The Destructive Synergy of Eating Disorders and Substance Abuse – Jena Morrow Margis, CADC

Author: Jena Morrow Margis, CADC

Clinical Development Institute Faculty Member, Timberline Knolls

The past several decades have brought about an increasing awareness of both eating disorders and substance use disorders, and for this we as a society can certainly be grateful. (Progress!) However, as “aware” as we may be regarding each of these life-controlling issues individually, many of us are less aware of just how often the two tend to go hand-in-hand. And since knowledge is power, it would behoove us to explore this synergistic (albeit destructive) relationship between these proverbial strange bedfellows.

Many of us may be familiar with the staggering statistics regarding eating disorders; we can thank NEDA and other national and global organizations for the important work they do to keep us current on the numbers. But to put things in perspective, let’s take a look at the stats specifically regarding EDs (eating disorders) and substance use/abuse: 

-Up to 50% of people with eating disorders use alcohol or drugs, a rate 5 times higher than that of people without EDs.

-Up to 35% of those who are dependent on alcohol or drugs have also had EDs, a rate 11 times greater than the general population.

Common risk factors of both EDs and SUDs (substance use disorders) include brain chemistry, family history, low self-esteem, depression, anxiety, and social/peer pressure. Common behavioral characteristics include: social isolation, compulsive behavior, and risk for suicide.

Substances commonly used by people with eating disorders include alcohol, laxatives, emetics (ipecac), diuretics, amphetamines, heroin, and cocaine.

With ED and SUDs co-occurring so frequently, it is essential for sufferers to have access to treatment (at all levels of care) that can simultaneously address both issues. There is an increasing need for providers and facilities that can (and are willing to) treat co-occurring disorders.

In the past, it has been common for an individual dealing with both of these issues to seek treatment from a facility or a provider which focused solely on one or the other. They might spend some time in outpatient counseling or several weeks in a residential facility and emerge from treatment with a greater handle on one issue, only to find that during or immediately following treatment, the other issue would rear its head with a vengeance — and thus would begin the cycle so often referred to in recovery circles as Whack-a-Mole: beat down the eating disorder, and the substance abuse “pops up.” Beat down the substance abuse, and up pops the eating disorder behaviors all over again — and so on. 

Thankfully, more providers and facilities today are treating these issues simultaneously — even if only because decades of sufferers’ experiences of frustration have taught the treatment field that it is essential to offer holistic, simultaneous treatment of comorbidities. 

As with eating disorders, substance use disorder sufferers have greater likelihood of recovery with early intervention. If you or someone you know is struggling with ED and substance use, this is not a battle to be fought alone. Help is available. Hope is accessible. And most importantly, recovery is possible — from eating disorders, from substance abuse, and from both simultaneously!