Creek Speak

Bulimia & Co-Occurring Substance Use Disorder – Is there a connection?

People often think of eating disorders, such as bulimia, and substance use disorders as separate conditions; however, there is often an overlap between the two. Research shows that roughly 50% of individuals suffering from an eating disorder are also abusing drugs and/or alcohol, a rate that is five times greater than that of the general population.

Studies show that individuals suffering from bulimia nervosa have a 50% higher rate of alcohol use when compared to those without an eating disorder.  The connection between bulimia and addiction is strengthened as substance use often leads to a lack of hunger and increased food restriction, which can lead to binging episodes later.

Similarities between Eating Disorders and Co-Occurring Substance Use Disorders

Eating disorders and addiction share common characteristics as they both affect brain and body functions, and emotional health. Like eating disorders, substance use disorders have a strong genetic factor, as well as links to environmental and psychological factors.

Substance abuse and eating disorders may be two very diverse issues, but they both have similar causes.  The behaviors may look very different, but the truth is that those struggling with an eating disorder and/or substance abuse are both hurting people as they search for a way to cope, to numb, to feel better. Substance use disorders often co-occur with eating disorders, such as bulimia, as methods to manage negative emotions or traumatic experiences or to self-medicate mental health conditions.

Common contributing factors include:

  • Trauma
  • Depression
  • Anxiety
  • Aversive childhood experiences
  • Shame
  • Abandonment
  • Attachment issues
  • Biological component
  • Social/environmental experiences

Laura Cordova, Primary Therapist at Magnolia Creek, adds, “I see many connections between substance use and eating disorders, mainly the use of the maladaptive behaviors of binging and purging, drinking, or using substances, and the need to cope with underlying trauma. I also believe trauma may be one of the primary links between substance abuse and eating disorders.  Research shows high correlations between substance use and trauma, as well as eating disorders and trauma.”

Bulimia and Substance Use

Bulimia nervosa involves a cycle of binge eating followed by behaviors such as self-induced vomiting or over-exercise to rid the body of the food consumed. As the frequency of the binge-purge cycle increases, the pattern becomes more firmly engrained in the brain.

Binge Purge Cycle Infographic

As a person engages in the binge-purge cycle, and then uses a substance, the brain is altered to strengthen the desire to continue to use the substance. The brains structure and neural pathways, which are responsible for reward and pleasure, are changed to increase the symptoms of both disorders. Feelings of shame and guilt, both common in bulimia and addiction, often follow the binge-purge episode, and substances are frequently used to subdue these emotions.

Laura adds, “One common theme we see in eating disorder therapy is a connection between cocaine and Adderall use in efforts to suppress appetite and lose weight.  Client’s with bulimia may use drugs to suppress their appetite in between binging and purging episodes.  This substance use often develops into addiction over time.”

Treatment for Eating Disorders and Co-occurring Substance Abuse

Treatment for eating disorders and co-occurring substance use disorder needs to address both conditions simultaneously. In addition to treating the addictive behaviors, addressing the root cause of the addiction is needed to promote healing and establish coping skills. At Magnolia Creek, we provide a holistic approach designed to support each client as they explore the contributing factors related to their eating disorder and co-occurring substance abuse. In combination with individual and group therapy sessions centered around addictive behaviors and recovery, we believe 12-step integration is an essential tool. We provide psychoeducation on the 12-steps as well as regular times for weekly client-led meetings and off-site meetings.

Our clinical team works with the client to provide a customized treatment approach using an evidence-based treatment model that integrates experiential therapy and activities such as art, psychodrama, ropes, movement, and recreational outings to build confidence, challenge distorted thinking, and help clients develop effective coping skills through experience and metaphor.  We are committed to helping our clients develop the skills they need to establish abstinence and begin maintaining recovery.

If you or a loved one is struggling with an eating disorder or mental health disorder, Magnolia Creek can help. Using evidence-based treatment modalities, we work with you to help you fully recover. To learn more about our program, please call us at 205-678-4373 or complete our contact form.