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ED Bytes: A look at what Substance Use Disorder (SUD) and Eating Disorders (ED) have in common

 

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Written by Janele Bayless, Wellness Coordinator for Nutrition Education in the Student Life Student Wellness Center at The Ohio State University.

 

Eating disorders are complex, serious conditions affecting a person’s physical, mental, emotional and social wellbeing.  According to the National Eating Disorders Association (NEDA), 20 million women and 10 million men suffer from a clinically significant eating disorder at some time in their life, and many more struggle with body dissatisfaction and sub-clinical disordered eating attitudes and behaviors.

Nearly 50% of those with eating disorders also abuse alcohol and/or drugs, a rate five times greater than the general population (NEDA, 2012).  A number of factors can contribute to those with eating disorders (ED) and substance use disorders (SUD), such as genetic, biological, psychological, and environmental factors.  Concerning is that these co-occurring disorders can have higher than expected rates of death from medical complications (i.e. cardiovascular disease, stroke, cancer, HIV/AIDS, hepatitis B and C, lung disease, cognitive changes) and suicide.

Research from a study about Collegiate Recovery Programs (CRP) found that over half of participants (52.6%) reported a drug addiction as their primary lifetime problem, with alcohol a distant second (38.9%).  Most also reported a secondary problem behavior with one in ten (10%) identifying an eating disorder as their behavioral addiction (Laudet, Harris, Kimball, Winters, & Moberg, 2015).

Although not a medical term or diagnosis, “drunkorexia” refers to someone who restricts their food intake throughout the day or week in order to save their calories for alcohol and avoid gaining weight.  Studies have shown that 30% of women between the age of 18 and 23 diet so they can drink, and this pattern of behavior can serve as a trigger for developing an eating disorder and/or alcoholism (Archer, 2013).  Several risk factors are involved when people drink with little to no food in their stomachs, such as binge eating later from hunger and purging from alcohol and/or food intake.  Consuming calories from alcohol instead of food can also lead to nutrition deficiencies over time.

In addition to alcohol and illicit drugs, individuals with eating disorders may also abuse prescription (i.e. steroids, insulin, thyroid medications, Ritalin, Adderall) and over-the-counter medications (i.e. diet pills, laxatives, diuretics, weight loss supplements) in order to manage their weight.  For some individuals, substance use may cause appetite suppression, leading to significant weight loss that can trigger an eating disorder. In other cases, eating disorders and substance use is relied upon for avoidance-based coping, leaving emotions unaddressed and problems unresolved.

For those with eating and substance use disorders, early intervention is imperative for short and long-term success.  CRP’s can be a hub for connecting college students to appropriate resources. For students in need of treatment or help and support in their recovery, a team of health professionals (i.e. therapist, dietitian, physician) who can treat and work collaboratively is ideal. Support groups can also offer additional accountability and support throughout the week, as well as family and friends.

 

References

Archer, D. (2013). Drunkorexia: The new fad diet for young women – eat less…drink more. Retrieved from: https://www.psychologytoday.com/blog/reading-between-the-headlines/201310/drunkorexia.

Dennis A.B. & Helfman B. (2012). Substance abuse and eating disorders: What parents and families need to know. Retrived from: http://www.nationaleatingdisorders.org/sites/default/files/ResourceHandouts/SubstanceAbuseandEatingDisorders.pdf.

Laudet, A.B., Harris, K., Kimball, T. Winters, K.C., & Moberg, D.P. (2015). Characteristics of students participating in Collegiate Recovery Programs: A national survey. Journal of Substance Abuse Treatment, 51, 38-46.

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