The Relationship Between Eating Disorders and Substance Abuse

The Relationship Between Eating Disorders and Substance Abuse
Page content

Substance abuse is the excessive use of drugs such as alcohol, amphetamines, barbiturates, benzodiazepines, cocaine, methaqualone, and opioids. Use of such drugs cause physical, social, and psychological harm, and probably criminal penalty depending on local jurisdiction.

Eating disorders are a group of conditions that characterize abnormal eating habits such as insufficient or excessive food intake, which affects the individual’s physical and emotional health. Common forms of eating disorders include binge eating, bulimia nervosa, and anorexia nervosa.

Research has shown that eating disorders and substance abuse share a link. For example, a 2003 study by the National Center on Addiction and Substance Abuse [CASA] at Columbia University reveals that about 50 percent of individuals with eating disorders abuse alcohol or illicit drugs opposed to 9 percent of the general population who indulge in substance abuse. This study also reveals that about 35 percent of those who use alcohol or illicit drugs have eating disorders compared with 3 percent of the general population who suffer from eating disorders. The positive relationship between bulimia and substance abuse is more compared to anorexa nervosa and substance abuse.

Image Credit: Everett

Common Characteristics

People suffering from eating disorders and substance abuse share common causative or risk factors and personality characteristics.

Various studies reveal the possible role of genetics, cultural influences, environmental theories, exposure to trauma, and the role of the brain and attachment as the major factors responsible for the complex association between eating disorders and substance abuse.

Dusty Miller, in her book Women Who Hurt Themselves: A Book of Hope and Understanding, says that both eating disorders and substance abuse represent a trauma reenactment syndrome caused by childhood factors such as trauma, grief, a history of abuse, parental neglect or abandonment, and parents indulging in substance abuse. Other common risk factors include unhealthy peer norms or social behavior.

Both eating disorders and substance abuse are marked by compulsive behavior or an obsessive preoccupation or craving for food or substance. People suffering from these disorders experience mood-altering effects, prefer social isolation, and have low-self esteem, depression, anxiety, or compulsivity.

Both these disorders usually occur in times of transition or stress. Treatment is difficult, often requiring intensive therapy

Relationship Triggers

While research is conclusive regarding the common risk factors and characteristics of eating disorders and substance abuse, research remains inconclusive on whether eating disorders drive substance abuse or vice versa, or whether the two occur simultaneously.

A 2003 study by Wandler & Wolfe suggests that certain substances help individuals with eating disorder lose weight, and that substance abuse may be a way that a client with eating disorders self-medicates to alleviate negative psychological symptoms. The intake of substances such as alcohol, nicotine, amphetamines, and cocaine suppress appetite and cause the brain to experiences satiety, suggesting eating disorders driving substance abuse.Many people with eating disorders use caffeine, diuretics, tobacco, cocaine, and heroin to control weight, suppress appetite, and increase metabolism, further driving the speculation that eating disorders drive substance abuse.

A 1999 study by Wiseman, Sunday, Halligan, Korn, Broan, & Halmi, however, reveal that overeating may result when withdrawal from substances lessen the stimulation of the brain’s pleasure center. This suggests that substance abusers encounter eating disorders because of the substance abuse.

Treatment and Recovery

The major divergence between eating disorders and substance abuse lies in recovery. The substance abuser aims to restrict or abstain from the substance, whereas the person with eating disorder cannot abstain from food. Instead, they try to abstain from the symptoms such as starvation, rigid dieting, binge eating, purging, body loathing, and others, to forge a new enhanced relationship with food.


  • Heidtke, Annsley. “Eating Disorders and Substance Abuse.” Retrieved from on 7 November 2010.
  • Ressler, Adrienne. “Insatiable Hungers: Eating Disorders and Substance Abuse.” Social Work Today, Vol. 8 No. 4. Retrieved from on 07 November 2010.
  • Wandler, K. & Wolfe, K. (2003). “Eating disorders and substance abuse: Treating the co-morbid patient.” Presentation at the International Association of Eating Disorders Conference, Miami, FL.
  • Wiseman, C., Sunday, S., Halligan, P. Korn, S., Broan, C., & Halmi, K. In: National Center on Addication and Substance Abuse. (2003). “Food for Thought: Substance Abuse and Eating Disorders.” New York, National Center on Addication and Substance Abuse.