Eating Disorders and Substance Abuse

It is estimated that nearly 30 million people in the United States alone struggle with some type of eating disorder.
Highly stigmatized and surrounded by myths, they may not always be as obvious as many people believe. Although the belief that eating disorders primarily affect young, white women is popularized, they affect countless people regardless of age, race, and gender. In many cases, eating disorders often go unnoticed because many people are not aware of the signs. Symptoms and behaviors are often driven by individual factors that may not align with what stereotypes are often present to the masses, causing many people to suffer in silence and disorders to remain undetected.

Types of Eating Disorders

Eating disorders are complex and may develop as a result of numerous genetic, environmental, and individual factors. Although they have long been portrayed as disorders that affect specific populations, they can affect anyone and are commonly found in athletes, adolescents, and adults over 50 years old. They are also often found in LGBTQ+ populations and among people of color, but due to stigmas and lack of resources, these groups tend to experience greater difficulty in receiving a diagnosis and adequate treatment options.

There are several types of eating disorders and while there are some similarities and overlap, they tend to be fueled by different influences. An eating disorder is characterized by an abnormal relationship with food, and while not all behaviors lead to the development of an eating disorder, they can indicate a potential growing issue.

The most commonly observed eating disorders include:

  • Anorexia nervosa: One of the most well-known types of eating disorders, anorexia is characterized by individuals obsessively focusing on staying thin. Although a person with anorexia may think they are overweight, those with the disorder are often underweight.
  • Bulimia nervosa: Bulimia is a disorder in which a person will consume large amounts of food in a short period of time and then purges (often vomiting or using laxatives).
  • Binge eating disorder: Binge eating is more common than anorexia or bulimia. Binge eating involves eating excessive amounts of food in a short period of time, but they do not purge. Binge eating is characterized as a repetitive behavior that happens frequently over a period of time.
  • Orthorexia: This eating disorder is characterized by a fixation on eating “clean” or “pure” foods. It is relatively new compared to other types of eating disorders and has become increasingly prevalent.
eating disorders and substance abuse

Signs You May Be Struggling with an Eating Disorder

Identifying an eating disorder is not always easy. Often times, once the signs of an eating disorder become more apparent, the disease has become more advanced. The longer an eating disorder lasts, the more difficult it can become to treat, making it important to watch for signs that one may be developing. While these signs do not necessarily mean a person has an eating disorder, they can be an early indicator that a person may need help:

  • Weight concerns: Are they overly focused on their weight? Do they talk about dieting, “clean eating”, or often express desires to lose weight or look different?
  • Exercising: Are they increasing the frequency of exercise without consuming more calories? Do they become upset or agitated if they cannot exercise?
  • Food preparation and control: Do they have an increased interest in cooking but do not eat what they make? Do they make separate meals for themselves or become upset when they are unable to control what food they eat (i.e. unable to order what they want at a restaurant)?
  • Eating behaviors: Do they frequently go to the bathroom right after eating? Do they refuse to eat in the presence of others or exhibit strange behaviors regarding how they eat?
  • Mood changes: Are they more anxious, irritable, or fatigued? Do they exhibit lower levels of energy or have they become more in control and exhibit perfectionist-type behaviors?

While some of these behaviors and symptoms may be linked to other underlying conditions or life experiences, they can also be linked to the development of an eating disorder. Particularly, in situations where a major life-changing event has occurred or stressors are taking a toll, eating disorders and other mental health conditions may begin to surface as a response.

Eating Disorders and Substance Abuse

While it is not always clear which develops first, eating disorders and substance abuse often go hand-in-hand.

In some cases, substances may be used as a means of control. Legal and illegal substances may be used to help control weight. Stimulants, cocaine, inhalants, caffeine pills, laxatives, nicotine, and diet pills are just some of the many substances that may be misused. In other cases, a person using drugs or alcohol may develop an eating disorder because of the substance’s ability to affect appetite. Many people with substance abuse disorders struggle with adequate nutrition and a co-occurring eating disorder can exacerbate this, leading to the development of additional physical and mental health problems.

Some researchers suggest that eating disorders can develop into a type of addiction themselves. Research and health care professionals have identified overlapping characteristics found in addiction and eating disorders. They share several risk factors, including:

  • Changes in brain chemistry
  • Family history
  • Depression, anxiety, or low self-esteem
  • Peer pressure
  • Messaging from pop culture and the media
  • History of abuse
  • Experience of trauma

Treating Eating Disorders & Substance Abuse Simultaneously

Because of the frequency in which these can co-exist, it is important for a proper assessment to take place before starting treatment. Eating disorders require an extra level of care to address properly while simultaneously treating addiction. Addiction by itself often leads to poor physical health as a result of inadequate nutrition and eating disorders can often worsen this. Treatment often focuses on improving diet and physical health through nutrition and exercise, but an untreated eating disorder can threaten this aspect of recovery. While working to gain control over addiction, a person with a co-occurring eating disorder must also work to lessen control over food consumption.

Due to the complex relationship between addiction and eating disorders, many treatment programs require that recovery from an eating disorder starts first. This is because eating disorders can take a dramatic toll on physical health. Detox and initial recovery can be difficult due to the experience of withdrawal symptoms and ensuring a person is healthy enough to work through recovery is imperative.

Without properly treating both an eating disorder and an addiction simultaneously, losing access to substances can worsen a person’s eating disorder. As they lose the ability to escape through substances, they may use binging, purging, and control over food consumption as a means of coping. Essentially, treating one without the other may lead to a person using the other condition as a coping mechanism. Co-occurring treatment is vital in ensuring that while one condition is being treated, the other does not begin to worsen.

Treatment for addiction and eating disorders is a long-term process that does not necessarily lead to a cure. Rather, treatment is the tool used to help a person learn the life skills necessary to support sobriety and cope with stressors or triggers in a healthy way. Uncovering the underlying influences and root causes of development can help a person effectively manage symptoms, minimize cravings, and avoid the pitfalls of relapse.

mindfulness for recovery

If you or someone you know is struggling with an eating disorder and substance abuse, allow Nexus Recovery to help. We have a caring, compassionate staff who understands eating disorders and help people regain control of their life. Reach out and contact us today for more information.

If you or a loved one are suffering from alcohol or drug addiction, we’re here to help. Contact us today and speak with one of our trusted recovery advisors.

In addition to physical cravings, someone with an addiction issue will also spend a tremendous amount of time thinking about their drug of choice. These thoughts become a compulsion and impossible to control, which leads to drug-seeking behavior that can sometimes be criminal.

Feelings of depression, sadness, anxiety, despair, and the like are often at the root of substance abuse. The substance might temporarily mask these feelings, but they return once the high wears off, creating a vicious circle of drug abuse.

Taking a substance will temporarily stop the cravings and compulsion for it, but soon the same feelings return. In time, it takes more and more of the same substance to achieve the same effect it once had.

People addicted to drugs and alcohol may feel like they have no control over their drug use. Refraining from using or stopping seems to be an impossibility for them. The substance controls them, rather than the other way around.

Someone addicted to drugs or alcohol will continue to seek them out even if their addiction has made them lose friends, family, spouses, and jobs. Drug-seeking behavior can even lead to diseases such as hepatitis and HIV/AIDS.

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