Eating Disorders and Substance Abuse
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A relationship between eating disorders and substance abuse has been recognized and studies have indicated that a large number or women and men with eating disorders also have problems with alcoholism and chemical dependency. In addition, women who are classified as substance abusers have increased rates of eating disorders.
The reported incidence of substance abuse is lower among individuals with anorexia nervosa than individuals with bulimia. This trend has been explained by the strong need to maintain a sense of control demonstrated by people with anorexia, particularly a tendency to restrict caloric intake. For people with bulimia impulsivity has been associated with increased substance abuse.
Studies have shown that at least 30% of patients with bulimia nervosa (prior to recovery) have a history of current or prior substance abuse. People with bulimia often use alcohol either in conjunction with, or as an alternative to bingeing/purging i.e. binge drinking instead of eating.
People with eating disorders may use alcohol and drugs as a coping mechanism in an attempt to deal with feelings, to relieve psychological pain and cope with stress, anxiety, guilt, depression and shame. Other functions of substance abuse may be to suppress weight or initiate a way to purge the body of food. Some substances may also serve the function of calming oneself sufficiently so that one can eat.
Some commonly abused substances include:
| alcohol | amphetamines, including diet pills | aspirin |
| cigarettes | glue and other inhalants | cocaine and heroin |
| hallucinogens | ipecac poison | laxatives and diuretics |
| pain killers, including medication with codeine such as Tylenol or Demerol | tranquilizers | caffeine, including coffee and diet drinks |
Treatment of eating disorders and substance abuse are usually addressed separately, but this approach may neglect the relationship between the two. Therefore; treatment types for eating disorders should consider substance abuse and treatment programs for substance abuse should consider problems with eating. An individual should anticipate that when involved in a treatment program for either an eating disorder or substance abuse problem symptoms of the other problem will become intensified and harder to deal with. Some therapeutic strategies may include, 12 step programs, cognitive behavioural interventions and psycho-educational groups.
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