How to Manage a Co-Occurring Eating Disorder and Addiction For the Long Term

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Contributor: Crystal Karges, MS, RDN, IBCLC, Director of Content and Social Media at Eating Disorder Hope/Addiction Hope

For many complex reasons, eating disorders and addiction often occur alongside one another. Research in these areas has alluded to possible reasons why, including shared genetic traits that predispose a person to addictive type behaviors, hormonal influences, neurobiology and brain-based factors, and more.

There is also the possibility that underlying mood and personality disorders can increase susceptibility to both eating disorders and substance abuse.

For example, a person who may be dealing with depression or anxiety may develop abnormal eating behaviors as a means of establishing control or coping. This can also be true of addictive type behaviors, where a person turns to substance use to cope with overwhelming circumstances or emotions.

It is also thought that a person who struggles with both an eating disorder and substance abuse has certain type of personality traits, like compulsivity. In other instances, substances may be used as part of the eating disorder, such as stimulant medications and/or street drugs utilized for weight loss.

Increased Dangers With Co-Occurring Disorders

A person in recovery from co-occurring disorders must work that much harder to remain both in recovery from the eating disorder and abstinent from the drug of choice. Integrated and comprehensive treatment programs that specialize in co-occurring disorders are what is often needed to establish full recovery from both an addiction and eating disorder.Road to recovery from co-occurring

Behaviors commonly observed in those recovering from both an addiction and eating disorder is the dormancy of one disease and rise of the other. For example, a person with bulimia who has also struggled with binge drinking in the past may not necessarily be actively drinking.

However, because of the history, the susceptibility to using alcohol is increased. It is possible that when in recovery from bulimia, alcohol use may resume. For these reasons, comprehensive treatment cannot be stressed enough.

Being Aware of Triggers

Understanding possible scenarios that may trigger either an eating disorder or substance abuse as well as developing effective coping skills are necessary for sustaining long term recovery efforts from both an eating disorder and substance abuse. When the default way for coping has been to engage in eating disorder behaviors and/or utilize substances as a means of distracting, escaping, and more, it is critical to have alternative means of dealing with stressors that might be experienced in the recovery journey. Effective coping skills are often taught within a comprehensive treatment program for co-occurring disorders. This might involve anything from Dialectical Behavior Therapy, Cognitive Behavioral Therapy, and more.

Adapting new ways for coping might also occur through learning a new skill or spending time doing an enjoyable hobby, like art, drama, engaging with pets or animals, yoga and other forms of therapeutic exercise and more. (Note: Exercise should be used with caution and only under the direction of professionals, as this can be part of an eating disorder). While it may not seem as effective to utilize new means for coping, with repeated use, these behaviors can become part of a lifestyle that supports recovery efforts.

Staying Connected to Support

Woman in grassEven beyond treatment for co-occurring addiction and eating disorder, ongoing support is another important component for maintaining long term recovery efforts and effectively managing co-occurring disorders.  For behaviors that tend to isolate, it is necessary to stay connected to those who care about you and understand the obstacles that you may be facing. It may be helpful to join a support group that meets on a consistent basis, even if you feel like things are going well. Having a community that you can relate with on a regular basis can give you the safe space you need for sharing, process, and developing important relationships.

Maintaining recovery from co-occurring disorders also involves having a mentor as an accountability source. Being proactive with setting up appointments with your treatment team on an ongoing basis can also help create consistent accountability for you during your recovery journey. With thoughtful planning and connection to professional resources, you can successfully maintain recovery from co-occurring disorders.


Crystal Headshot 2About the Author: Crystal is a Masters-level Registered Dietitian Nutritionist (RDN) with a specialty focus in eating disorders, maternal/child health and wellness, and intuitive eating. Combining clinical experience with a love of social media and writing, Crystal serves as the Special Projects Coordinator for Eating Disorder Hope/Addiction Hope, where her passion to help others find recovery and healing is integrated into each part of her work.

As a Certified Intuitive Eating Counselor, Crystal has dedicated her career to helping others establish a healthy relationship with food and body through her work with EDH/AH and nutrition private practice.


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.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on August 2, 2016
Published on EatingDisorderHope.com