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Eating Disorders & Addiction | Dual Diagnosis Prevalence, Symptoms, Risk Factors, & Treatment

Published on May 5, 2021
Eating Disorders & Addiction | Dual Diagnosis Symptoms & Treatment

Similar to addiction, eating disorders are mental health conditions that involve compulsive behaviors. It is common for people with eating disorders to develop a co-occurring substance use disorder or addiction

However, people with a substance use disorder are also at risk of developing an eating disorder. The symptoms of eating disorders and addiction can be dangerous and potentially life-threatening. 

If you notice signs of either condition in a loved one, professional treatment is crucial. 

How Often Do Eating Disorders & Addiction Co-Occur?

Dual diagnosis is when someone has a substance use disorder and a co-occurring mental health disorder, like an eating disorder. Eating disorders and addiction occur together at high rates, especially in women, adolescents, and young adults. 

About half of men and women with eating disorders have a substance abuse problem, compared to 9% of the general population. Nearly 35% of people with a substance abuse problem have a co-occurring eating disorder, compared to 3% of the general population. 

Types Of Eating Disorders

Although eating disorders may sometimes begin with small behaviors to change weight or appearance, they are much more complex. Eating disorders involve a range of mental health disorders that can cause psychological distress and severe physical harm. 

Eating disorders are often associated with low self-esteem and a loss of control. They involve unhealthy thoughts, beliefs, and eating behaviors. If left untreated, eating disorders can be fatal or cause long-term health problems. 

The most common eating disorders include:

Anorexia Nervosa

People who suffer from anorexia nervosa often view themselves as overweight, which results in self-destructive behaviors. 

People with anorexia nervosa may compulsively check their body weight and restrict calories. It is also common for people with anorexia nervosa to take laxatives to lose weight faster. 

Symptoms of anorexia nervosa may include:

  • restricted eating 
  • extreme weight loss
  • intense fear of gaining weight
  • distorted body image

Anorexia is extremely dangerous and sadly, many people who suffer die from starvation or suicide. About 12-18% of people with anorexia nervosa also have a co-occurring substance use disorder. 

Learn more about Anorexia & Addiction

Bulimia Nervosa

People with bulimia nervosa experience frequent episodes of binging and purging. A binge (consuming large amounts of food) is associated with a lack of control. This is followed by a compulsive behavior, like purging or excessive exercise. 

Symptoms of bulimia nervosa include:

  • dehydration
  • sore throat
  • electrolyte imbalance
  • swollen glands
  • tooth decay

Similar to anorexia nervosa, people with bulimia nervosa may take laxatives or diuretics after a binge. In addition, bulimia nervosa is associated with a high rate of alcohol abuse compared to other eating disorders. 

Learn more about Bulimia Nervosa & Addiction

Binge-Eating Disorder

Binge-eating disorder is the most common eating disorder in the United States. It involves periods of consuming large amounts of food. However, unlike bulimia nervosa, it is not followed by purging. 

Symptoms of binge-eating disorder include:

  • overeating
  • eating in secret
  • feelings of guilt or shame associated with eating
  • frequent dieting

Learn more about Binge-Eating Disorder & Addiction

Substance Use Disorders

A substance use disorder (SUD), also known as addiction, involves compulsive drug or alcohol use regardless of consequences. 

Addiction often affects several areas of a person’s life, including family, work, and friendships. Drug-seeking behaviors can sometimes also cause legal or financial hardships. 

The following signs of addiction are important to remember:

  • excessive drug or alcohol use
  • intense cravings for the substance
  • increased tolerance to the substance
  • physical dependence
  • changes in mood or behavior
  • withdrawal from friends and family

It is important to remember addiction and eating disorders are not a choice but a mental illness. They require appropriate treatment and aftercare that addresses both addiction and the eating disorder. 

Risk Factors For Co-Occurring Eating Disorders And Addiction

Eating disorders primarily affect women and men are 1.3 times as likely to be diagnosed with addiction. However, both men and women can develop eating disorders and a co-occurring substance use disorder. 

A combination of genetics, environment, psychological, and social factors can influence the development of both eating disorders and addiction. 

Common risk factors for developing a co-occurring eating disorder and SUD include:

  • childhood trauma 
  • impulsive behaviors
  • history of parental concern with weight and appearance
  • family history of substance abuse or eating disorders
  • social pressures to use substances or lose weight
  • taking substances to lose weight

Many people with eating disorders may also have other co-occurring anxiety disorders. If undiagnosed and untreated, people may self-medicate their symptoms with drugs or alcohol. 

Dual Diagnosis Treatment For Eating Disorders & Addiction

People with eating disorders have an increased risk of suicide and physical health problems. Having a co-occurring addiction can worsen symptoms of both conditions. Although treatment can be challenging, it is possible. 

Dual diagnosis treatment requires a collaboration of psychiatrists, doctors, nurses, and addiction specialists. Together, this team of professionals can offer a well-rounded and personalized approach to treatment. 

Treatment centers may offer the following dual diagnosis services:

  • detox
  • inpatient/residential treatment
  • support groups
  • behavioral therapy
  • partial hospitalization
  • outpatient treatment 

These treatment centers offer a wide variety of services and activities that can improve addictive behaviors and disordered eating. 

Programs range from highly structured (residential) to more flexible (outpatient). Your treatment team will work with you to determine the severity of your addiction and eating disorder and what will be most effective for you. 

If a loved one is struggling with a co-occurring eating disorder and addiction, call us today to discuss treatment options. 

Written by Ark Behavioral Health Editorial Team
This page does not provide medical advice.

National Institute Of Mental Health (NIMH) - Eating Disorders
National Library Of Medicine - Does Anorexia Nervosa Resemble An Addiction?
National Library Of Medicine - Substance Use Disorders in Women with Anorexia Nervosa
National Library Of Medicine - The Risk of Substance Use Among Adolescents and Adults With Eating Disorders
U.S. Department Of Justice - Food for Thought: Substance Abuse and Eating Disorders

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