Substance abuse is quite prevalent among individuals with eating disorders. Substance abuse refers to the harmful use of substances, such as alcohol, illicit drugs and tobacco.
According to The National Center on Addiction and Substance Abuse at Columbia University (2003), individuals with eating disorders are up to five times more likely to engage in substance abuse than the general population. Additionally, individuals who engage in drug and alcohol abuse are over ten times more likely to have eating disorders than the general population.
The Link Between Eating Disorders and Substance Abuse
The link between eating disorders and substance abuse isn’t clear. An individual with an eating disorder may engage in substance abuse to control her appetite. Conversely, if she first has a problem with alcohol or drug abuse, she may develop an eating disorder due to the suppressant effect these substances have on her appetite. Binge eating can also occur when the chemical stimulation wears off.
Both the control of food intake and the use of harmful substances can be a means of dealing with stress, depression and other psychological problems, such as low self-esteem.
Substance Abuse and Eating Disorders’ Effects and Risk Factors
Those who binge and purge are more likely to engage in substance abuse than individuals with anorexia nervosa. Not surprisingly, substance abuse and bulimia nervosa share a number of similarities. Both are long-term disorders with similar cycles of reward and reinforcement. Other shared characteristics include:
- Changes in mood
- Compulsive behavior
- High relapse rates
- Low self-esteem
- Obsession with a substance
- Performance of rituals (i.e., always preparing drugs or food the same way)
- Secretive behavior.
Substance abuse and eating disorders also share a number of common risk factors.
- Heavily influenced by external factors, like the media and social perception
- Likely to develop in families with a history of eating disorders, alcohol abuse or drug abuse
- Likely to develop in stressful times or in response to a traumatic event, such as sexual abuse.
Treatment and Diagnosis
Until recently, patients with both eating disorders and substance abuse received separate treatment for these disorders. Now, however, doctors are beginning to screen patients for both disorders at the same time. The shared characteristics and risk factors of these disorders form the basis for treatment programs that treat eating disorders and substance abuse simultaneously.
Traditional 12-step addiction programs are ineffective for treating people with eating disorders who have very serious behavioral, physical and psychological problems. Blended eating disorder/addiction treatment programs address these issues.
National Association of Anorexia Nervosa and Associated Eating Disorders. (n.d.) Information about treatment. Retrieved July 14, 2010, from http://www.anad.org/get-information/information-about-treatment/
Ressler, A. (2008). Insatiable hunger: Eating disorders and substance abuse. Retrieved July 14, 2010, from http://www.socialworktoday.com/archive/070708p30.shtml
The National Center on Addiction and Substance Abuse at Columbia University. (2003).
World Health Organization. (n.d.) Substance abuse. Retrieved July 14, 2010, from http://www.who.int/topics/substance_abuse/en/