Co-Occurring Disorders: When Eating Disorders Meet Substance Abuse

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eating disorders treatmentEating disorders and substance use disorders often come hand in hand. Studies show that anywhere from 8% to 41% of drug abusers struggle with bulimia nervosa (BN). Another 2% to 10% of drug addicts struggle with anorexia nervosa (AN).  Eating disorders are particularly common with alcoholism. These mental health disorders are also prevalent in drug addiction.
There are many theories as to why eating disorders are a common co-occurring disorder. Both disorders are believed to have one thing in common: atypical endogenous opioid peptide (EOP) activity. EOPs can influence both alcohol and food consumption. They may also affect one’s eating behavior. Irregular neurochemical levels may also affect eating behavior and cause behavioral problems. Serotonin is of particular interest. This neurotransmitter is believed to control eating, decision-making and moods. While researchers now have some idea as to how eating disorders are linked to addiction, there’s still a lot of mystery surrounding this phenomenon.
If you’re a drug addict or alcoholic, there’s a good chance that you might have an eating disorder. You might not necessarily avoid food and lose weight. Binge eating is also considered to be a type of eating disorder. Alcohol or drug addiction treatment can help you deal with both the addiction and the co-occurring disorder. A successful treatment plan can help you become both physically and mentally healthier. Here’s what you need to know about these two disorders.

Common Eating Disorders Found with Substance Abuse

binge eatingThere are different types of eating disorders. It’s much more than just anorexia, which is the most commonly known. Many eating disorders stem from body image issues. However, a chemical imbalance in the brain can also result in this type of co-occurring disorder.
Understanding the differences between the various types of eating disorders is important. It helps addiction treatment centers determine which treatment program is most suitable for each patient. It also helps treatment consultants determine which behavioral therapy to recommend. Take a look below for the most common types of eating disorders linked to substance use disorders.

Anorexia Nervosa

Anorexia nervosa (AN) is perhaps the most well-known eating disorder. A patient with anorexia will refuse to maintain normal body weight. They will usually aim for 15% below what’s considered normal for their age and height. Patients with anorexia nervosa have a body dysmorphic disorder. They have significant body image issues and have an intense fear of being fat.
There are two different AN subtypes. There’s a ‘restricting’ subtype that involves strict dieting and exercising without any binge eating. They restrict their food intake. There’s also a ‘binge eating/purging’ subtype. This subtype will binge eat when they can and then purge themselves using laxatives, diuretics or enemas. They may also induce vomiting. None of these options are healthy for the body at all. In severe cases, those with AN can end up starving themselves to death.

Bulimia Nervosa

Bulimia nervosa is another known eating disorder. This eating disorder causes an individual to binge eat an excessively large amount of food within a relatively short period of time. The individual will then purge their body of the food. BN is mostly known for its regular use of extreme methods for weight loss. Patients with bulimia nervosa regular abuse laxatives, diet pills or diuretics. They may also engage in excessive exercise. The purging behaviors are prevalent in BN.
For a person to be diagnosed with BN, they must engage in binge eating and inappropriate at least twice a week. This type of eating disorder is more prevalent among young females, affecting 2% to 2% of the population.

Purging Disorder

Another type of eating disorder is a purging disorder. This happens when a person uses vomiting, laxatives or diuretics to avoid weight gain. This eating habit happens even after small meals. The patient does not necessarily experience binge eating episodes.

Night-Eating Syndrome

Another type of eating disorder is when a person eats most of their calories between dinner and breakfast time. They only eat at night. This is also known as a nocturnal eating syndrome, or NES. NES is actually a fairly serious eating disorder. It has been linked to depression, hormonal imbalances, stress and even abnormal sleep patterns.

Eating Disorder Not Otherwise Specified (EDNOS)

Eating Disorder Not Otherwise Specified includes many other eating disorders. Some of these are missing just one or two signs and symptoms for a diagnosis of another disorder. Binge eating disorder is another mental disorder. Patients eat just as much food. They binge eat at least twice a week and usually have unhealthy body image issues. They may experience weight gain. Binge eating disorder can be a form of emotional eating. They may have a lack of control over their eating habits.

Relationship Between Eating Disorders and Addiction

risk factorsSo, why is someone struggling with an addiction more likely to develop eating disorders? The answer may lie in brain chemistry. As suggested above, EOPs can influence both alcohol and food consumption. Abnormal levels can lead to a food intake disorder. It can also lead to the development of alcoholism and other addictions.
Other than EOPS, we also need to focus on serotonin, gamma-aminobutyric acid (GABA) and dopamine systems. There’s still quite a lot of research in this field. Many people have found that serotonin level can affect not only addiction, but also eating disorders. Those with low serotonin levels may be more likely to try drugs. It’s an attempt to self-medicate. They may also be more likely to develop an eating disorder. They may lose their appetite or happen upon many other changes. Providing patients with selective serotonin uptake inhibitors (SSRIs) have helped improve eating disorders.
Some of these changes are psychiatric. They affect how a person feels about themselves. Eating disorder, like addiction, is a mental illness. One of the largest risk factors as to whether a person will develop eating disorders or addiction is genetics. Genetics play a role in 50% of the cases. A person can be predisposed to developing eating disorders like anorexia.

Types of Treatment Available for These Types of Co-Occurring Disorders

If you’re struggling with an eating disorder, then your best bet is to seek residential treatment. With residential treatment, patients stay at the facility. In-house chefs prepare all of their meals. This helps the rehab center ensure that patients are eating healthily. They monitor eating habits and patterns to see whether they should address anything.
While some drugs, like SSRIs, may help treat an eating disorder, the most important part of treatment is behavioral therapy. Medical stabilization is also important. Depending on the severity of the disorder, hospitalization may be necessary. Heart arrhythmias are a huge issue among patients with eating disorders.
Look for rehab centers that specialize in treating eating disorders. Treatment of eating disorders should include the following:

  • Nutritional counseling. Patients should learn more about nutrition and how it affects their physical and mental health. They should learn how to cook, how to choose which foods to eat and more.
  • Medical care and monitoring. Antidepressants are often used to treat eating disorders as well. The patient will need to undergo both physical and psychiatric examinations to determine what the cause of the eating disorders may be.
  • Individual and group therapy. Learning how to challenge negative thoughts and behavior patterns is important. Many eating disorders are body dysmorphic disorders. Patients need to learn how to deal with these disorders and cope with them.
  • Family therapy. Working through interpersonal issues with the family can help.

Some patients will even join a 12 step support group. Being able to rely on other people can make a world of a difference. It can speed up recovery for both disorders.

Choose the Right Rehab to Treat Co-Occurring Disorders

treatment for eating disordersEating disorders are not the only type of co-occurring disorder that can happen alongside substance abuse. There are plenty of other disorders that can emerge as well. With that said, patients who develop eating disorders during their fight with substance abuse will need to be especially careful. The neurochemical levels in their brain may have changed significantly. They may have a difficult time with both the eating disorder and the addiction.
Treating both disorders at the same time is crucial to recovery. It’s absolutely necessary. Amethyst Recovery offers dual diagnosis addiction treatment. We can tailor your loved one’s treatment plan to include nutritional counseling and a wide array of other behavioral therapies. We can help diagnose symptoms of an eating disorder and can help speed up their recovery. Patients leave the treatment center feeling like a different person. They’re a healthier and happier version of themselves.


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