Tue. Jan 18th, 2022

Eating Disorders and Co-Occurring Substance Abuse: What’s the Connection?

Although not common knowledge, eating disorders often co-occur with substance abuse. Studies suggest that 50% of those suffering from an eating disorder are also abusing substances, a rate five times greater than that of the general population. Other research shows that 30%-50% of all people suffering with bulimia have a co-occurring substance abuse, while it is less common in those with diagnosed with anorexia, but they do occur.

There are similarities between the physiological conditions, neurotransmitters, and personality traits of eating disorders and substance abuse. As it does with eating disorders, genetic, biological, environmental, and psychological factors also influence substance abuse.

Other links between these disorders include:

• Coping Mechanism: Those suffering from an eating disorder will often use drugs or alcohol when they are feeling depressed or have low self-esteem. Someone with a substance use disorder may develop an eating disorder when they use food to satisfy cravings or to avoid withdrawal symptoms.
• Weight Control: For some, substances may cause appetite suppression leading to weight loss, which can, in turn, trigger an eating disorder. Other drugs, such as cocaine, are often used to increase metabolism.

There are three common types of eating disorders:

• Self-starvation and excessive weight loss characterize Anorexia Nervosa. Studies show that 10%-20% of those suffering from anorexia will die from complications related to it, giving it the highest mortality rate of any mental illness. Sufferers often have low self-esteem and need to control their emotions and surroundings.
 A cycle of binge eating followed by purging characterizes Bulimia Nervosa. The goal of bulimia is to rid the body of unwanted calories and the sensation of being overly full. Many of those suffering report they have little or no control over their hunger when they binge.
• Recurrent binge eating in a short period with a sense of loss of control and shame characterizesBinge Eating Disorder. Binge eating disorder affects an estimated 3.5% of women and 2% of men, making it the most common eating disorder in the U.S.

According to SAMHSA, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), no longer uses the terms substance abuse, but refers to it as substance use disorders, occurring when “the recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home.” Defined as mild, moderate, or severe to indicate the level of severity, substance use disorders are based on evidence of impaired control, social impairment, risky use, and pharmacological criteria, and will often include substances such as:

• Alcohol
• Illicit drugs (marijuana, heroin, cocaine (including crack)
• Hallucinogens
• Inhalants
• Prescription-type psychotherapeutics (including pain relievers, stimulants, and methamphetamine)

When an eating disorder co-occurs with substance use, the consequences, assessment, treatment, and recovery are more difficult for both disorders than just one. Treatment for dual diagnosis is an integrated way to help reduce the pattern of patients wavering between an eating disorder and substance abuse.

Residential treatment addresses both disorders at the same time. Our program is comprehensive and strengths-based, incorporating elements of spirituality, mindfulness, nutrition, art, movement/exercise, and psychotherapy. For a person with a true dual-diagnosis we use the principles of 12-step recovery, and require attendance at least three 12-Step or SMART recovery meetings per week.

Those suffering from co-occurring disorders often struggle with poor self-esteem, and feelings of guilt. Through weekly individual therapy sessions, daily psychoeducational groups, and weekly meetings with the clinician and dietary staff, clients learn ways to cope with stress, express emotions, learn distraction and self-soothing skills, balance wants versus needs, and handle conflict. With the guidance of our certified dietician, clients develop an individualized meal plan to nourish the body’s needs. Our comprehensive treatment approach helps to end the behaviors contributing to the dual diagnosis.

There is a high rate of relapse for those struggling with the dual diagnosis, so relapse prevention strategies are a common part of most treatment programs, as well.

Eating disorders and co-occurring mental health conditions greatly impact families, and there is a greater chance for a full recovery when there is a reliable support system.

Educate yourself, be proactive and know that both these disorders are treatable. 



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