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September 3, 2017

Co-Occurring Eating Disorders and Substance Abuse Treatments

Man struggling with eating disorder

Eating disorders, such as anorexia nervosa, bulimia nervosa, and binge eating disorder are severe psychiatric illnesses influenced by multiple complex factors.

A person who has an eating disorder will commonly struggle with other forms of mental health illnesses, including mood disorders and substance abuse addiction.

Co-occurring disorders specifically define the existence of a substance use disorder and a mental health disorder, such as an eating disorder.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), almost 8 million adults in the United States have co-occurring disorders, though the number is likely much higher due to many instances being underreported [1].

Because co-occurring disorders presently differently in every individual and can have varying symptoms based on severity, these conditions can often go undetected or be difficult to diagnose.

In addition, co-occurring disorders often have overlapping symptoms, which may influence treatment for one condition but not the other. With co-occurring disorders, integrative and comprehensive treatment is necessary for full recovery.

Early Identification for Co-Occurring Disorders

Many people with co-occurring disorders will often present to their primary doctors or health care providers first to seek help for a related issue resulting from either their mental health condition or substance use disorder.

Primary care providers who are able to appropriately screen for co-occurring disorders can play a significant role in early identification of potential behavioral health issues.

This can allow an individual to connect with appropriate resources for co-occurring disorder treatment and begin the process of healing and recovery. Because about a third of all people experiencing mental health illnesses will also struggle with a substance use disorder, screening for co-occurring illnesses can also help with early identification [2].

Similarly, more than half of all drug users report experiencing mental illness, and again, this can be an opportunity to screen for co-occurring disorders.

Treatment Options for Co-Occurring Disorders

In the case of co-occurring disorders, such as substance abuse addiction and an eating disorder, early intervention and application of appropriate treatments can help improve prognosis.

Woman sitting on bench struggling with co-occurring disorders

On the other hand, co-occurring disorders that are undiagnosed or left untreated can result in severe mental, physical, and psychological complications.

Evidenced-based treatment approaches for co-occurring disorders specifically includes integrated treatment, which addresses and treats both the substance use disorder and mental health issue simultaneously.  The reason that this approach is important is that it allows a person to truly heal and address underlying issues that may be contributing to both conditions.

Integrated treatment for co-occurring disorders will typically involve multidisciplinary care, including medical treatment, nutritional restoration, psychiatric care, psychotherapy, medication management, counseling, and more.

It is important to work with a specialized treatment program that can provide integrated treatment in an interrelated manner. There are many options, regarding levels of care available, when it comes to treatment for co-occurring disorders.

Based on the severity of the illnesses, an individual may require treatment at a higher level of care to address acute issues related to the co-occurring disorders. Integrated treatment options may range from inpatient hospitalization, residential treatment, partial hospitalization, intensive outpatient care, or outpatient care.

Detoxification may be required for a substance use disorder, depending on the severity of the addiction, and this may be the first phase of treatment for many individuals recovering from co-occurring illnesses.

Many integrated treatment programs for co-occurring disorders will often offer self-help and support groups or encourage participants to become involved in community groups.

Integrated treatment may involve 12-step programs, such as Alcoholics Anonymous or Narcotics Anonymous, in addition to other forms of treatment.

Individualized Care for Co-Occurring Disorders

Most importantly, it is crucial to have individualized care for co-occurring disorders, in addition to integrated treatment.

Woman by the lake

Because of the complexities involved with co-occurring disorders, there is not necessarily a one-size-fits-all approach to treatment that is guaranteed to work for everyone. There may be similar underlying factors related to both conditions; however, this may be different from person to person.

For example, an individual with a history of trauma may require specialized forms of psychotherapy to help address this, while a person who may be suffering from loss or grief may have a different pathway to healing.

If you or someone you love has been dealing with a co-occurring disorder, it is important to know that you are not alone in your struggle. Whatever your journey has been up to this point, there is hope for recovery and healing.

Seeking out help is the first step toward your recovery journey, and getting connected to comprehensive, individualized, and integrative care will support your healing.

Sponsored by Magnolia Creek

Peacefully nestled in 36 wooded acres and located just outside of Birmingham, Alabama, Magnolia Creek Treatment Center for Eating Disorders treats women (18 years and older) who struggle with eating disorders, mood disorders, anxiety disorders, obsessive compulsive disorder, post-traumatic stress disorder, attachment disorders, dissociative disorders, personality disorders, and co-occurring addictive behaviors. Magnolia Creek’s phenomenal team of therapists, doctors, nurses, and dietitians is dedicated to providing the highest quality of care using current research-supported methods in a cozy, retreat-like setting. With a dual license to treat eating disorders and mental health disorders, we work collaboratively with our clients to create an individualized treatment approach for each client that not only nourishes the body but also strengthens the spirit.

LindasmithAbout the Author: Linda Smith is the Chief Executive Officer of Magnolia Creek Treatment Center for Eating Disorders in Columbiana, Alabama. Prior to joining Magnolia Creek, Linda served as an Electronic Interchange Consultant for Comprehensive Radiology Groups throughout the state.

She also worked with one of the leading facilities in addiction, Pine Grove Behavioral Health and Addiction Services located in Hattiesburg, MS. She has extensive experience in inpatient, outpatient, residential and partial hospitalization treatment, and is well versed in eating disorders, co-occurring mental health disorders, substance abuse, and love and sex addiction.


[1]: Substance Abuse and Mental Health Services Administration, “Co-Occurring Disorders”, https://www.samhsa.gov/disorders/co-occurring Accessed 15 August 2017
[2]: National Alliance on Mental Illness, “Dual Diagnosis”, https://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Dual-Diagnosis Accessed 15 August 2017

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer 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 on September 3, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on September 3, 2017.
Published on EatingDisorderHope.com

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