Eating Disorders and Substance Abuse Finding the Connection Treating the Pain

According to statistics from the National Eating Disorders Association, close to 50% of people with eating disorders are also abusing substances at a rate 5 times greater than the general population. In males with Binge Eating Disorder, 57% will suffer lifelong addiction issues. Like eating disorders, substance abuse creates severe physical and psychological complications, include cardiac issues, lung disease, stroke, liver problems, and cognitive disruptions.

Also like eating disorders, substance abuse issues are influenced by genetic, psychological, and biological and environmental factors. Addictive processes can can begin for any number of reasons, but shared with eating disorders are the risk factors inherent to the illnesses. Adrienne Ressler, MA, LMSW, CEDS (2008) reports that adverse events early in life have a significant influence on the development of long-term, hard to treat illnesses. People who grew up in an alcoholic household, experienced trauma or abuse, grief, or neglect are at a higher risk for developing eating disorders, substance abuse issues, depression, anxiety, self-harm, and physical illnesses. Suicidal ideation and attempts are also high in people who experience eating disorders and substance abuse.

What Comes First: The Eating Disorder or the Substance Issue?

This is not easily understood, but what we do know is that substance abuse can be present before, during, or after an eating disorder. A person who abuses drugs with an appetite suppressing effect may develop an eating disorder as the result of weight loss. One may also turn to substances after entering recovery for an eating disorder in order to cope with things that were previously managed by the eating disorder behaviors. These illnesses tend to numb pain, anger, rejection, and really any emotion- the things we so often try to avoid. When both illnesses are present, it is imperative to work with a team that can address both. This helps to reduce the likelihood that a person may switch from one illness to the other in order to cope. Once stabilized and ready for intense treatment, a person with co-occurring eating disorder and substance use must learn healthy coping skills.

Finding Suitable Treatment

Finding the right treatment team is the first step in overcoming these co-occurring illnesses. The sooner a diagnosis is made and a plan set in place for treatment, the better the prognosis for recovery. An eating disorder specialist who can also assess for substance issues is key. An assessment will help to determine the best level of care. Many inpatient and residential treatment programs for eating disorders now address common co-occurring issues like substance abuse as well. This is important, because without this focus on all of the issues, one will thrive while the others are treated…leading to a higher relapse rate and incidence of the untreated problem.

Do not be afraid to ask for help. Do not be afraid to seek and engage in treatment. There is nothing in life that can’t be worked through- it just takes time and the right team approach.



National Eating Disorders Association. Substance Abuse and Eating Disorders.

Ressler, A. (2008). Insatiable Hungers: Eating Disorders and Substance Abuse.