Substance use disorders (SUDs) and eating disorders (EDs) are often viewed—and treated—as entirely separate conditions. They show unique signs and symptoms, have distinct diagnoses, and are often treated in separate settings, by different providers. But beneath the surface, eating disorders and substance abuse actually have a lot in common.
Substance abuse and eating disorders also commonly co-occur. Research shows that more than one-third of alcohol and drug users also struggle with an eating disorder. Similarly, experts found that more than 25% of individuals with eating disorders will also meet the criteria for a co-occurring substance use disorder. These rates are even higher among women.
If your loved one is struggling with an eating disorder, a drug or alcohol problem, or a combination of the two, it’s extremely difficult to know what to do. You are likely overwhelmed by their changing behaviors, increased secrecy, mood swings, and physical downturn already—knowing how to help (or where to find it) can feel overwhelming.
Whether you’re a parent, teacher, or friend, understanding the connection between substance abuse and eating disorders—as well as how to identify and treat them—is essential to keeping your loved one safe. Left untreated, these co-occurring conditions can cause serious, long-term health effects.
Below, we explore the connection between substance use and eating disorders, as well as the most effective ways to support your loved one through these struggles.
Understanding Substance Use Disorders (SUDs) and Eating Disorders (EDs)
Substance use disorders (SUDs) and eating disorders (EDs) are serious, complex mental health conditions that affect a person’s behavior, physical health, and emotional well-being. They are distinct conditions, by definition, but stem from a similar place.
- A substance use disorder is the clinical term for substance addiction. It’s characterized by the repeated and compulsive use of drugs or alcohol, despite any negative consequences. Over time, substance use can lead to changes in the brain—causing dependence, loss of control, and withdrawal symptoms that make it difficult to stop without help.
- Eating disorders, on the other hand, involve a disturbed or disordered relationship with food and/or body image. Those with eating disorders exhibit compulsive behaviors around eating, such as restrictive eating, purging behaviors, or cycles of binging. These are often driven by deep emotional distress or distorted perceptions of one’s body and weight. There are many types of eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder.
While eating disorders and substance use disorders may look different on the surface, they also share important similarities. Both can become all-consuming, both are tied to mental health, and both can have serious (and sometimes life-threatening) physical consequences if left unaddressed.
Substance Abuse and Eating Disorders: Why Do They Co-Occur?
As the previous statistics showed, substance use disorders and eating disorders often co-occur. This is because they often stem from similar underlying factors: Genetics, mental health, trauma, and other environmental exposures can play a role.
Many individuals, for example, develop these disorders after using food and drugs or alcohol as ways to cope. It’s not uncommon for a person to turn to the bottle, or take a few drugs, to try and escape overwhelming emotions or thoughts. Those who have been exposed to trauma, abuse, neglect, or chronic stress, as well as those with low self-esteem and difficulty controlling emotions, are especially vulnerable.
In addition, some people use substances to try and cope with disordered thinking around food—they may use drugs to suppress their appetite, manage food anxiety, or cope with guilt and shame around eating. Alternatively, people may develop disordered eating behaviors alongside substance abuse as a form of control. The problem is that these behaviors become cyclical.
There are also biological and genetic risk factors to consider. Individuals with a predisposition to eating disorders may be more susceptible to developing a substance use disorder, and vice versa.
Why are Co-Occurring Substance Abuse and Eating Disorders So Risky?
On their own, substance use disorders and eating disorders carry their own severe risks. Substance abuse, for example, can lead to overdose as well as long-term mental health struggles—on top of physical dangers like cardiovascular problems, organ failure, and respiratory distress. Eating disorders, meanwhile, can cause malnutrition, osteoporosis or bone loss, digestive issues, and heart problems.
When both an SUD and eating disorder are present, the two can reinforce and exacerbate one another. Substance use can intensify disordered eating patterns, while eating disorder behaviors can heighten cravings or reliance on substances. Without proper treatment and support, this cycle can become increasingly difficult to break. And the side effects can escalate over time.
This is where professional treatment comes into play.
How Substance Abuse and Eating Disorders are Treated
On their own, substance use disorders and eating disorders each require specialized, structured care:
- Substance use disorder treatment often includes psychotherapy, medical intervention (when needed), lifestyle changes, and relapse prevention strategies to help individuals safely stop using substances and set themselves up for recovery.
- Eating disorder treatment typically involves psychotherapy, medical monitoring and care, nutritional support, and coping strategies to better handle the negative thought patterns and views that trigger disordered eating.
However, when these conditions occur together—in the same person, at the same time—treating them separately is not an option. Treatment for these conditions must be integrated, accounting for the entirety of a person’s needs and symptoms.
The Substance Abuse and Mental Health Services Administration emphasizes the importance of integrated, coordinated care for individuals facing co-occurring substance abuse and eating disorders, stating, “Integrated care addresses EDs and SUDs concurrently through holistic, person-centered approaches. By considering physical, mental, and emotional health – including evidence-based therapies and medical and nutritional support – integrated care plans reduce the risk of return to misuse and promote long-term recovery.”
Integrated treatment for both substance use disorders and eating disorders, therefore, should include:
- A unified treatment plan, addressing both conditions at the same time
- Evidence-based therapies like cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) to get to the root of these issues, and develop long-term coping strategies
- Medical and psychiatric care to support overall physical and mental health
- Nutrition counseling alongside substance use recovery support
- Family involvement to strengthen long-term recovery, especially for teens and young adults—SAMHSA specifically states that family provides connection, engagement, and hope throughout the treatment journey
Integrated substance abuse and eating disorder treatment recognizes that these conditions do not exist in isolation. Instead of addressing symptoms separately, it focuses on the underlying causes—such as trauma, emotional dysregulation, and co-occurring mental health conditions—while also stabilizing physical health and building coping skills that will bolster a person’s recovery long-term.
Finding Integrated Treatment for Eating Disorders and Substance Abuse
Because substance use disorders and eating disorders are so deeply interconnected, effective treatment must take a whole-person approach. While finding a treatment provider that offers this can feel overwhelming, it can also bring peace of mind. Rather than having to navigate multiple treatment paths, families choosing an integrated care approach will rest assured that their loved one is receiving treatment at every level, for every need and diagnosis.
At Turnbridge, we specialize in helping teenagers and young adults navigate complex, co-occurring conditions like these. Our integrated approach combines mental health care, substance use treatment, and eating disorder treatment, addressing the root causes behind each disorder while guiding individuals toward a lasting and sustainable recovery. We also work closely with families, providing education, support, and reassurance every step of the way. Each client that steps through our doors receives a personalized treatment plan, tailored to their individual needs.
We know you may be concerned and overwhelmed right now, but treatment is within your reach. Recovery from co-occurring substance use and eating disorders is possible. For more information, do not hesitate to reach out to Turnbridge. Call us at 877-581-1793 to take that first step towards healing.