Eating disorders are complex and insidious conditions that, when left untreated, can be fatal. The same concerning risks can be said for addiction to drugs or alcohol. But is there a relationship between the two disorders? And does one cause the other?
Research from the National Eating Disorder Association shows that a staggering 50 percent of individuals diagnosed with eating disorders also abuse alcohol or illicit drugs. Furthermore, up to 35 percent of people with substance use disorders also have an eating disorder—a rate 11 times higher than the general population.
Understanding Eating Disorders
Eating disorders affect both physical and emotional functioning. These conditions typically include a preoccupation with food and exercise, obsession with body shape and weight, and themes of perfectionism and control.
While the conditions can develop at any time, most eating disorders start in the early teen or young adult years.
Anorexia entails severe restriction of food, resulting in significantly low body weight. Anorexia also includes a bingeing/purging subtype.
Bulimia refers to periods of compulsive overeating or bingeing, followed by compensatory behaviors to "reduce" the effect of the food. These compensatory behaviors may include purging, laxative misuse, or excessive exercise.
Binge-eating disorder is similar to bulimia in that individuals experience a loss of control and 'binge' on food on a routine basis. However, these individuals do not use the same compensatory behaviors.
Other Specified Feeding or Eating Disorder (OSFED)
OSFED is a diagnosis used for individuals who exhibit disordered eating patterns without meeting the full criteria for one of the other diagnoses. For example, the individual may meet all the symptoms for anorexia without significant weight loss. Or, they may meet all the criteria for binge eating disorder or bulimia, but the episodes are not as frequent.
Risk Factors For Teen Eating Disorders
Research has not pinpointed an exact cause for eating disorders. As with most mental illnesses, the development appears to be multifaceted.
That said, there are several risk factors associated with eating disorders including:
- Family history of eating disorders
- Co-occurring history of other mental illness
- History of extreme dieting
- Chronic stress and trauma
- History of being teased or bullied
- Limited or lack of a healthy social network
As we can see, many of these same risk factors have a crossover effect with substance use risk factors.
How Both Conditions "Feed" Each Other
For example, the slang term drunkorexia refers to the common phenomenon of people restricting food intake during the day to make room for alcohol calories at night. This restriction is a prevalent trend across college campuses.
Additionally, some people turn to stimulants like cocaine, Adderall, or methamphetamine for the appetite suppression effects.
Both eating disorders and substance use disorders carry enormous shame and stigma. Individuals tend to feel insecure with themselves (internally and externally). As a result, they may attempt to focus on areas they believe they can control (i.e., body weight, food intake) to compensate for all the struggles they feel they cannot control.
Even if a person is in recovery from an eating disorder or a substance use disorder, it is not uncommon to "relapse" into the other condition.
Treating Both Conditions
An individual struggling with a co-occurring eating disorder and substance use disorder needs treatment that addresses both issues.
To manage both disorders, individuals will need support in:
- learning relapse prevention tips
- developing healthy coping skills
- improving self-esteem and self-worth
- practicing grounding/relaxation skills
- building positive support
- increasing vulnerability and honesty with self and others
Failure to seek and receive treatment can lead to a relapse in one or both conditions.