According to the National Eating Disorders Association (NEDA), up to 50 percent of people with an eating disorder abuse illicit drugs or alcohol at some point in their lives. In the United States alone, an estimated 30 million people struggle with some type of eating disorder.
The most common eating disorders linked to alcohol abuse include bulimia, binge-eating disorder (BED), and anorexia – sometimes referred to as drunkorexia.
According to NEDA:
- The lifetime rate of eating disorders among people who abuse or are dependent on substances is 11 times that of the general population
- Substance abuse rates among people with eating disorders include:
- Anorexia Nervosa: 12 to 18 percent
- Bulimia Nervosa: 30 to 50 percent
- Binge Eating Disorder: 25 percent
- Both alcohol abuse and eating disorders have genetic, biological, and sociocultural risk factors
Like alcohol use disorders, eating disorders affect people of all genders from a variety of backgrounds, and can have a significant impact on physical, mental, and psychological health.
A common difficulty people with more than one mental health disorder face in treatment is only being treated for one issue. In this case: alcohol abuse or the eating disorder. Only treating part of a person’s struggles is counterproductive, and can increase the risk of relapse and further harm.
The most effective way to treat alcohol abuse in people with eating disorders is through an integrated dual-diagnosis treatment program.
What Is An Eating Disorder?
Eating disorders are mental illnesses characterized by abnormal eating behaviors that can have a negative impact on physical, mental, and psychological health.
Anorexia nervosa, an eating disorder that involves the restriction of food, has the highest mortality rate of any mental illness, including major depression.
Eating disorders can be caused by a variety of environmental, genetic, social, and cultural factors. Like alcohol, food intake is a mechanism that can be manipulated in order to lend a sense of control, or to cope with stress.
The most common eating disorders include:
- anorexia nervosa
- bulimia nervosa
- binge eating disorder (BED)
- other specified feeding or eating disorder (OSFED, previously known as eating disorder not otherwise specified, or EDNOS)
Professional opinions are divided on whether or not eating disorders can be directly compared to issues like drug addiction and alcohol abuse. However, there are several overlapping factors, such as emotional difficulties and a pressuring social environment, that can appear at the core of both these issues.
Why Is Alcohol Abuse So Common In People With Eating Disorders?
In many ways, food and alcohol serve similar roles. They can both be used to numb or distract from difficult emotions, or to cope with stress.
Similar to people with substance abuse, people with eating disorders often have a history of neglect, abuse, or trauma. In these instances, efforts to control weight or body-size may be used as a means to cope with resulting emotional distress.
Various forms of stress and emotional difficulties can also serve as initial triggers of many drinking and disordered eating problems, including:
- separation or divorce
- relationship problems
- sexual assault
- school or work-related stress
- unstable home environment
Eating disorders can occur at any point in a person’s life, but most often develop in a person’s teen years or young adulthood. This is a stage of life where many people also begin experimenting with illicit or risky activities such as drinking.
People with eating disorders, who are already struggling with physical and emotional difficulties, can become more vulnerable to abusing illicit drugs and substances. In some cases, alcohol may be welcomed as a balm for relieving eating disorder-related stress.
Bulimia And Alcohol Abuse
Bulimia is the most common eating disorder known to crossover with substance abuse. Bulimia is an eating disorder wherein a person eats an excessive amount of food in a short time, and compensates through at least one purging behavior, such as:
- self-induced vomiting
- laxatives or diuretics
- excessive exercise
Contrary to popular beliefs about eating disorders, the majority of people with bulimia are of normal weight or are overweight. However, they may still experience changes in weight, as well as other negative effects on physical health.
Like those who abuse alcohol, bulimics often have impulsive personalities and, in a sense, can become addicted to their pattern of bingeing and purging food. While this generally begins as a way to control weight, bulimic behaviors may also be used to combat feeling a loss of control in other aspects of a person’s life.
Both bulimic and alcoholic behaviors can be used to numb or distract from emotions, such as depression, shame, and guilt. Thus, this can lead to bulimia and alcoholic tendencies sometimes going hand-in-hand.
People with bulimia may also drink heavy amounts of alcohol to help them vomit – a dangerous practice that can lead to dehydration, heart palpitations, or alcohol poisoning.
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Binge Eating And Alcohol Abuse
Binge eating disorder (BED) is the second most common eating disorder to co-occur with substance abuse. Like those with bulimia, a person with BED experiences episodes of eating excessive amounts of food. Unlike bulimics, there is usually no attempt to purge the food.
For people with BED, food can often serve as a temporary relief from feelings of self-loathing, anxiety, depression, or shame. Incidences of overeating, however, can also increase these negative feelings, leading to a frustrating and self-destructive cycle.
Alcohol abuse can lead to a similar pattern, at once serving as both a form of relief and a source of shame and embarrassment.
Anorexia And Alcohol Abuse
Anorexia is a complex disease that, like other eating disorders, thrives on feelings of depression and shame. The primary signs of anorexia are a low intake of food and changes in weight. However, people with anorexia may also purge their food, or only have significant anxiety around eating specific food groups.
Alcohol, which can be high in calories, can complicate a person’s efforts in calorie restriction. This may provide one explanation for why alcohol abuse is less common in people with anorexia than those with bulimia or BED.
However, some intoxicating effects of alcohol can also be appealing for someone suffering from the physical and psychological effects of anorexia. Alcohol can cause feelings of relaxation and pleasure, two sensations that can eventually begin to elude someone struggling with anorexia.
Anorexia is an isolating illness, with people often avoiding social situations in which they may be pressured to eat or otherwise lie about their food intake. Drinking can become a way to maintain a feeling of connection to others and offer a sense of feeling “normal”.
In an effort to compensate for alcohol calories, some people with anorexia may restrict how much they eat during the day, or purge their food. This practice of compensation is what is often termed ‘drunkorexia,’ and is increasingly common among young college students.
Drunkorexia itself is not a diagnosable disorder, but has become a blanket term for eating less to compensate for calories from heavy drinking. Those with ‘drunkorexia’ may also eat less in order to get drunk quicker or after drinking smaller amounts. This can increase a person’s risk for serious consequences, including alcohol poisoning, dehydration, and severe malnutrition.
The Dangers Of Co-Occurring Alcohol Abuse And Eating Disorders
Both eating disorders and alcohol abuse share a common effect of malnutrition. Neglecting a healthy diet and nutritional deficiencies are common in people who abuse alcohol. Heavy drinking can also damage organs in the body responsible for processing nutrients, leading to nutritional deficiencies.
Common consequences of poor nutrition can include:
- poor concentration
- memory problems
- weakened immune system
- constipation or diarrhea
The added harm of an eating disorder can make health issues even more serious in those who abuse alcohol. Engaging in both heavy drinking and eating disorder behaviors can lead to serious health problems, such as:
- irregular heartbeat
- liver and kidney damage
- suicidal thoughts and behaviors
- heart failure
- sudden death
Alcohol abuse in someone with an eating disorder is dangerous and can become life-threatening. If you or someone you know is struggling with an eating disorder and alcohol abuse, it’s important to seek help as soon as possible.
Treatment For Alcohol Abuse And Eating Disorders
Unlike alcohol, food and water are necessary for survival. While a person can become sober from alcohol, there is no way for a person recovering from an eating disorder to avoid food. As a result, the aim of treatment is to promote a healthy and balanced relationship with food and body-size.
Struggling with both alcohol abuse and an eating disorder can make the recovery process more challenging, but not impossible. The most effective way to treat co-occurring eating disorders and alcohol abuse is through an integrated, dual-diagnosis treatment program.
Vertava Health offers several dual-diagnosis addiction treatment tracks for people with one or more co-occurring mental disorders. Within our programs, we have counselors and other treatment specialists with extensive knowledge in treating both eating disorders and alcohol abuse.
Treatment services within our dual-diagnosis eating disorder programs include:
- medical detox services
- individual behavioral therapy
- expressive therapies (art, dance, music)
- group therapy
- mindfulness and relaxation techniques
- nutritional therapy
At Vertava Health, each person’s treatment plan is developed with their unique needs in mind. This means taking into account medical concerns, mental health, and treatment history. Through this integrated approach, we help patients achieve full and lasting recovery from their alcohol abuse and eating disorders.
Contact us today for free and confidential support in finding a dual-diagnosis treatment program that meets your personal needs.