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

Eating Disorders

In This Article

Note: Please read the first part of this series here.

Anorexia Nervosa Signs and Symptoms

Besides being underweight, other signs and symptoms of anorexia nervosa include:

  • An obsession/preoccupation with food by counting calories and severely limiting caloric intake
  • Fear of gaining weight/being fat
  • A constant desire to lose weight or maintain a weight that is morbidly thin
  • Use/abuse of laxatives and diuretics
  • Distorted body image (body dysmorphia)
  • Excessive exercising
  • Irregular bowel movements/Constipation
  • Lack of menstrual cycle in women
  • Tooth decay and bone loss
  • Depression and anxiety
  • Dehydration/electrolyte imbalances
  • Rapid or irregular heart beat

Any range of symptoms may occur to nutritional deficiencies or dehydration. The mortality rate for anorexia nervosa is officially around 4%, but the actual number may be much higher. Because it is a disorder that may cause a variety of complications for long periods of time, the cause of death listed for an anorexia patient may be classified as something else. Eating disorders account for more deaths than any other mental illness.

Treatment for Anorexia Nervosa

For those seriously underweight, hospitalization may be required. In addition, the scope of treatment is directly related to many of the problems associated with malnutrition, such as bone loss. Intravenous fluids may be needed for those who refuse to eat solid foods.

A registered dietitian is often consulted, with the main goal being education of healthy eating habits. Anti-depressants or anti-anxiety drugs may be prescribed.

Once the patient has stabilized, therapy will be the most critical aspect of treatment. Eating disorders are personal diseases, with complex etiologies. Family upbringing, issues with self image and control, as well as cultural/media pressure to maintain a certain body type may all play a role in anorexia nervosa.

Finally, substance abuse related to use or overuse of diet pills, amphetamines, heroin, or other illegal drugs may be necessary. The musician, Amy Winehouse, is believed to have have anorexia nervosa in addiction to substance abuse issues.

Bulimia Signs and Symptoms

Bulimia is an eating disorder characterized by “binging and purging.” The sufferer will often consume extremely large portions of food, then regurgitate the contents. Bulimics may maintain a normal weight, but they do so at a cost. Signs/Symptoms include:

  • Evidence of binge eating, such as missing food or discarded wrappers
  • Evidence of self-induced vomiting, i.e. disappearing for long periods of time after meals
  • Appearing out of control in relation to food intake
  • Use/abuse of laxatives, diuretics, or diet pills
  • Excessive exercise/need to burn calories consumed
  • Discolored/decaying teeth
  • Irregular bowel movements/constipation
  • Damage to digestive system
  • Dehydration/electrolyte imbalances
  • Rapid/irregular heart beat

Treatment for Bulimia

Initially an IV may be needed to replenish fluids and stabilize electrolytes. Damage caused to teeth, bones and organs are treated medically as they present.

Like all mental disorders, therapy is a very important part of treatment and healing, as the bulimic likely suffers from depression, anxiety, or body image/control issues. Cognitive behavioral therapy (CBT) is often the treatment of choice, and patients are taught to use more effective coping mechanisms and establish normal eating patterns.

Like other eating disorders, bulimia sufferers commonly abuse a wide range of substances, including alcohol, cocaine, prescription medication, and OTC laxatives, diuretics, and diet pills. In addiction to weight maintenance, depression and self-esteem issues often contribute to abuse. Thus, anti-depressants or anti-anxiety medications are often used to stabilize mood.

More to come in this series – “bigorexia” and non-specified eating disorders.

If you suspect you or someone you know is abusing drugs or alcohol, please seek help immediately.

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