as well as the ways that each problem exacerbates the other. 

There is no formula for treating people with eating disorders and addictions. Each case is different, and each person has different needs. There are many levels of severity and urgency that can exist with these conditions. Some patients might need immediate, full-time medical care for both conditions, while others might be able to continue their daily lives during treatment.

Some treatments, such as cognitive-behavioral therapy, are commonly used to treat each of these conditions. It is likely that some form of talk therapy will be helpful in most patients’ treatment journeys.

If you or someone you know is suffering from this unique co-occurring disorder, seek help now. Both eating disorders and addictions can be deadly if left untreated, and it is unlikely that the issues will resolve on their own.