How do you Deal with the Co-Occurrence of an Eating Disorder and a Substance Use Disorder?
Cessation of alcohol and drugs can be an important part of eating disorder recovery, as these substances interfere with hunger and fullness cues. Often time substances such as alcohol can be used to induce vomiting by bulimic patients, and drugs such as methamphetamine can be used as appetite suppressants or compensatory purging. Many eating disorder patients hide out in addiction treatment, and many addicts hide out in eating disorder treatment. Patients may attempt to mask their true condition and may not be aware of it. Clinicians who are not trained in both spectrums may fail to identify their primary diagnosis.
Individuals in early substance abuse recovery describe dysfunctional eating practices including binge eating and the use of food to satisfy drug cravings. Early recovery can be very stressful, which can lead to craving, compulsivity, and relapse risk. However, there is a difference between an individual with substance use disorder who binge eats and a patient with binge eating disorder who uses drugs, however some individuals display characteristics of both. Successful treatment should clearly identify the primary diagnosis, as nutrition therapy for eating disorders is often times at odds with nutrition therapy for addictions. Nutrition In Recovery attempts to normalize disordered eating patterns for individuals in early recovery, stressing that disordered eating is likely related to altered brain chemistry and type of food consumed, and does not necessarily indicate an eating disorder. New research is attempting to formulate treatment modalities for co-occurring eating disorder and substance use disorder, addressing both issues simultaneously.
Nutrition, Addiction, & Eating Disorder Resources:
- Mr. Wiss has written a chapter on nutrition therapy for eating disorder, substance use disorder, and addictions. The chapter addresses the disorders separately and co-occurring, and can be ordered on Amazon HERE
- Listen to a 10-minute interview with David Wiss MS RDN discussing this concept of Integrated Treatment
- Read and download Mr. Wiss’ publication Incorporating Food Addiction into Disordered Eating: The Disordered Eating Food Addiction Nutrition Guide (DEFANG)
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