Substance Use

Eating Disorders and Addiction: Is There a Link?

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Eating disorders, such as anorexia nervosa, bulimia nervosa, and binge-eating disorder, often coexist with substance abuse issues like drug or alcohol addiction. These problems overlap and the methods individuals use to cope with stressors such as trauma or a lack of self-esteem. In attempts to manage these challenges, some may resort to unhealthy eating behaviors or substance misuse. 

Both conditions can alter the brain’s chemical balance by impacting neurotransmitters such as dopamine, which plays a crucial role in how we seek pleasure. (1)

It is not uncommon for someone to face battles against both an eating disorder and a substance use problem at the same time. This dual struggle can perpetuate feelings of guilt and shame, which complicates efforts towards seeking assistance and breaking away from these harmful cycles.

Recognizing the link between these issues is vital; it paves the way for comprehensive treatment strategies focusing on holistic recovery processes to enhance overall health outcomes.

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Understanding Eating Disorders

When examining the relationship between eating disorders such as anorexia nervosa, bulimia nervosa, or binge eating disorder and addiction to drugs or alcohol, it becomes evident that they often intersect due to shared risk factors and coping mechanisms.

The following may contribute to individuals turning to substances or disordered eating habits:

  • Genetic predispositions
  • Environmental triggers
  • The need to manage stress, trauma, or low self-esteem (2)

Both disorders can alter brain chemistry, similar to drug addiction, particularly affecting neurotransmitters like dopamine, which play a role in regulating pleasure-seeking behaviors when weight loss is occurring. (3)

Individuals often face the dual challenge of managing an eating disorder alongside a substance use disorder, plunging into a harmful spiral of shame and guilt—occasionally rooted in family history. This combined battle can exacerbate their loss of control, making it difficult to reach out for help and escape from bad habits and negative consequences.

Acknowledging the co-occurrence of these disorders and tackling them together within treatment strategies can markedly improve the chances of attaining lasting recovery and boosting overall health.

Mental Health Risks Associated with Eating Disorders

Eating disorders not only affect physical health but also pose significant risks to mental well-being. Knowing more about these mental health risks is crucial for effective treatment and recovery efforts.

  1. Depression and Anxiety: Those grappling with eating disorders frequently endure symptoms associated with depression and anxiety. An incessant preoccupation with diet, body weight, and self-perception can create feelings of insignificance, despair, and heightened anxiety. These mental health challenges can intensify the manifestations of the eating disorder itself, perpetuating a relentless cycle of negative thoughts and actions. (4)
  2. Obsessive-Compulsive Behaviors: A considerable number of individuals facing eating disorders exhibit obsessive-compulsive disorders, or OCD, concerning food intake rituals, dietary habits, and perceptions of their bodies. These behaviors act as mechanisms to mitigate anxiety levels and create a semblance of control over their lives. Nonetheless, these compulsions can drastically disrupt daily activities and play a significant role in sustaining the disorder’s presence. (5)
  3. Social Withdrawal and Isolation: Eating disorders often lead to social withdrawal and isolation. Individuals may avoid social gatherings involving food, feel ashamed of their bodies, or fear judgment from others. This isolation can worsen feelings of loneliness, depression, and anxiety, further perpetuating the cycle of disordered eating behaviors.
  4. Self-Harm and Suicidal Thoughts: The intense emotional distress associated with eating disorders can lead to self-harming behaviors and suicidal thoughts. Individuals may engage in self-harm as a way to cope with overwhelming emotions and impulsivity or punish themselves for perceived failures related to food or body image. The hopelessness and despair experienced during the darkest moments of the eating disorder can increase the risk of suicidal ideation. (6)
  5. Distorted Body Image and Low Self-Esteem: Eating disorders are often accompanied by a distorted body image and low self-esteem. Individuals may perceive themselves as overweight or flawed, even when they are underweight or objectively thin. This distorted perception fuels the cycle of disordered eating behaviors and contributes to feelings of inadequacy and self-loathing. (7)
  6. Cognitive Impairment: Malnutrition resulting from eating disorders can impair cognitive function, affecting concentration, memory, and decision-making abilities. These cognitive deficits can make it challenging for individuals to engage in therapy, and will likely develop anxiety disorders.
  7. Personality Disorders and Co-occurring Conditions: Eating disorders frequently co-occur with other mental health conditions, such as borderline personality disorder, substance use disorders, and mood disorders. Addressing these co-occurring conditions is essential for comprehensive treatment and long-term recovery. (8)

Physical Health Risks Associated with Eating Disorders

Compulsive behaviors like eating disorders carry a range of physical health risks. Below are the common types of disorders and their physical health risks. As a disclaimer, these risks could affect people differently because eating disorder symptoms always vary.

Anorexia Nervosa

Anorexia Nervosa creates a ripple effect of health dangers that infiltrate multiple bodily systems. For starters, it puts your heart in jeopardy, triggering steep declines in pulse and blood pressure that can be life-threatening. (9)

One consequence that frequently goes unnoticed is the detrimental effect on skeletal well-being.

Starvation conditions also trigger a chain reaction, causing the body to break down protein stores for energy. As a result, the production of immune cells declines, weakening the body’s natural defense mechanisms.

The severe caloric restriction also impacts neurological function, which may manifest as impaired concentration and emotional volatility. (9) In extreme cases, the body’s prolonged malnutrition can result in multi-organ failure, a life-threatening situation requiring immediate medical attention. (9)

Bulimia Nervosa

One of the most concerning disorders is Bulimia Nervosa. This condition involves repeated cycles of binge eating followed by compensatory behaviors to prevent weight gain. 

Engaging in binge-eating and purging activities can result in severe health complications, including: (10)

  • Fluid imbalance
  • Dental deterioration
  • Periodontal conditions

For example, untreated dehydration could progress to kidney dysfunction. Similarly, tooth decay and gum disease are prevalent due to regular vomiting, which exposes teeth to stomach acid — compromising oral hygiene.

Binge Eating Disorder

Binge Eating Disorder (BED) is another eating disorder marked by uncontrolled consumption of large amounts of food, often leading to obesity or excessive weight gain. High cholesterol levels coupled with type II diabetes are substantial risk factors associated directly with this disorder. (11)

High blood pressure, known for increasing strain on the heart and possibly leading to cardiac diseases, is another significant risk factor.

Treatment Approaches for Co-Occurring Eating Disorders and Addiction

Addressing co-occurring disorders, such as eating disorders intertwined with addiction, requires a comprehensive treatment approach. In this context, comprehensive means targeting both conditions simultaneously to maximize the potential for effective recovery outcomes.


Cognitive behavior therapy (CBT) enables individuals battling these dual diagnoses to understand how their thought patterns influence behaviors for dieting, aiding them in forging healthier coping mechanisms. (12)

Group Therapy

Group therapy sessions offer another valuable resource by creating supportive environments where patients can share experiences and learn from others facing similar struggles. Studies suggest that communal support with treatment providers fosters feelings of acceptance and understanding, which are key components in any healing journey. (13)

Nutritional Counseling

We cannot underestimate the role of nutrition in recovering from substance misuse or disordered eating habits. Nutritional counseling works to set up healthy dietary habits and provides knowledge on how nutrition impacts overall well-being. (14)

This service often extends beyond meal planning assistance — it includes education about nutritional deficiencies caused by substance misuse or unhealthy food practices.

Mindfulness Techniques

Integrating mindfulness techniques into daily life is a strategy known to help manage stressors that frequently trigger addictive behaviors or problematic relationships with food. Yoga or meditation can reduce cravings while boosting overall well-being.

Eating Disorders and Addiction

Eating disorders and substance abuse are often linked because they share common risk factors and serve similar psychological needs for individuals suffering from them. Both can be coping mechanisms for stress, trauma, or emotional difficulties, offering temporary relief from uncomfortable feelings. 

People with eating disorders may use substances to suppress appetite, cope with the emotional turmoil related to body image, or numb the physical pains associated with disordered eating behaviors. Similarly, those who abuse substances might neglect balanced nutrition, leading to eating disorders.

Eating Disorders and Substance Abuse

People struggling with eating disorders often face additional mental health challenges like depression, anxiety, or issues related to substance abuse. Addressing these coexisting conditions is essential for a comprehensive treatment approach. (15)

Half of individuals with eating disorders were also found to engage in excessive alcohol use and use of illicit drugs. (16)

The presence of substance use disorders can increase the negative impact of an eating disorder.

Why Is There a Close Relationship Between Eating Disorders and Addiction?

Eating disorders often originate from a need to exert control over one’s body or emotions. In their pursuit of this control, individuals may find themselves veering towards substance abuse as a form of emotional relief or coping strategy. This, then, can lead to psychiatric disorders, drug use, or alcohol addiction.

Individuals with bulimia nervosa might consume alcohol to diminish their hunger or induce vomiting, while those battling binge-eating disorder may use drugs that stimulate food intake.

Both conditions frequently serve as coping mechanisms for internal emotional turmoil, exacerbated by external influences such as social pressures. In a culture that often equates thinness with worth and uses substances as a social lubricant, those with low self-esteem may turn to disordered eating or substance abuse as a form of self-medication or to gain perceived social acceptance.

Which Substances Do People With Eating Disorders Abuse?

Individuals with eating disorders engage in the misuse of both illegal and legal drugs. Those with anorexia often use substances to shed pounds and lose body weight, while those battling bulimia utilize drugs to curb their appetite.

The list commonly includes:


Stimulant substances have gained notoriety for their appetite-suppressing properties. These include:

  • Adderall
  • Methamphetamine (meth)
  • Cocaine

For individuals dealing with weight concerns or distorted body image — common features of many eating disorders — these substances may seem like immediate solutions. (17)

However, relying on stimulants sets off a dangerous cycle where physical health plummets due to malnutrition while mental well-being suffers from addiction-related repercussions.”

Over time, increased tolerance levels necessitate higher consumption, intensifying addictive tendencies of drug abuse and problematic eating habits.


Alcohol can serve as a coping mechanism for people with eating disorders, providing temporary relief from anxieties associated with meals or calorie intake. (18)

This often leads to dependency and exacerbates existing nutritional deficiencies caused by irregular meal routines common in various forms of disordered eating behaviors.

Eating Disorders and Their Prevalence

Mental illnesses such as Anorexia Nervosa and Bulimia Nervosa impact many people around the world.

Anorexia Nervosa

Anorexia Nervosa is a complex mental health challenge characterized by an overwhelming fear of gaining weight. This fear often manifests as extreme food restriction or even self-imposed starvation.

Those struggling with this condition see themselves as overweight despite often being critically underweight due to their skewed sense of reality. Women are disproportionately affected by Anorexia Nervosa.

Bulimia Nervosa

Bulimia nervosa involves a cycle of binge-eating episodes followed by purging behaviors, such as:

  • Forced vomiting
  • Excessive exercise
  • Avoid weight gain 

This cycle perpetuates feelings of guilt about eating habits and further reinforces the harmful behavior pattern.

Known as Binge Eating Disorder, or simply BED, this condition — though different in some key aspects — is closely related to other eating disorders and is notably the most frequently diagnosed eating-related condition in the United States. The absence of any subsequent purging activities particularly characterizes it.

Can Eating Disorders Cause Withdrawal Symptoms?

While withdrawal symptoms are typically associated with substance use disorders, there is emerging evidence suggesting that certain eating disorders can also induce withdrawal-like symptoms. This phenomenon is particularly noticeable in individuals with binge eating disorder (BED) and bulimia nervosa.

  1. Binge Eating Disorder (BED): Those suffering from BED frequently encounter uncontrollable episodes of excessive eating, during which they ingest substantial quantities of food rapidly. Following these bouts, individuals often describe feelings akin to withdrawal, including:
    • Discomfort
    • Guilt
    • Shame
    • Physical unease

Additionally, they might experience mood fluctuations and irritability that mirror the symptoms seen in substance withdrawal scenarios. (19)

  1. Bulimia Nervosa: People with bulimia nervosa partake in cycles of binge eating succeeded by compensatory actions like self-induced vomiting, over-exercising, or misusing laxatives or diuretics as a means to counteract their intake. Post these activities, some report experiencing bodily symptoms such as:
    • Nausea
    • Headaches
    • Weariness
    • Digestive issues (that are reminiscent of withdrawal indicators)
  2. Neurobiological Mechanisms: The underlying neurobiological mechanisms contributing to withdrawal-like symptoms in eating disorders are not yet fully understood. However, research suggests that alterations in brain chemistry, particularly involving neurotransmitters like serotonin and dopamine, may play a role. These neurotransmitter imbalances could contribute to dysregulated mood states and physical discomfort following binge eating episodes or purging behaviors.
  3. Psychological Factors: Feelings of guilt, shame, and emotional pain linked to disordered eating practices can amplify withdrawal-like sensations in those with eating disorders. The psychological pain arising from a perceived lack of control during binge-eating instances or the physical discomfort following purging acts heightens withdrawal experiences, fueling a vicious cycle.
  4. Treatment Implications: Acknowledgment of withdrawal-like phenomena within the context of eating disorders is crucial for formulating effective therapeutic approaches. Treatment options targeting these symptoms might include cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), dietary counseling, and medication management.

Get the Right Treatment For You

Securing the most suitable treatment tailored specifically to your needs is of paramount importance when navigating through the complexities of eating disorders and concurrent substance abuse challenges. Achieving a successful recovery frequently necessitates an all-encompassing approach that confronts both conditions head-on.

This includes not only tackling the physical manifestations of these issues but also delving deep into the psychological underpinnings, such as co-occurring mental health disorders.

If you or a loved one is in search of effective treatment options for an eating disorder, rest assured that support is available. Engaging with treatments designed to address both eating and substance use disorders can significantly enhance outcomes by breaking cycles of behavior rooted in emotional distress and addiction.

Remember, starting this journey toward recovery might initially seem scary for most Americans; however, it’s a big step towards restoring balance and finding lasting peace. With access to appropriate care for the general population—encompassing medical interventions like pharmacotherapy alongside eating disorder treatments, mental disorder assistance, and substance misuse towards brighter horizons filled with hope and rejuvenation.

At Zinnia Health, we offer comprehensive treatment programs tailored specifically for those dealing with dual diagnoses like eating disorders and drug and alcohol abuse. Our approach considers all facets of your well-being, including physical health and emotional stability. Connect with us at (855) 430-9439.


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Ready to get help?
(855) 430-9439
Why call us? Why call us