Contributor: Crystal Karges, MS, RDN, IBCLC, Special Projects Coordinator at Eating Disorder Hope/Addiction Hope Alcoholism research.
The connection between eating disorders and substance abuse is undeniable, and many individuals who suffer with a mental illness, such as an eating disorder, are more likely to develop substance abuse. The relationship also works the other way, where people who struggle with substance abuse have a higher chance of developing a mental illness, like an eating disorder.
Research has demonstrated that individuals with eating disorders were up to 5 times as likely as those without eating disorders to abuse illicit drugs or alcohol
. Some studies have observed that up to 50 percent of people with eating disorders abuse illicit drugs or alcohol compared to approximately 9 percent of the general population
The converse relationship has been observed as well, where up to 35 percent of individuals dependent on drugs or alcohol develop eating disorders, compared to 3 percent of the general population
Increasing Awareness of This Connection
What are the connections between substance abuse and eating disorders? More specifically, what are the similarities between bulimia and alcoholism that make individuals more likely to develop a co-occurring relationship? With growing rates of substance abuse and eating disorders, increasing awareness and understanding can ultimately lead to improved treatment efforts for those who are suffering and the community at large.
Alcoholism treatment research
When comparing bulimia and alcoholism, there may be similarities between these two disorders that can give clues as to why these co-occurring disorders can develop together. Some research has speculated that individuals who develop bulimia and alcoholism, or other substance abuse disorders, have underlying personality traits that are unique to the types of behaviors that are commonly observed in these disorders.
Common Personality Traits: Impulsivity
A common personality trait seen in individuals who develop bulimia is impulsivity. A person with bulimia commonly displays impulsive behaviors in their eating, such as binging on abnormally large amounts of food, engaging in purging behaviors, etc. These impulsive behaviors can be carried into other problematic activities, such as compulsive exercising, shoplifting, promiscuity and substance abuse
An individual with bulimia who commonly acts out impulsively may do so not only with eating but with alcohol as well, which may be observed in binge drinking behaviors or excessive use of alcohol.
Though research has identified a similar impulsive personality trait among individuals who develop bulimia and alcoholism, the origin of the trait is not known. Some experts hypothesize that personality traits are influenced by genetic predisposition among other factors.
Environmental and Emotional Disturbances
Another possible factor in individuals who suffer with alcoholism and bulimia may be environmental in nature. Emotional disturbances, such as the experience of trauma, physical, and/or sexual abuse may lead a person with an impulsive personality to act out in behaviors that offer a false sense of control in a chaotic environment. Impulsive behaviors seen in bulimia and alcoholism may be a means of regulating emotional disturbances in individuals who have suffered some form of trauma.
While many factors can contribute to the similarities between bulimia and alcoholism and the reasons these disorders are co-occurring, focus on early intervention can help a person struggling find the treatment they need to recover.
Dealing with the Complexity of Co-occurring Disorders
Co-occurring disorders are extremely complex and warrant professional help that can assist a person in healing and recovering from both the substance abuse and eating disorder. This often requires a collaborative approach among professionals, involving the treatment from medical doctors, psychiatrists, therapists/counselors, a registered dietitian, and more.
The battle with alcoholism and bulimia can be overwhelming but there is cause for hope. If you are struggling with these co-occurring disorders, confide in someone you trust to begin the process of connecting to the treatment you need to recover and heal.
Community Discussion – Share your thoughts here!
Have you struggled with co-occurring disorders, such as bulimia and alcoholism? What treatment approaches did you find helpful in treating the mental health disorder and substance abuse? What encouragement might you offer to another individual who is also struggling with co-occurring disorders?
CASA Columbia, “Food for Thought: Substance Abuse and Eating Disorders”. http://www.casacolumbia.org/addiction-research/reports/food-thought-substance-abuse-and-eating-disorders Accessed 18 July 2015
Alcoholism research paper pdf
Woodside, D. Blake, “Substance Abuse in Women with Bulimia Nervosa”, http://www.psychiatrictimes.com/articles/substance-abuse-women-bulimia-nervosa
Last Updated &, Reviewed By: Jacquelyn Ekern, MS, LPC on July 31st, 2015
Published on EatingDisorderHope.com