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Commonly Co-Occurring: Eating Disorders, Anorexia, and Substance Abuse

Eating Disorders Anorexia

In This Article

Eating disorders are primarily psychological diseases, in which the sufferer either (a) refuses to eat, or eats very little by restricting calories, or (b) binge eats large amounts of food, then immediately purges (vomits) the contents of their meal. However, there may be reverse symptoms, which will also be addressed here.

On the surface, eating disorders may appear to be a different than other addictions, such as drugs and alcohol. Indeed, they are. They are known as behavioral or process addictions. The sufferer is addicted to the process of eating, not eating, eating/purging, or eating in whatever unhealthy or odd manner that they personally chose.

Also, it is not uncommon for persons who suffer with eating disorders to suffer from substance abuse. Cocaine, heroin, and amphetamines are all well-known appetite suppressants, and remain a common link between a body/weight obsessions and drug abuse. In fact, the National Center on Addiction and Substance Abuse (CASA) reports that over 1/3 of all alcohol and drug users suffer from an eating disorder. Conversely, nearly 50% of individuals with an eating disorder may be abusing drugs and/or alcohol.

There are two main diagnoses for eating disorders – anorexia nervosa and bulimia. To begin, a brief discussion on anorexia nervosa, as well as a few of the disease’s clinical requirements.

Anorexia Nervosa (AN)

Note: AN can affect both males and females, but it typically does so in different ways. Use of pronouns is not in any way meant to minimize one gender or the other.

Anorexia nervosa is largely characterized by a consistent desire to lose weight, or maintain a weight that is lower than what is considered healthy. As part of this disease, the sufferer usually presents comorbidly with some type of body dysmorphic disorder (BDD), or an unrealistic perception of one’s on body. BDD is not an eating disorder per se, but is instead a behavior/belief that may be classified as a type of obsessive-compulsive disorder (OCD).

With BDD, the patient’s skewed perception of herself is not flattering – it is the opposite. Body dysmorphia in the anorexic causes her to believe that her body is more “fat” or less becoming than it really is. It is basically an imagined defect, and is most likely a common, natural, and genetically occurring feature with no deformity present.

The typical female anorexic patient is in her teens or early 20’s, but can be any age. She will restrict calories at meals, even to the point of starvation. There may be excessive use of laxatives, diuretics, diet pills, amphetamines, and illegal drugs, such as cocaine or heroin.

In extreme cases, the patient will drop below 85% of her healthy weight. Males are usually not affected by AN in the same manner. Athletes who are required to maintain a certain weight, such as those in wrestling, may engage in habits typical of the anorexic female. However, the basic core of the disorder, body dysmorphia, may not be present.


If you suspect you or someone you know has an addiction to drugs or alcohol, please seek help immediately.

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