Sometimes difficulties come in pairs. Often one problem carries along other problems in its wake. This appears to be the case with eating disorders and substance abuse.
A comprehensive study has shown that these two struggles often co-exist. In fact, it is difficult to untangle them in terms of cause and treatment. Understanding that they co-occur does prove helpful in recognizing what to look for when one or the other condition presents itself. The latest treatment guidelines suggest that the conditions should be treated simultaneously.
Strong Connection Discovered
The comprehensive study was conducted through the National Center on Addiction and Substance Abuse at Columbia University (CASA) in 2003. The three-year study was jointly released through the president of CASA and the United States Secretary of Health, Education and Welfare. In it, we learn that just about one-half of those who struggle with an eating disorder also are involved in drug or alcohol abuse as opposed to the nine percent of the public who abuse substances. Looking at it from the other direction, close to 35 percent of those who misuse substances also have an eating disorder as compared to around three percent of the general public who suffer with the condition.
This means that when a person is discovered to be battling anorexia or bulimia, for example, it is likely that the person is also addicted to smoking, indulges in binge drinking or uses illegal drugs. The presence of one problem should alert caregivers to look for the presence of the other. The connection between the two problems is that strong. Both chemical addictions and eating disorders stem from problems of low self-worth or control/power issues. Therefore, it is not surprising that the two problems share a number of risk factors and manifest with common behaviors.
Shared Risk Factors
- The problem most often begins/occurs during periods of stress or transition.
- There is similar brain chemistry.
- There are commonalities in family history.
- Sufferers demonstrate low self-esteem, anxiety and depression.
- There have been unhealthy peer/social pressures.
- Sufferers are vulnerable to outside messages through advertising or entertainment.
- Both problems exhibit compulsivity, secretiveness and obsessive behavior.
- Both result from or lead to social isolation.
- Both can result from another psychiatric disorder.
- Both conditions are tough to treat and can be life-threatening.
- Both issues carry high rates of relapse.
Experts remain unclear if these linkages are a result of human genetics, influences from culture and environment, or traumatic exposure. So far, we only know that a definite link exists.
One Difference Is in Recovery
Though chemical dependency and eating disorders share much in common, there is one glaring difference between them and that is in how the conditions are treated. With a substance abuse problem the aim is to stop the use of something whereas with an eating disorder, abstinence may be the problem needing to be addressed.
In the past, mental health care providers treated the problems singly, one after the other. It was discovered that this sometimes meant that while one condition improved, the other worsened. Best practice today is to treat the conditions simultaneously.
People attempt to cope with the stresses and hurts in life in myriad ways. Some find positive and healthy ways to cope. Some withdraw from society, others shop compulsively and still others engage in risky behaviors. Addictions and eating disorders are mechanisms that individuals may at least temporarily help manage the pain they experience. Both must be treated if the person is to learn healthy ways to confront and cope with stress rather than seek to escape from it.