Eating Disorders and Addiction Are a Common — and Dangerous — Combination


Contributor: Staff at Sierra Tucson

On their own, addiction and eating disorders can cause serious emotional, social, and physical problems. Nearly 20 million Americans age 12 and older battled a substance use disorder in 2017, according to the National Survey on Drug Use and Health (NSDUH) [1].

Eating disorders, meanwhile, will affect 9% of the U.S. population in their lifetime [2]. Nearly 26% of people who have eating disorders attempt suicide, and eating disorders have the highest mortality rate of all mental illnesses — with anorexia nervosa topping that list [3].

When an eating disorder co-occurs with addiction, the results can be even more dangerous. According to the National Center on Addiction and Substance Abuse, up to 50% of people who have eating disorders abuse alcohol or illicit drugs — a rate five times higher than the general population [4].

Flipped the other way, 35% of individuals who abuse alcohol or other drugs have a co-occurring eating disorder, which is a rate 11 times greater than the regular population. So, which eating disorders tend to have the highest association with substance use?

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Research has found a stronger link between bulimia nervosa and addiction (37%) than both anorexia nervosa (27%) and binge-eating disorder (23%) [5].

Risk Factors for Co-Occurring Disorders

It’s not completely clear what factors contribute to such a high prevalence of co-occurring eating disorders with addiction. However, one association between the two is that people often seek substances such as methamphetamine or diet pills in an attempt to reduce their weight.

Some studies have suggested that there are genetic commonalities between substance use disorders and eating disorders. Bulimia, in particular, appears to share behavioral traits, such as increased impulsivity, that are also frequently seen in those who struggle with addiction.

Generally speaking, some of the risk factors for people who display symptoms of both eating disorders and substance use disorders include:

  • History of childhood abuse
  • Family history of addiction or eating disorders
  • Trauma
  • Low self-esteem
  • Vulnerability to peer pressure or advertising
  • Genetic factors such as brain chemistry, which can impact dopamine and serotonin levels

How to Treat Substance Use Disorders That Co-Occur with Eating Disorder

Woman struggling with eating disorder and addiction at the same timeBecause eating disorders often co-occur with addiction, it’s important to find a comprehensive treatment that addresses both concerns. Both disorders increase the risk of medical complications, so that’s another critical component to consider.

Medication that is often used to treat one disorder may exacerbate symptoms of the other. An integrated treatment model that considers a person’s unique needs and treats both disorders while understanding the potential for overlapping complications is best.

Along with this, it’s important to find a program that treats the whole person rather than just the symptoms of addiction and the co-occurring eating disorder they’re struggling with. For many people, the right type of treatment provides a holistic approach.

Psychological counseling and psychotherapy are popular ways to address the symptoms of eating disorders and addiction, and some of the leading ways to treat both disorders involve principles of cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT).

CBT helps patients become aware of negative thinking so that they can change those patterns and respond in more effective ways. DBT gives patients the tools to manage painful emotions and decrease conflict in relationships.

No matter what treatment you choose to address co-occurring eating disorders and addiction, it’s important to remember one thing: your situation is never hopeless. Better days — and better health — can be right around the corner if you get the help you deserve.


[1] Substance Abuse and Mental Health Services Administration. (2018). 2017 NSDUH Annual National Report.

[2] National Association of Anorexia Nervosa and Associated Disorders. (n.d.). Eating Disorder Statistics.

[3] South Carolina Department of Mental Health. (n.d.). Eating Disorder Statistics.

[4] The National Center on Addiction and Substance Abuse (CASA) at Columbia University. (2003). Food for Thought: Substance Abuse and Eating Disorders.

[5] Killeen, T.; Brewerton, T. D.; Campbell, A.; Cohen, L. R.; and Hien, D. A. (2015). Exploring the relationship between eating disorder symptoms and substance use severity in women with comorbid PTSD and substance use disorders. The American Journal of Drug and Alcohol Abuse, 41(6), 547–552.

About Our Sponsor:

Sierra Tucson BannerLocated in Tucson, Arizona, Sierra Tucson is the nation’s leading residential and outpatient treatment center for substance use disorders, trauma-related conditions, chronic pain, mood and anxiety disorders, and co-occurring concerns. We provide integrated, holistic care for adults age 18 and older of all genders, including specialized programs for military members, first responders, and healthcare workers. Sierra Tucson was ranked No. 1 in Newsweek’s list of Best Addiction Treatment Centers in Arizona for 2020.

The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published January 13, 2021, on
Reviewed & Approved on January 13, 2021, by Jacquelyn Ekern MS, LPC

About Baxter Ekern

Baxter is the Vice President of Ekern Enterprises, Inc. He is responsible for the operations of Eating Disorder Hope and ensuring that the website is functioning smoothly.