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Dually Addicted: Eating Disorders Often Co-Exist With Substance Abuse

When a Twelve-Step group such as AA, Al-Anon, or NA brings out a huge frosted layer cake to celebrate someone’s recovery anniversary, most people will have a slice, though some might pass because they are avoiding sugar.

However, a person with a binge-eating disorder, or who uses food to cope with their feelings, might say no during the meeting — then buy a box of cookies after the meeting and eat them all on the way home.

Co-existing addictions

Eating disorders frequently co-exist with alcoholism and drug abuse, and some can be just as deadly. The public face of anorexia nervosa is often an extremely thin woman or girl, but this is only one form of the many types of eating disorders. People with eating disorders come in all body sizes, all ages, all genders, and all economic, social, ethnic, or other group demographics.  They include individuals who use food to cope with their feelings or feel unable to cut back despite a profoundly unhealthy weight, individuals with bulimia nervosa who binge eat and use self-induced vomiting to compensate for the binge, and those with anorexia nervosa.  Lesser known eating disorders also exist such as Pica, characterized by the compulsion to eat non-food items like hair, dirt, or paper; or Diabulimia, where an individual with type 1 diabetes who omits or misuses insulin to purge or control calories. The National Eating Disorders Association (NEDA), lists the following statistics on co-existing eating and substance use disorders:

  • 35% of people with substance abuse problems also have eating disorders
  • 50% of people with eating disorders also have substance abuse issues
  • 57% of men with binge-eating disorder have a substance abuse problem

Either of these disorders could come first, with the other developing during or after treatment, or they could have co-existed all along, Amy Baker Dennis, PhD, a NEDA specialist, says. “There’s a lot of symptom substitution. We find that individuals who are going through eating disorder treatment, once their eating symptoms subside, we often see the resurgence or the beginning of a substance abuse problem.”

How your health is affected

NEDA says that eating disorders have the highest mortality rate of any psychiatric illness, and that up to 20% of individuals with anorexia will die as a result. Other eating disorders, including bulimia or binge eating, can have similar mortality rates.

“Besides medical complications from binge eating, purging, starvation, and over-exercise, suicide is also common,” a NEDA article says.

What makes us vulnerable?

Risk factors are similar for eating disorders and substance abuse, such as brain chemistry, family history, low self-esteem, depression, anxiety, and social pressures, NEDA reports. Other shared characteristics include compulsive behavior, social isolation and risk for suicide. Genetics also play a part.

The substances most frequently abused by individuals with eating disorders include caffeine, tobacco, alcohol, laxatives, emetics, diuretics, appetite suppressants (amphetamines), heroin, and cocaine, according to the NEDA website.

Recovery is yours.

Recovery Centers of America treatment facilities can treat substance abuse and co-existing eating disorders such as overeating, binge eating or the use of food to cope with feelings, says Dr. Deni Carise, RCA’s Chief Scientific Officer. Medically monitored detoxification from the substance used is an initial part of treatment, followed by intense addiction therapy and a long-term recovery plan.

Individualized nutrition counseling can be provided at every RCA addiction recovery center, Dr. Carise adds. Seriously ill clients with an eating disorder such as complicated anorexia nervosa or bulimia, may require separate treatment, she says.

Recovery from an eating disorder is not easy. Unlike alcohol and drugs, where many people strive for total abstinence, individuals “addicted” to food cannot completely abstain from eating. They need to use food (their “drug of choice”) without over- or under-eating.

But recovery is possible, and those who are recovering from substance use disorders can use the same tools to further their eating disorder recovery. A life free of alcohol, drugs and disabling eating disorders is available for anyone.



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