Getting Help for Substance Use & Eating Disorders
Roughly 50% of people who suffer from eating disorders also suffer from a substance use disorder. Co-occurring disorders can be difficult to overcome on your own without professional help, but dual diagnosis treatment can help you fully recover from both disorders at the same time, and allow you to gain improved physical, mental, and emotional health. Use our treatment center directory to find dual diagnosis treatment near you, or call our 24/7 confidential helpline at 866-351-3840(Who Answers?) to discuss your options with an experienced addiction counselor.
Here’s what you need to know about the relationship between eating disorders and substance use disorders, and how dual diagnosis treatment can help you recover from both conditions.
Signs of Co-Occurring Substance Use & Eating Disorders
Substance abuse and eating disorders share many of the same characteristics, which can help make it easier for you to spot whether your loved one is struggling and needs help. Some cases of eating disorders may be regarded as addiction, since impulsivity and compulsivity are common traits associated with both eating disorders and substance use disorders.
Common signs of co-occurring substance abuse and eating disorders:
- Secretive behavior
- Extreme weight loss or weight gain
- Compulsive and/or impulsive behavior
- Rituals that may seem unusual or uncharacteristic
- Cravings for drugs, alcohol, and/or foods
- Obsessive preoccupation with drugs, alcohol, and/or certain eating behaviors
- Using high doses of drugs as time goes by
- Increasing or decreasing the amount of food being consumed as time goes by
- Devoting more time to obtaining and using drugs
- Devoting more time to practicing behaviors of the eating disorder
- Neglecting other interests in favor of drug use and/or the eating disorder
- Inability to stop using drugs or practicing behaviors associated with the eating disorder
- Withdrawal from social activities and loved ones
- Continued use of the drug or eating disorder behaviors despite negative consequences
- Unexplained mood swings and irritability
- The onset of mental health disorders or suicidal thoughts
- Tolerance and physical dependence on drugs and/or alcohol
- Withdrawal symptoms when drugs are stopped abruptly
- Using drugs or alcohol to facilitate the eating disorder
Signs of co-occurring substance use and eating disorders can sometimes vary depending on the drug being used, and on the type of eating disorder. For instance, stimulant drugs like cocaine and methamphetamine can suppress appetite, while marijuana can drive food cravings and binge eating.
Eating disorders commonly linked to substance use:
- Anorexia nervosa. This eating disorder is characterized by self-imposed starvation that leads to extreme weight loss and malnutrition. People who suffer anorexia may skip meals completely, or only munch on low-calorie foods like celery and rice cakes.
- Bulimia nervosa. Those who suffer bulimia will binge-eat large amounts of food within a short time, then force themselves to purge the food from their bodies to prevent calorie absorption. Vomiting, laxative use, and excessive exercise are common purging methods among those with bulimia.
- Binge eating. This disorder is characterized by uncontrolled eating that usually only stops when someone can no longer eat due to experiencing complete fullness. Some who binge-eat may resort to purging, but usually only in an effort to relieve pain caused by overeating.
- Purging disorder. This eating disorder is characterized by repeated purging that takes place after small or regular meals, rather than just after binge-eating episodes.
- Diabulimia. Restricted only to people who suffer diabetes, diabulimia is characterized by misusing or skipping insulin injections to achieve weight loss.
- Nocturnal-eating syndrome. Also known as night-eating syndrome, this disorder is marked by consuming high amounts of calories between dinner and breakfast time. Nocturnal-eating syndrome is also strongly linked to stress, depression, sleep disturbances, and hormonal imbalances.
How Common is this Dual Diagnosis?
Over 35% of people with a substance use disorder also have an eating disorder, compared to a prevalence of between 1 and 3% among the general population. Additionally, an estimated 50% of people who abuse drugs and alcohol have an eating disorder, compared to a prevalence of about 9% among the general population.
Binge eating is the most common eating disorder associated with alcohol and illicit drug use. Nearly 25% of people who suffer from binge eating disorder will suffer a substance use disorder at some point in their lifetime, while 2.7% of this population currently suffers from a substance use disorder. Binge eating sets in at the average age of 23 years, and occurs more frequently among females, college students, and young adults between the ages of 18 and 29.
Bulimia and anorexia are also strongly tied to substance use disorders. A study examining substance use rates among teens with eating disorders found that the lifetime prevalence of substance use was 48.7% among those with bulimia, 24.6% among those with anorexia, and 28.6% among those with an eating disorder not otherwise specified.
People who suffer from co-occurring eating disorders and drug abuse will often choose substances that allow them to experience relief from eating disorder symptoms. Or, they may choose substances that help them practice some of the behaviors related to their eating disorder. For instance, a person who suffers bulimia may abuse alcohol to induce vomiting more easily, while also using alcohol to disguise symptoms of their eating disorder.
Here are substances most commonly abused by people with eating disorders:
- Stimulants. Prescription and illicit stimulants such as Adderall, Ritalin, cocaine, and meth work by stimulating the central nervous system to increase energy while also reducing appetite. Those who suffer from eating disorders like anorexia may abuse stimulants to eat fewer amounts and achieve weight loss.
- Alcohol. People with eating disorders like anorexia who restrict their food intake may resort to drinking their calories instead of eating them, such as with alcohol. Those with bulimia may binge-drink alcohol to induce vomiting.
- Opioids. Heroin, fentanyl, and prescription painkillers work by depressing the central nervous system to relieve pain and induce feelings of relaxation. Those suffering physical pain and discomfort caused by their eating disorder may use opioids to experience pain relief, and to benefit from euphoria that helps them escape negative psychological symptoms.
- Marijuana. Cannabis produces effects of extreme relaxation to relieve feelings of stress and anxiety associated with many eating disorders.
Many who suffer from eating disorders may also abuse drugs and alcohol to mask or evade traumatic memories, or negative thoughts and feelings that triggered their eating disorder in the first place. However, drug abuse only worsens problems surrounding eating disorders, and won’t treat the root cause behind the disorder.
Which Disorder Causes the Other?
When it comes to co-occurring eating disorders and a substance use disorder, most people develop an eating disorder first before developing problems surrounding drug dependence and addiction. However, it’s possible for substance use disorders to also lead to eating disorders, since some may practice certain eating behaviors to cope with symptoms of drug abuse. For instance, marijuana and hashish can increase appetite and lead to binge-eating episodes. Those who suffer marijuana use disorder may start practicing behaviors surrounding bulimia so they can continue to abuse marijuana and engage in binge eating without gaining weight.
Eating disorders and substance use disorders share similar root causes. Both disorders have been linked to family genetics, personality traits like impulsivity, emotional trauma, environment, family dynamics, and chemical imbalances in the brain. Stress is another major root cause of co-occurring disorders, since people may practice certain eating behaviors or abuse drugs to relieve or cope with stress.
When left untreated, co-occurring substance use and eating disorders can worsen one another and lead to serious health complications, including drug overdose and death. Seeking professional dual diagnosis treatment is the best way to overcome both disorders, and lower the risk for these side effects. Knowing risk factors for eating disorders and substance use disorders can help you stay safe, and clue you in to whether a loved one may need help recovering from a dual diagnosis.
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Who is at Risk for this Dual Diagnosis?
Eating disorders and substance use disorders share many common risk factors. Mental health disorders are a strong risk factor for this dual diagnosis, along with family history, social pressures, low self-esteem, and environment. This dual diagnosis also shares characteristics of social isolation, compulsive behavior, and suicidal thoughts.
When it comes to eating disorders, there is no single risk factor likely to trigger an eating disorder on its own. Evidence suggests that eating disorders are triggered by multiple different factors, but often start during teen years and young adulthood. An estimated 90 to 95% of people who suffer anorexia are female, while an estimated 80% of those with bulimia are female. However, rates of binge eating disorder are similar among males and females.
Common risk factors for eating disorders:
- Genetics. People with relatives who have eating disorders are more likely to develop eating disorders themselves.
- Brain function. Eating disorders have been linked to certain patterns and changes in brain activity.
- Social factors. Spending time with people who have negative views about body images, or having to endure ridicule from others about your body type are examples of social factors that can lead to eating disorders.
- Trauma. Sexual assault and abuse, major life stressors during childhood, and other traumatic events are common risk factors for eating disorders.
- Psychological factors. Personality traits such as impulsivity, perfectionism, and low confidence are common risk factors for eating disorders, as are mental health disorders such as depression, bipolar disorder, and anxiety.
Substance use disorders offer the same risk factors as eating disorders, except they revolve around drug and alcohol use instead of unhealthy eating behaviors. For instance, people who spend time in environments with easy access to drugs and alcohol are at higher risk for developing substance use disorders, as are those pressured by peers in their schools and communities to use drugs and alcohol.
Shared risk factors for this dual diagnosis:
- Family history of eating disorders and/or drug addiction
- Changes in brain chemistry
- Occurrence during times of stress or major life events / transitions
- Feelings of impulsivity or compulsivity
- Low confidence and self-esteem
- Depression, anxiety, or another mental health disorder
- History of trauma or abuse
- Lack of parental supervision
- Influence from unhealthy parenting behaviors
- Peer pressure
- Social pressures
Getting Dual Diagnosis Treatment
If you or someone you love is suffering from a co-occurring substance use disorder and eating disorder, understand that dual diagnosis treatment can treat both disorders in full. Many addiction treatment centers offer a range of therapies to help people recover from both drug and alcohol dependence, along with the underlying root causes of their addiction and eating disorder.
What Does Dual Diagnosis Treatment Entail?
Dual diagnosis treatment for substance use disorders and eating disorders begins with drug or alcohol detox. Detox helps you overcome physical dependence on drugs and alcohol so you no longer have to rely on these substances to prevent the onset of withdrawal symptoms. When choosing an addiction treatment center, look for those that offer a medical detox, which allows you to withdraw from drugs and alcohol under 24/7 medical care and supervision to reduce the risk for complications. A medical detox may also involve the use of medications that relieve some or all withdrawal symptoms.
Detox is followed by a combination of therapies that treat the core, psychological root causes of your addiction and eating disorder. These therapies are usually aimed at treating behavioral and emotional symptoms related to one or both disorders, and generally teach you how to live a healthier, sober lifestyle backed with good nutrition and eating habits.
Therapies commonly offered as part of dual diagnosis treatment:
- Nutrition therapy and counseling
- Individual, group, and family therapy
- Cognitive behavioral therapy
- Exercise therapy
- 12-step support group therapy
Those recovering from a dual diagnosis may fare best in an inpatient treatment setting, where doctors can monitor recovery from malnutrition, heart problems, and other physical problems caused by eating disorders and substance abuse. A medical detox and dual diagnosis therapies are commonly offered at many inpatient drug detox centers.
Call 866-351-3840(Who Answers?) to discuss all the available treatment options in your area.