Eating Disorders & Substance Use Disorder

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Eating disorders (ED) and substance use disorders (SUD) often co-occur. It is extremely important for those suffering from both ED and SUD, to receive specialized treatment that addresses both issues.

What is Substance Use Disorder?

Substance use disorder (also called substance abuse disorder) occurs when a person is unable to control the use of a drug or medication, either legal or illegal [1]. SUD affects a person’s brain and behavior, leading to health problems and issues at home, work, or school [2].

Eating Disorders and Substance Use Disorders

Individuals with eating disorders are up to 5 times more likely to abuse alcohol or illicit drugs than those without eating disorders, revealed a study by the Center on Addiction [3]. The study also found that up to 50 percent of individuals with eating disorders abused illicit drugs or alcohol, compared to only 9 percent of the general population.

The same study concluded that girls with eating disorder symptoms were nearly 4 times more likely to have used cocaine and inhalants than girls without eating disorder symptoms.

Substances commonly abused by individuals with eating disorders include alcohol, amphetamines, laxatives, diuretics, heroin, emetics, and cocaine [4].

What is the Connection Between Eating Disorders and Substance Use Disorders

There are several possible connections between ED and SUD. First, eating disorders and substance use disorders share many of the same risk factors, like depression, anxiety, brain chemistry, low self-esteem, family history, and social pressures [5].

One study found that among women with SUD, 93 percent reported a lifetime history of physical abuse, and 63 percent reported sexual abuse [6]. Similarly, many individuals suffering from an eating disorder have experienced some type of trauma or abuse in their lives. One report found that those who experience two or more episodes of childhood sexual abuse (CSA) were nearly 5 times more likely to develop bulimia compared to those who did not experience CSA [7]. Further, the National Eating Disorder Association (NEDA) states that approximately 30 percent of individuals with an ED have been sexually abused [8].

Asian American Woman dealing with Eating Disorders and Substance Use DisordersNot only do ED and SUD share common risk factors, but in many cases, they also go hand in hand. For example, one study exploring the initial motivation for drug use found that 36 percent of women in treatment for methamphetamine use disorder initially started using the drug as a way to lose weight [9]. Similarly, individuals with ED sometimes use opiates and appetite suppressant drugs to control their weight and cope with anxiety and restlessness, which can lead to later addiction and substance use disorder [10].

Treatment for ED and Substance Use Disorder

Both eating disorders and substance use disorders are highly treatable illnesses. However, it is extremely important for individuals suffering from both ED and SUD to receive specialized treatment that addresses both disorders, not just one. Why? Since the disorders often go hand in hand, addressing and treating only one disorder leaves the individual at risk of relapse and can prevent them from fully recovering.

While many eating disorder treatment centers are able to help patients who abuse over-the-counter diet pills and laxatives, some are not able to address more serious substance use disorders such as alcohol or illegal drug use. Conversely, most SUD treatment programs are not equipped to address or treat eating disorders.

That’s why it’s so important to find a treatment center equipped to address both SUD and ED.

If you or a loved one are suffering from both an eating disorder and a substance use disorder, know that you’re not alone. There are many treatment options available to help you find healing and lasting recovery. Take the first step today, and look for treatment centers in your area that address both addictions and eating disorders.


[1] Mayo Foundation for Medical Education and Research. (2017, October 26). Drug addiction (substance use disorder). Mayo Clinic.

[2] U.S. National Library of Medicine. Substance use disorder: MedlinePlus Medical Encyclopedia. MedlinePlus.

[3] Addiction Research & Reports. Center on Addiction. (2003, December).

[4] Substance Abuse and Eating Disorders. National Eating Disorders Association. (2020, February 6).

[5] Ibid.

[6] Killeen, T., Brewerton, T. D., Campbell, A., Cohen, L. R., & 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.

[7] Lena Sanci, M. B. B. S. (2008, March 1). Childhood Sexual Abuse and Eating Disorders in Females. Archives of Pediatrics & Adolescent Medicine.

[8] Trauma and Eating Disorders. National Eating Disorder Association. (2012).

[9] Brecht, M. L., O’Brien, A., von Mayrhauser, C., & Anglin, M. D. (2004). Methamphetamine use behaviors and gender differences. Addictive behaviors, 29(1), 89–106.

[10] Calero-Elvira, A., Krug, I., Davis, K., López, C., Fernández-Aranda, F., & Treasure, J. (2009). Meta-analysis on drugs in people with eating disorders. European eating disorders review: the journal of the Eating Disorders Association, 17(4), 243–259.

Sarah Musick PhotoSarah Musick is a freelance writer who specializes in eating disorder awareness and education. After battling with a 4-years long eating disorder, she made it her mission to help others find hope and healing in recovery.

Her work has been featured on numerous eating disorder blogs and websites. When she’s not writing, Sarah is off traveling the world with her husband.

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 July 6, 2020, on
Reviewed & Approved on July 6, 2020, 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.