The Relationship Between Bulimia and Addiction

Article Contributed by Jacquelyn Ekern, MS, LPC and Founder of Eating Disorder Hope and Crystal Karges, MS, RDN, IBCLC for Eating Disorder Hope

chains-19176_640The chaotic nature of Bulimia Nervosa reflects many similarities with drug and alcohol addiction. In fact, Bulimia Nervosa is commonly co-occurring with drug addictions. Many research studies have demonstrated the overlapping behaviors of eating disorders and substance abuse and the similar addictive personality that is often observed in individuals who suffer with both addictions and bulimia.

For example, the National Center on Addiction and Substance Abuse has shown that approximately 35 percent of all women who suffer from alcoholism also suffer with an eating disorder [1]. Eating disorder sufferers also have an increased risk of abusing alcohol or illicit drugs, with studies revealing that up to 50 percent of individuals with eating disorders simultaneously struggling with substance abuse [2].

What Are the Factors of This Relationship?

What factors contribute to the similar nature of these psychiatric illnesses? What links these disorders and makes them frequent co-morbid conditions among sufferers?

The following factors may explain the commonalities that are observed in both eating disorders, such as bulimia, and substance abuse and/or addiction:


Eating disorders and substance addiction are influenced by a variety of factors, including genetics. Shared genetic influences can certainly result in the correlation that is seen between bulimia and substance abuse.

Research has found that approximately 83 percent of the phenotype connection between substance abuse and bulimia nervosa was determined by genetic influences [3]. Genetic factors also influence the expression of a person’s biological make-up, which can account for the development of co-occurring conditions.

For example, a individual may have lower levels of neurotransmitters as a result of their genetics, which can be linked to the susceptibility of addictive disorders. The biology and genetics of a person will directly determine if they are vulnerable to developing an eating disorder, drug addiction, or both.


Many similar environmental factors can trigger the development of bulimia or substance abuse in genetically predisposed individuals. This can include stressors such as:

  • Childhood abuse
  • Trauma
  • Life transitions, including:
    • Moving to college
    • Experiencing a divorce
    • The death of a loved one

Family history can also be an influential factor. Individuals who have family members that have either abused drugs or alcohol or who struggled with an eating disorder have a greater chance of developing similar behaviors.


Bulimia and substance addiction share may common behaviors and characteristics, such as:

  • Compulsivity (drinking, bingeing, purging, excessive exercise, etc)
  • Obsessive preoccupation (with food, a substance, or an activity)
  • Ritualistic behaviors
  • Impulsive choices
  • Social isolation


Sad_BeautyConditions that are psychological by nature may also connect bulimia with a drug/alcohol addiction.

This includes low-self esteem, depression, and anxiety. Other existing psychological disorders, such as post-traumatic stress disorder (PTSD) can also influence the development of co-morbid conditions.

Suffering with co-morbid conditions, such as bulimia and a drug addiction, can be overwhelming and devastating. The physical, emotional, and psychological consequences that result from these disorders can be destructive to both the individual and the loved ones involved in their life.

There Is Still Hope

Even in the bleakest of situations, there is always hope. Because of the similar nature of these conditions and the frequency with which they co-occur, many treatment centers offer programs specifically tailored for dual-diagnoses.

The complexity that is involved with treating both an eating disorder and substance abuse is prevalent, and professional treatment that specializes in co-morbid conditions is highly recommended and encouraged.

Treatment Is Available

Treatment for these conditions may overlap and includes various forms of:

  • Psychotherapy
  • Pharmacological treatments
  • Psychiatric work
  • Medical nutrition therapy
  • Careful monitoring under the care of a physician

Enlisting the help and support of professionals who specialize in dual diagnosis treatment can promote recovery and help a person truly heal from the many factors involved in both bulimia and drug addiction.

If you or a loved one is suffering with both bulimia and an addiction to drugs or alcohol, do not delay in asking for the help you need, as the combination of these conditions can prove fatal. Talk to a loved one or trusted friend or mentor if you are not sure where to turn to for help. There is hope for your recovery and for the restoration of your life.


  • Love to Know Recovery, “Eating Disorder Statistics”,
  • National Center on Addiction and Substance Abuse (CASA) at Columbia University. (2003).Food for Thought: Substance Abuse and Eating Disorders. New York, National Center on Addication and Substance Abuse.
  • Healthy Place, “Co-Morbid Substance Abuse and Eating Disorder Statistics”,