Substance Abuse Is Common with Eating Disorders

Eating disorders have high rates of co-occurrence with other conditions, such as depression and substance use. Although many investigations have focused on alcohol abuse, several recent studies describe the degree of use of illicit drugs.

Findings reported in the International Journal of Eating Disorders, 2006 (Vol. 39: 5) confirm that drug use and addiction often occurs alongside an eating disorder. Investigators interviewed 136 women with anorexia and 10 with bulimia who were assessed for using drugs every 6 to 12 months for about 9 years. A total of 42 patients (17%) had a history of illicit drug use. Interestingly, 19 of the women (63%) started abusing drugs for the first time during the study. These data indicate that a careful history of drug use should be assessed in patients with eating disorders

Cocaine, amphetamines, and marijuana were the most commonly abused drugs. Also noteworthy is that of the 19 women whose drug use began during the study, 31% of them reported an episode of major depression. Mood disorders were more likely to occur in anorexic or bulimic patients who also started using drugs. Earlier studies have linked mood disorders, eating disorders, and substance abuse.

Other Research

A 2004 report done by The National Center on Addiction and Substance Abuse (CASA) at Columbia University found that up to up to 35% of alcohol or illicit drug abusers have eating disorders compared to three percent of the general population. The report lists caffeine, tobacco, alcohol, diuretics, laxatives, emetics, amphetamines, cocaine and heroin as substances that are used by eating disordered individuals to suppress appetite, lose weight, and self-medicate negative emotions.

This report also found that women who have bulimia who are alcohol dependent report a higher rate of suicide attempts, anxiety, personality and conduct disorders and other drug dependence than bulimic women who are not alcohol dependent.

"For many young women, eating disorders like anorexia and bulimia are joined at the hip with smoking, binge drinking and illicit drug use," said Joseph A. Califano, Jr., CASA president and former US Secretary of Health, Education and Welfare.

He adds, "This lethal link between substance abuse and eating disorders sends a signal to parents, teachers and health professionals—where you see the smoke of eating disorders, look for the fire of substance abuse and vice versa."