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Addiction and Eating Disorders



A toxic and often secret partnership  

At school and in the media, school-aged youth are bombarded with unhealthy, unrealistic messages about being thin, popular, attractive, cool, etc. The need to fit in can lead to feelings of fear and insecuritywhich manifest as poor body image, unhealthy dieting and drug/alcohol experimentation. Without intervention, these behaviors can develop into full-blown eating disorders and addictions. 

Left untreated, both eating disorders and addictions can have dire consequences, including disruption of school, compromised relationships, physiological illnesses, cognitive challenges and even premature death. In fact, anorexia nervosa and addiction have some of the highest death rates of any mental health condition. 

However, hope and healing is possible with the help of supportive a family and expert medical intervention. 

Dr. Dena Cabrera, clinical director at Rosewood Centers for Eating Disorders, shares insight and observations about the critical the link between eating disorders and addiction in youth. She also offers a bit of advice to concerned parents and youth. 

The relationship between addiction and eating disorders 

According to Cabrera, if you suspect that a young person in your life struggles with an eating disorder or addiction, it is important to also look out for the possibility of a co-occurring addiction or eating disorder. 

“At Rosewood Ranch, the eating disorder is secondary to a co-occurring condition in about 70 percent of our adolescent population,” she says. “Often, the primary condition is addiction, trauma, self-injury, severe anxiety or obsessive compulsive disorder. In order to help our clients achieve long-term recovery, we have learned that it is essential to treat whole person, including the root cause of his or her eating disorder and addiction.” 

Dr. Cabrera’s anecdotal observations are supported by research by CASA Columbia, which indicates that up to 50 percent of those with eating disorders struggle with simultaneous drug or alcohol abuse. Their research also shows that up to 35 percent of those struggling with substance abuse problems struggle with a co-occurring eating disorder. The correlation between substance abuse and binge eating disorders (BED) is particularly high, with up to 57 percent of males with BED struggling with long terms substance abuse. Additional statistics from the CASA Columbia study include:  




  • Girls ages 10 to 14 who dieted more than once a week were nearly four times as likely to smoke, compared to non-dieters. 
  • Girls with eating disorder symptoms were almost four times as likely as girls without eating disorder symptoms to have abused inhalants and cocaine. 
  • Of female high school students, 12.6 percent abused diet pills, powders or liquids to control their weight without a doctor’s advice. 

People struggling with eating disorders and addiction share similar characteristics, including the need for intensive professional treatment, high relapse rates, life threatening consequences, chronic illness, and preoccupation/secrecy surrounding their eating disorder or addiction. 

Evidence is also beginning to show that both substance abuse and eating disorders are influenced by genetic, biological, environmental and physiological factors. According to recent studies, an estimated 40 to 60 percent of an individual’s vulnerability to addiction can be attributed to genetic factors. Studies also reveal a statistically high correlation between certain genetic factors and alcoholism. 


The danger of under-diagnosis and incomplete treatment 

Despite research that clearly signifies a high correlation and close relationship between eating disorders and addictions, many parents and treatment professionals are still uninformed about this phenomenon. The result is that each year thousands of youth struggling with both addiction and an eating disorder are treated for only one or the other condition.  

Clients at Rosewood Ranch often receive their first addiction diagnosis while in treatment at Rosewood for their eating disorder. A similar phenomenon is noted by the clinical team at the Palm Beach Institute, which often sees clients who initially seek treatment addiction that also suffer from a previously undiagnosed eating disorder. 

Under-diagnosis, incomplete diagnosis and lack of proper treatment is a pervasive issue as noted by a National Treatment Center Study which found that of 351 publicly funded substance abuse treatment programs, only 50 percent screened for co-occurring eating disorders, 16 percent offered treatment for co-occurring eating disorders, and 3 percent had a formal referral arrangement with eating disorder treatment providers. 

Getting the help you need 

“If you suspect an eating disorder or addiction, please be certain to have the person receive a full mental health assessment,” advises Dr. Cabrera. “Sometimes one condition can mask another, but with an in-depth clinical analysis, one can get a fuller picture of a young person’s clinical condition and needs.” 

Dr. Cabrera also encourages concerned friends and family to invite the struggling individual to discuss any concerns, fears or insecurities they have in regards to body image, fitting in, drug/alcohol experimentation, etc. And, when they share these concerns, listen. Do not dismiss them as trivial. Instead, try to understand what the individuals root fear or concern is, then offer them unconditional love, support, and comfort that they need. Loving and listening is more powerful than lecturing. 

B// Monique Funk, Rosewood Centers for Eating Disorders 

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