Around half of all individuals battling an eating disorder also struggle with alcohol and/or drug abuse. And, more than a third of those battling addiction also have an eating disorder. Eating disorders, drug abuse, and addiction regularly co-occur and require specialized, comprehensive care models for recovery.

Both disorders need to be addressed in an integrated fashion at the same time. They can be intertwined and difficult to tell one apart from the other. Eating disorders and drug addiction can share many similarities. Simultaneous management of both is optimal for making lasting healthy lifestyle changes.

Considerations for Addiction Treatment with an Eating Disorder

Drug addiction and an eating disorder can have many of the same symptoms. Integrated treatment models that can manage both disorders at the same time can be highly beneficial. Both eating disorders and drug addiction include compulsive behaviors, and both involve a lack of control over actions that are physically, emotionally, and socially harmful.

An eating disorder is often categorized as an addiction as well. Similar treatment methods are useful in treating drug use and eating disorders, including:

  • Pharmacological options, such as medications and supplements
  • Behavioral therapies that seek to understand the root cause of the disorders, teach life skills, and bring about positive lifestyle changes
  • Group and individual therapy that can be directed at teaching coping skills and methods for managing triggers
  • Support groups where peer interactions can provide positive influences, fellowship, and mentoring for relapse prevention

Addiction treatment for someone also battling an eating disorder will need to be specialized and make considerations for both disorders. For instance, someone who struggles with an eating disorder has an unhealthy relationship with food. This will mean that mealtimes may need to be supervised, nutrition specialized, and eating habits managed differently.

Both drug abuse and an eating disorder can negatively impact physical health, weight, and appetite levels. When the disorders co-occur, they need to be managed at the same time with an understanding of how each interacts with the other.

When seeking an addiction treatment center when a co-occurring eating disorder is also present, be sure to find a facility with experience, knowledge, and the ability to treat both disorders at the same time with multiple resources. Substance abuse, mental health, and medical professionals should all be working in tandem to create and carry out a treatment plan for co-occurring disorders at a specialized facility.

A program catering to treatment for co-occurring disorders strives to help individuals learn how to manage both disorders for an improved quality of life.

The Connection Between Addiction and Eating Disorders

Drug addiction and an eating disorder share many of the same initial causes, Psychology Today explains.

  • Similar parts of the brain can be involved, including areas involved in impulse control, reward processing, and emotional regulation. Both compulsive eating and/or purging can activate the reward center in the brain, just as drug abuse can. With time, repetitive drug use and patterns of eating can change the brain’s chemical makeup and wiring.
  • Genetic links can be a factor. Both eating disorders and drug addiction are considered to be heritable in some way.
  • Environmental triggers can play a role in the onset of both disorders. Trauma, family and peer pressure, and messages in the media can lead to drug abuse. They can also lead to unhealthy eating habits, which can segue into addiction and a possible eating disorder.
  • Stress and underlying mental health issues can trigger drug abuse and eating disorders. Unhealthy eating patterns and drug use can be methods of self-medication and ways to ease mental pain and emotional distress.

Which Came First?

When treating an eating disorder and addiction at the same time, it can be helpful to understand which disorder came first. However, this can sometimes be hard to determine. Drug use can lead to unhealthy eating patterns, which may then lead to an eating disorder, or drugs may be a method of controlling weight as a result of an eating disorder.

There can be different things to consider depending on which came first. For instance, when the eating disorder was present before the substance abuse, Social Work Today reports that a person is more likely to also suffer from social phobia, obsessive-compulsive disorder (OCD), and panic disorders. If the substance abuse was first, the individual is more apt to have started abusing substances at a younger age and be more dependent on multiple substances.

An understanding of how eating disorders and addiction are connected can help design and manage a treatment plan for both disorders.

Eating Disorders and Common Drugs of Abuse

Eating disorders involve food or body-related obsessions that lead to unhealthy habits, such as overeating, undereating or eating restrictions, excessive exercise, or purging behaviors. Eating disorders are most common in women and adolescents.

Drug abuse may be used to restrict appetite, purge foods, or control weight. An eating disorder can also be the result of chronic drug use and drug dependence that negatively affects the brain’s ability to be stimulated by food. This can lead to overeating.

Some of the most common drugs of abuse for someone battling an eating disorder include:

  • Alcohol
  • Tobacco
  • Caffeine
  • Heroin
  • Cocaine
  • Laxatives
  • Diuretics
  • Emetics
  • Amphetamines (appetite suppressants)

Bulimia is a disorder involving binge eating and then purging. Individuals who purge after eating are more likely to also abuse alcohol and illicit drugs.

Cannabis is also a commonly abused drug. Nearly 40 percent of individuals battling bulimia nervosa also abuse substances.

Around 30 percent of those struggling with anorexia — which involves severe food restrictions and/or excessive exercise to control weight — abuse substances. More than 20 percent of individuals battling a binge eating disorder also abuse substances.

Complications of Co-Occurring Disorders

An eating disorder can complicate addiction treatment by adding multiple layers of treatment considerations and possible complications into the mix. Someone struggling with an eating disorder is often significantly malnourished and will need medical care. They also often need medications and medical intervention. This may need to be carried out in a hospital setting initially.

Eating disorders can have severe medical and physical health complications that can become life-threatening.

The risk for suicide is higher in those battling both an eating disorder and addiction.

Person's feet strapped to a scale with measuring tape.

Mental health states will need to be continuously monitored during treatment to ensure safety.

Eating disorders and addiction are both relapsing and chronic diseases with significant physical, behavioral, and emotional ramifications that will need to be addressed and managed throughout a complete treatment program and into ongoing recovery.

Specialty Integrated Treatment for Addiction and Eating Disorders

The eating disorder and drug abuse must be managed at the same time during an addiction treatment program. Special considerations will need to be made to accommodate someone who is battling these co-occurring disorders.

Relapse prevention is a big part of addiction treatment programming. While abstinence is required for drug addiction, the same is obviously not true for food. You have to eat. The person needs to develop a healthier relationship with eating, their body, and food in general.

Nutrition planning and special considerations regarding meals and mealtimes are often necessary. Triggers are not as easily avoided with eating disorders, so solid skills need to be developed to learn how to manage them in the future. An integrated treatment program will include therapy for improving self-image and self-worth to minimize relapse. Support groups made up of others with similar struggles can be very helpful in providing insight as to what may work in recovery.

Alternative methods, including mindfulness meditation, can help to manage stress and improve self-awareness. A comprehensive addiction treatment program for co-occurring disorders will often include a variety of holistic and traditional methods to enhance recovery.

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