The link between eating disorders and drug abuse is more complex than many people know. It’s not simply a matter of “two problems at once” — both disorders can fuel the other in ways that can make recovery seem impossible without support.
If you’re battling an eating disorder and addiction, you are not alone. Research indicates that as many as 50% of individuals living with eating disorders are also struggling with addiction. This striking figure underscores the interconnectedness of these conditions.
The Hidden Connection: Why Eating Disorders and Addiction Go Hand in Hand
When we consider eating disorders like anorexia, bulimia and binge eating in combination with drug or alcohol addiction, this is what’s known as a dual diagnosis. Both conditions have some pretty significant parallels that help explain why they frequently co-occur.
The following list outlines common aspects shared by both eating disorders and substance abuse:
- Coping with difficult emotions through behaviours
- Problems with control and compulsivity
- Alterations in the brain chemistry altering reward systems
- Often from underlying trauma, stress or depression
- Social isolation and secrecy around behaviours
When it comes to your “usual” anorexia and bulimia, there is a layered cake of mental illness stacked; that is, depression in general is frequently found with both. Dual diagnosis treatment often incorporates depression coping strategies.
Think of it like this: it’s possible that a person with anorexia would begin to use stimulants like cocaine or amphetamines to further suppress their appetite. Or someone who is trying to overcome bulimia might use alcohol as a way to dull the shame they feel after a binge episode. It’s a downward spiral in which each condition contributes to worsening the other.
Anorexia and Drug Addiction: A Dangerous Partnership
Anorexia nervosa is particularly dangerous when combined with substance abuse. People with anorexia already have severely restricted eating patterns and an intense fear of gaining weight. When drugs become involved, the situation can rapidly deteriorate.
Individuals with anorexia often abuse stimulant drugs due to their ability to suppress appetite and facilitate rapid weight loss. Cocaine, methamphetamines, diet pills, and even caffeine pills become tools in the arsenal of restriction.
But here’s what’s really scary – using these substances while already malnourished can cause:
- Dangerous heart rhythm problems
- Severe dehydration
- Kidney and liver damage
- Extreme mood swings and psychotic episodes
- Increased risk of sudden death
On the flip side, some people with anorexia might use alcohol or depressants to quiet the constant mental chatter about food, weight, and body image. The temporary relief these substances provide can quickly turn into dependency, creating another layer of complexity in treatment.
The Self-Medication Trap
No one sets out to have an eating disorder and a substance problem. That’s often in part because one condition comes first, and substances are used to medicate the suffering that it causes.
For instance, one might develop bulimia as a teenager and then begin to drink to cope with the shame and guilt that follows binge-purge episodes. Or a person might begin using drugs as a means of coping with trauma and, in turn, develop restrictive eating patterns in an effort to feel like they have control over their life.
This pseudo self-treatment can make you feel better temporarily, but it never deals with the profound issues driving both disorders. Instead, it enters a potentially devastating cycle that actually allows one behaviour to support another.
Warning Signs That Shouldn’t Be Ignored
Recognising dual-diagnosis eating disorder treatment needs early can be lifesaving. Some red flags to watch for include:
Physical signs:
- Dramatic weight loss or fluctuations
- Fatigue and weakness
- Dental problems (from purging and substance use)
- Frequent illness or infections
- Skin and hair problems
Behavioural changes:
- Secretive behaviour around food and substances
- Social withdrawal and isolation
- Mood swings and irritability
- Lying about eating habits or substance use
- Obsessive thoughts about weight, food, and getting high
Psychological symptoms:
- Depression and anxiety
- Perfectionism taken to extremes
- Low self-esteem and body dysmorphia
- Suicidal thoughts or self-harm behaviours
- Inability to cope with stress without using substances or disordered eating
If several of these signs are present, it’s crucial to seek professional help. Dual diagnosis conditions require specialised treatment that addresses both issues simultaneously.
Why Standard Treatment Often Falls Short
When a patient has two diagnoses at the same time, traditional therapies that focus on just one of the diseases are frequently ineffective. Its intended purpose will undoubtedly be undermined by this decision.
You can’t simply treat the eating disorder and expect the drug or alcohol problem to disappear on its own. Likewise, getting clean from narcotics or alcohol will not necessarily cure one’s disordered eating patterns. However, if both conditions are not dealt with at once and coordinated carefully with one another, then there is a high likelihood of relapse in either area.
Specialised dual diagnosis care is therefore essential! Treatment facilities that recognise the complexity of the relationship between addiction and eating disorders can offer comprehensive care that addresses both issues head-on.
What Effective Dual Diagnosis Treatment Looks Like
The fundamentals of successfully managing a dual diagnosis Holistic treatment that addresses the full person, including symptoms, is necessary for the effective management of co-occurring eating disorders and SUD.
Medical Stabilisation
This could include detoxification from substances as well as management of medical complications related to malnutrition or purging. Having medical standby for 24 hours during this period is frequently required, especially in severe cases.
Psychological Therapy
Cognitive Behavioural Therapy (CBT) is advantageous, as it allows individuals to recognise and modify thought patterns that underlie both addictive behaviour and disordered eating. Understanding how CBT operates and the techniques employed is valuable in recovery.
Dialectical Behaviour Therapy (DBT) is another method for teaching these important emotion-regulating skills, without you having to go down that route.
Nutritional Rehabilitation
This can contribute to healing the body of substance abuse, as well as helping to restore a normal relationship with food. It’s not only about meal planning—it’s about remedying the psychological damage these conditions have caused around food and eating.
Family Involvement
Eating disorders and addiction aren’t personal; they affect families. Having family participate in treatment contributes to a viable support system for lifelong recovery.
Holistic Therapies
Yoga, meditation, art therapy and mindfulness practices can assist people in learning to process stress and difficult emotions in new ways. For folks who have used substances or disordered eating as their main coping strategies, these can be particularly useful.
The Recovery Process: What to Expect
Recovery from a dual diagnosis isn’t a linear process. At times, it will be one step forward and one step back. That is totally standard, and it does not mean you are doing everything wrong.
In early recovery, you are still in the throes of intensive treatment; it’s a time where you will be learning new coping skills and allowing your body and mind to heal. In the second phase, you’re building a sober life with new social support and healthy strategies for coping with triggers.
To heal for long-term gains, you need continued support from therapy groups and tailored aftercare programs to help you manage life’s difficulties without reverting back. The ability to learn how to prevent relapse is actually just as important in eating disorder recovery as in substance abuse.
Why Location Matters in Treatment
Sometimes life’s triggers and stressors can make it seem almost impossible to focus on recovery. Resting and healing in a beautiful, supportive setting such as Bali can give you the space to be free of everyday norms and pressures; it creates the awareness necessary to fully focus on healing. Mental health rehab via residential care provides an intensive level of support for those challenged by co-occurring cases.
It is the intimate, small-group setting of Sivana Bali (with a maximum of nine clients at any given time) that truly enables this individualised care. Their clinical staff is supported by a full-time, dual-diagnosis psychiatrist who utilises evidence-based therapies such as CBT along with alternative treatments like yoga, meditation and mindfulness to address both the symptoms and root causes for both diagnoses.
The Role of Trauma in Dual Diagnosis
You simply can’t talk about eating disorders and substance abuse without getting to trauma. “Here’s a population of many people with eating disorders who seem to have trauma and PTSD, and most of them are not getting appropriate treatment for the PTSD.”
A history of physical, sexual, or emotional abuse is common among those with eating disorders and PTSD, according to research; one study found that roughly 43% of those with severe eating disorders also fit the criteria for PTSD.
The National Institute on Drug Abuse acknowledges that “research has shown that trauma in early childhood and later in life can increase a person’s risk for developing SUD.”
Trauma can create the stage for eating disorders and addiction by:
- Interference with the development of normal coping skills
- Intensifying Shame, Self-blame
- Resulting in Dissociation and Disembodiment
- Causing a state of hypervigilance and chronic stress responses
- Trust issues be difficult to trust people or have good relationships
The connections between abuse and self-harm can be interpreted as responses to a person’s past environment; trauma-informed therapy acknowledges these links, giving people opportunities to process their experiences. This could include specialist therapies such as EMDR (Eye Movement Desensitisation and Reprocessing) or somatic therapies, which work on reconnecting the mind and body.
Understanding the benefits of trauma therapy is crucial for anyone dealing with dual diagnosis conditions.
Building a Support Network
Recovery from dual diagnosis conditions isn’t something you can do alone. Building a strong support network is absolutely crucial for long-term success.
This network might include:
- Mental health professionals who understand dual diagnosis
- Support groups for people with similar struggles
- Family and friends who are educated about your conditions
- Recovering peers that can provide empathy and support
- Spiritual or religious communities, if you’re not a fan of what we call Woo-Woo Libraries If spiritual and religious areas are part of your belief structure.
Don’t undervalue the strength in seeing that others walked a similar path before you.
Nutrition and Recovery
Healing the relationship with food is one of the most difficult parts of healing from dual diagnosis states. Years of restriction, bingeing, purging, or using substances can completely disrupt normal hunger and fullness cues.
Nutritional rehabilitation needs to address both the physical and psychological aspects of eating. This might involve:
- Working with a registered dietitian who understands eating disorders
- Gradually reintroducing feared foods in a supportive environment
- Learning to eat regularly without using substances to cope with anxiety
- Addressing food rules and restrictions that developed during the eating disorder
- Understanding how nutrition supports recovery from substance abuse
Many people are surprised to learn that proper nutrition can actually help reduce cravings for drugs and alcohol. When your body is well-nourished, it’s better able to cope with stress and regulate mood naturally.
The Path Forward
If you’re reading this and recognising yourself in these descriptions, please know that recovery is possible. Thousands of people have successfully overcome dual diagnosis conditions and gone on to live fulfilling, healthy lives. The first step is often the hardest – reaching out for help – but once you do, you’ll discover that you don’t have to face this alone.
Treatment programs like those offered at Sivana Bali provide the comprehensive, integrated care that dual diagnoses require. Their lengthy programs, which last more than 60 days, give you the time you need to address the underlying causes of your problems and lay the groundwork for a long-lasting recovery. Keep in mind that asking for assistance is a sign of strength rather than weakness.
Recovery isn’t about becoming perfect. It’s about learning to be authentically alive, cultivating healthy coping strategies, and figuring out who you are besides your eating disorder and addiction.
The journey ahead may be difficult, but it is also full of promise. Take each day as it comes, be mindful of your emotions, and recognise that any progress is worth celebrating.
Frequently Asked Questions
Why do eating disorders and substance abuse often occur together?
Both conditions share common roots—underlying trauma, emotional pain, perfectionism, and altered brain reward systems. For some, drugs or alcohol become tools to control weight, numb feelings, or cope with stress, creating a dangerous cycle where one disorder fuels the other.
What are the warning signs of a dual diagnosis?
Watch for red flags like dramatic weight changes, secretive behavior, mood swings, dental issues from purging, social withdrawal, and frequent illnesses. Psychological symptoms such as extreme perfectionism, anxiety, or reliance on substances to cope with emotions are also key indicators.
Why is treating both conditions at the same time so important?
Focusing on just one issue usually leads to relapse in the other. Effective treatment must address eating behaviors, substance use, and the underlying trauma together—otherwise, progress in one area can unravel quickly.
What does dual diagnosis treatment involve?
Integrated care often includes medical stabilisation, detox (if needed), psychological therapy like CBT or DBT, nutritional rehabilitation, family involvement, and holistic therapies such as yoga or mindfulness. These elements work together to address both physical and emotional recovery.