In recent years, it has become apparent that there is a strong link between eating disorders and substance abuse. Studies by the National Center on Addiction and Substance Abuse (CASA) revealed that nearly one-half of people with eating disorders also abuse alcohol or illicit drugs. This is compared to 9% of the general population. In addition, about 35% of alcohol or illicit drug users have eating disorders compared to 3% of the general population.
So what are the characteristics, beliefs, and risk factors that send individuals into a neverending quest for the perfect body, perfect life, and the magic potion that will soothe anxiety, fear, and depression?
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the official text that is used to diagnose disorders. It contains the criteria for substance use disorders as well as other mental health problems. In the latest edition of the DSM, the criteria for SUDs (substance use disorders) are:
- Hazardous use – The substance has been used in ways that are dangerous to yourself or others. For example, overdosing, blacking out, or driving under the influence.
- Interpersonal or social problems due to substance use – Use of the substance has caused conflicts with other people or relationship problems.
- Neglected important roles to use – Responsibilities at home, work, or school are not being met due to substance use.
- Withdrawal – Withdrawal symptoms are experienced when substance use is stopped.
- Tolerance – You need to use more of the substance to get the same effect.
- Using larger amounts/longer – Larger amounts are being used or for longer periods of time.
- Attempting to quit repeatedly –You have no success when trying to cut back or quit.
- Time spent using – You spend a lot of time using the substance.
- Psychological or physical problems related to use –Use of the substance has caused physical health problems such as liver damage, or psychological problems such as anxiety or depression.
- Giving up activities to use – Skipping or stopping activities you used to enjoy in order to use the substance.
- Craving –You have cravings for the substance.
The specific cause of SUD isn’t known. There are several factors that can be a cause such as:
- The person’s genes
- The action of the drug
- Emotional distress
- Peer pressure
- Environmental stress
Many people who develop SUD also have:
- Attention deficit disorder (ADD)
- Attention deficit hyperactivity disorder (ADHD)
- Post-traumatic stress disorder (PTSD)
- Another mental health condition
An eating disorder is a serious condition related to persistent eating behaviors that affect your health negatively. They can also affect your emotions and your general ability to function in the important areas of your life. The most common eating disorders are anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED).
Come of the rituals, behaviors, and thinking that go with an eating disorder may fit the previously listed criteria. Eating disorders and substance abuse both tend to start with experimentation. But naturally, not everyone who experiments becomes physically and mentally in jeopardy.
Most eating disorders include concentrating too much on your body shape, weight, and food. This behavior can significantly affect your ability to get the necessary nutrition. Apart from the possibility of leading to other diseases, eating disorders can specifically harm your:
- Digestive system
Although adolescent girls and young women are more likely to have an ED, males can have eating disorders too. EDs can occur across a wide age range but usually develop in the teens and early 20s. These factors may increase the risk of developing an eating disorder:
- Family history of EDs
- Other mental health disorders: A history of depression, anxiety disorder, or obsessive-compulsive disorder.
- Dieting and starvation: Dieting is a risk factor for an eating disorder. Starvation has an impact on the brain and influences mood changes, anxiety, inflexible thinking, and appetite reduction. Weight loss and starvation may change the way the brain works in some people. This makes it hard to return to normal eating habits.
- Stress: Moving, starting a new job, going off to college, or a relationship or family issue can cause stress and increase the risk of an ED.
Watch for eating patterns and beliefs that may indicate unhealthy behavior. Red flags that may signal an eating disorder include:
- Making excuses for skipping meals or not eating
- Following an overly restrictive vegetarian diet
- Extreme focus on healthy eating
- Making own meals instead of eating what the family eats
- Withdrawal from usual social activities
- Constant complaining or worry about being fat and talking about losing weight
- Frequently looking in the mirror for believed flaws
- Using laxatives, dietary supplements, or herbal products for weight loss
- Excessive exercising
- Callused knuckles from inducing vomiting
- Loss of tooth enamel that may be the result of repeated vomiting
- Leaving during meals to use the bathroom
- Eating large amounts of food in a meal or snack than is usually normal
- Indicating depression, disgust, guilt, or shame about eating habits
- Eating in secret
When an individual has both a mental disorder and a drug or alcohol problem, it is called a dual diagnosis. This is a common occurrence. Approximately 50% of people with a mental disorder will also have a serious SUD at some time in their life and vice versa. The two disorders feed off each other and can worsen the symptoms of both. Even though they frequently occur at the same time, it doesn’t mean that one caused the other.
Are you struggling with an eating disorder or do you have a loved one who is? Achieve Wellness and Recovery has a dual diagnosis program meant to help people in your very situation. We have a treatment team experienced in treating co-occurring conditions like substance abuse and eating disorders.
We have three comprehensive outpatient programs so you can enter at the level appropriate for you while allowing you the opportunity to return home each day. EDs and SUDs are life-threatening disorders. Do not hesitate to get the help you need for yourself or your loved one. Contact us today.
Medically Reviewed By
Nicole Rettino-Lambert LCSW, LCADC, CCS, CCTP, CSTIP
Nicole Rettino-Lambert is a dually licensed clinician with over 20 years of experience working with children, adolescents, and adults in both addiction treatment and mental health treatment. Along with extensive experience in clinical work, she has held leadership roles in both inpatient and outpatient addiction treatments centers in New Jersey. Throughout her various leadership positions, Rettino-Lambert has developed clinical programming, assisted staff in their growth and development in the clinical field, and had the privilege of helping numerous individuals on their path to recovery.