Eating Disorders and Addiction

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The Harvard School of Public Health estimates that over 9% of the US population suffers or will suffer from one or more forms of eating disorders (ED). That’s over 28 million people from all walks of life, race, gender, and age.

These same people, according to the National Eating Disorders Association, are 50% more likely to develop substance use disorders (SUD), including illicit drug use and alcohol addiction.

Two or more conditions co-existing in this manner are what clinicians call co-occurrence, dual diagnosis, or comorbidity. It’s a complex health problem that when left unattended, can have life-threatening consequences to the individual suffering.

Thankfully, eating disorders and addiction are both treatable conditions with professional help and supervised treatment approaches. This post will walk you through everything you need to know about the co-occurrence of ED and SUD.

We’ll start by explaining what eating disorder is, its types and symptoms, how it relates to substance abuse, and the best treatment programs to recover.

What Is an Eating Disorder?

An eating disorder (ED) is a serious and complex mental illness characterized by unhealthy eating habits. The individual with ED may have problems with how they perceive and think about food, their appearance, weight and shape, and the act of eating itself.

Left untreated, the symptoms of ED can adversely affect the person’s mental health, physical well-being, and social life. ED may also result in death as a direct consequence of its symptoms.

In the US, it’s estimated that one person dies of ED every 52 minutes. That’s over 10,200 people dying every year. Worldwide, an astonishing 3.3 million lives are lost every year from the sinister mental disorder.

Current findings suggest that about 5% of the world’s population is affected by EDs, with symptoms often showing in adolescence and early adulthood. Due to its prevalence, this psychiatric disorder has the second highest mortality rate second only to opioid addiction.

What Causes Eating Disorders?

There are several potential causes why a person develops an eating disorder. Experts believe it to be an interplay between genetics, biology, temperament, psychology, and environment.

Anyone is at risk, regardless of gender, age, or ethnicity. It’s a common myth that women are the most likely to develop eating disorders, as a considerable chunk of ED cases concern men and adolescent boys.

People with a history of traumatic experiences, including physical, emotional, or sexual abuse are more prone to ED. Having relatives with similar eating conditions is another risk factor.

Eating disorders are likely to emerge alongside other mental illnesses like depression, anxiety disorder, personality disorder, obsessive-compulsive disorder, and substance abuse. Significant life changes, diet preferences, and involvement in sports may also contribute to ED.

Types of Eating Disorders

While “eating” is a recurring theme for these mental health ailments, eating disorders are a complex condition that relates to more than food. Here are some of the most common ED types you should know about:

• Anorexia nervosa: Anorexia nervosa is a type of ED that involves intense fear of weight gain and unhealthily low body mass index (BMI). A person with anorexia nervosa often has an unrealistic and usually distorted view of an ideal body image. To that end, they’d resort to extreme measures to limit their weight or shape, such as excessive exercise, restricting food intake, or using laxatives and diuretics.
• Bulimia nervosa: Bulimia nervosa is another common type of ED characterized by frequent episodes of binge eating immediately followed by purging. In an episode of bulimia nervosa, the person may eat until their stomach becomes painfully full. They often struggle with a loss of control while eating, causing intense shame and guilt afterward. At this point, they may attempt to purge the food by self-induced vomiting.
• Binge eating disorder (BED): Binge eating disorder is a similar disorder to bulimia but without the self-induced purging. The individual may rapidly eat massive amounts of food until they feel uncomfortably full, even without feeling hungry. Other symptoms include loss of control and feelings of shame or disgust afterward. Due to these, they get stuck into unhealthy and recurring cycles of not eating and binge eating.

Eating Disorder Symptoms

Watch out for these signs if you fear you or one of your loved ones suffers from addiction with a co-occurring eating disorder:

• Drastic mood swings
• Frequent episodes of fatigue, dizziness, or nausea
• Excessive anxiety over appearance
• Negative view of the self and low self-esteem
• Disordered eating behaviors resulting in nutrition deficiencies
• Noticeable changes in appearance, including hair loss, weight gain, and weight loss
• Physical symptoms like swollen sore throat, tooth decay, gut irritations, or dehydration
• Obsessive-compulsive symptoms, especially when selecting, preparing, or eating food

Eating disorders typically come with many health complications. Malnutrition, anemia, obesity, heart diseases, amenorrhea, changes in hormone levels, and bone loss are some examples of conditions a person with ED can become vulnerable to.

What Links Eating Disorder and Substance Use Disorder?

Eating disorders and drug addiction have many shared characteristics and risk factors. As such, those who engage in disorderly eating behaviors are more likely to develop drug abuse habits and vice versa.

These common risk factors include:

• Intense craving and obsession over the addictive behavior or substance
• Giving up personal interests, hobbies, or social relationships
• Loss of control and inability to stop the destructive behavior
• Increased frequency or intensity of symptoms
• Compromised social relationships, particularly with family and friends
• Continued use or enactment of addictive behaviors despite negative consequences

Like many forms of comorbid mental conditions, experts point to several reasons why eating disorders and addiction often co-occur.

A person’s genetic makeup, for one, has been considered a primary indicator. Certain mental health conditions can be passed down from parent to child, which may make the individual susceptible to SUD and ED.

Besides genes and brain chemistry, the environment of a person can become a huge influence. Peer pressure and pop culture norms, glorifying excessive drug and alcohol use or unrealistic body standards, may become potent environmental triggers for ED and addiction.

Some studies also suggest how temperament and personality traits, including novelty seeking, impulsivity, and underlying anxiety, become a common ground for both substance abuse and eating disorders.

Available Substance Abuse and Eating Disorder Treatments

Treatment providers may recommend several treatment approaches to deal with your unique symptoms. Ideal treatment should be personalized and integrated to address both ED and SUD, which may include the following:

• Detoxification: A patient with active SUD is less likely to engage and benefit from eating disorder treatments. As such, clinicians generally begin the program with detoxification or opioid substitution therapy to rid the patient’s system of the drugs. Some examples of medications used for detox are methadone, buprenorphine, naltrexone, and varenicline.
• Psychotherapy: Talk therapy is an evidence-based treatment approach that’s been shown to work for both ED, SUD, and other mental health conditions. A therapist may incorporate a number of talk therapies to address the underlying issues of the disorder, like cognitive behavioral therapy (CBT) or interpersonal psychotherapy (IPT).
• Maudsley approach therapy: The Maudsley approach is a family therapy based on family systems theory. Experts mainly use the Maudsley approach for treating anorexia and bulimia nervosa in adolescent patients. In this treatment, the therapist works alongside the patient’s family throughout the healing process.
• Nutrition counseling and rehabilitation: A registered dietician can help the patient understand the situation and improve their eating behaviors. They’ll evaluate the nutritional status of the patient as well as monitor weight gain or loss. They can also assist in making personalized diet plans with all the nutrients necessary for recovery.
• Support and self-help groups: Treatment providers offer many practical resources to help the patient recover. Support and self-help groups are one such resource. With support groups that provide a sense of community, hope, and accountability, the individual is more likely to recover from SUD and ED.

Final Thoughts: Getting Professional Help

Mental health conditions don’t appear obvious from the outside. Often, people choose to struggle by themselves for a long time and end up hurting themselves or the people they love in the process.

So, if you or anyone close to you suffers from substance addiction or an eating disorder, don’t hesitate to reach out. Live Free Recovery Services is ready to walk you through the healing process every step of the way and help you get back on track.

Start your recovery now!

References

• https://www.hsph.harvard.edu/striped/report-economic-costs-of-eating-disorders/
• https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders
• https://journals.lww.com/co-psychiatry/fulltext/2020/11000/review_of_the_burden_of_eating_disorders_.3.aspx
• Purging Disorder: Symptoms, Treatments, and More (healthline.com)
• The Genetics of Eating Disorders – PMC (nih.gov)
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2792687
• A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders – PubMed (nih.gov)
• Therapy for Eating Disorders: Types, Efficacy, and Recovery (healthline.com)
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414759