Eating Disorder Treatment That Addresses Nutrition, Mental Health, and Addiction
Eating disorders and addictions have much in common. Both deal with a complicated and unhealthy relationship with control, relief, and the body. Both are driven by emotional dysregulation that has been expressed through a specific behavior. And both have the potential to lead to severe physical problems that need to be treated physically and emotionally.
Many people who struggle with an eating disorder find themselves turning to substances, either to decrease their appetite, numb the shame surrounding food and body image issues, or calm the anxiety associated with recovery from an eating disorder. At Agape Detox Center, we understand the importance of treating each issue seriously. We offer an integrated dual diagnosis program where we provide evidence-based treatment options that cater to your specific needs.
What Are Eating Disorders?
Eating disorders are serious mental illnesses characterized by long-term distortions in eating habits and related thought patterns that create significant negative impacts on one’s physical and social well-being.[1] Although eating disorders are more commonly diagnosed in women, millions of men are also affected.[2] They most often begin during adolescence and young adulthood, though they can develop at any age.[3] Eating disorders are among the most medically dangerous psychiatric illnesses and are associated with some of the highest mortality rates of any mental health disorder.[4]
Some examples of eating disorders include:
- Anorexia Nervosa — Characterized by restricting food intake, fear of weight gain, and distorted body image. Anorexia nervosa is associated with one of the highest mortality rates of any psychiatric disorder and often requires close medical monitoring in addition to psychotherapy. [5]
- Bulimia Nervosa — Characterized by recurrent episodes of binge eating, compensated afterward by purging, using laxatives and diuretics, or over-exercising to avoid gaining weight.
- Binge Eating Disorder (BED) — Characterized by recurrent episodes of consuming large amounts of food within a short time span, accompanied by feelings of loss of control and distress. Does not involve compensatory behaviors like purging.
- Avoidant/Restrictive Food Intake Disorder (ARFID) — Characterized by highly selective or restricted eating that is not driven by body image but results in malnutrition or impaired function.
- Other Specified Feeding or Eating Disorder (OSFED) — A clinically significant eating disorder which does not fit into the previously mentioned categories but causes significant distress and impairment.
Signs and Symptoms of Eating Disorders
Symptoms of eating disorders vary depending upon the type. However, several symptoms appear across multiple presentations, including:
Behavioral signs
- Refusal to eat or severely restricting food intake
- Binge eating — consuming large portions of food quickly and secretly
- Purging behavior — self-induced vomiting or misuse of laxatives and diuretics
- Rigid food rules, rituals, or avoiding certain food groups entirely
- Over-exercising due to body-image concerns
- Frequently eating alone or avoiding social activities involving food
Psychological signs:
- Intense preoccupation with food, weight, calorie counting, and body image
- Distorted perception of body size or shape
- Intense fear of gaining weight
- Feeling ashamed, guilty, or disgusted about eating
- Low self-esteem tied closely to body image
- Emotional dysregulation — anxiety, depression, or emptiness tied to food and eating
Physical signs:
- Significant weight loss or fluctuation
- Fatigue, dizziness, and fainting
- Gastrointestinal complaints
- Dental erosion or calluses on knuckles (signs of purging)
- Electrolyte imbalances that can cause cardiac complications
Eating Disorders and Substance Abuse: The Co-Occurring Connection
There have been many studies documenting the co-occurrence of eating disorders and substance use disorder, with studies showing that people with eating disorders — especially bulimia nervosa and binge eating disorder — are at increased risk of developing an alcohol use disorder and other substance use disorders than the general population.[6]
Multiple pathways connect these two disorders. Some people with anorexia nervosa may use alcohol to decrease their appetite and manage the anxiety associated with eating and food.[7] Bulimia nervosa is also associated with high rates of substance abuse, particularly stimulants and alcohol.[8] Stimulants like cocaine and Adderall are misused for purposes of weight loss and appetite reduction in multiple eating disorder presentations.[9]
Also important is the common psychological landscape. Both eating disorders and addiction involve impaired impulse control, distorted cognitive patterns and perceptions, emotional dysregulation, and the use of a particular behavior or substance to alleviate internal discomfort.[10] Both disorders can create cycles of relief and shame, both are driven by a complex relationship with control, and both respond to losing that sense of control in ways that seem counterproductive even if they feel necessary in the moment.
Co-occurring substance use disorders are associated with greater medical complications, increased psychiatric severity, and poorer treatment outcomes among people with eating disorders.[11] Similarly, eating disorders negatively impact the course of addiction. The physical instability, malnutrition, and emotional dysregulation created by an active eating disorder pathology greatly complicate maintaining sobriety.[12] Treatment that addresses both aspects of these co-occurring disorders is essential.
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When to Get Help
Both eating disorders and substance use require immediate professional intervention.
The signs that indicate dual diagnosis treatment is needed include:
- Using alcohol, stimulants, or other substances to manage your appetite or weight
- Substance use that has become intertwined with binge-purge cycles or restrictive eating patterns
- Your eating disorder recovery has been complicated or undermined by substance use
- You were receiving treatment for addiction, but did not receive treatment for a co-occurring eating disorder
- Significant medical issues resulting from either the eating disorder or the substance use
- A loved one whose eating disorder and substance use appear to be escalating simultaneously
Eating Disorder Treatment at Agape Detox
We understand that recovery from an eating disorder is a process that requires specialized clinical focus and that if there is also an addiction involved, both conditions need to be treated at the same time in order to achieve long-lasting and successful recovery.
At Agape Detox Center, our dual diagnosis approach includes:
- Comprehensive Assessment: All new admissions to Agape Detox Center undergo a comprehensive medical, psychiatric, and psychological assessment upon admission. This assessment includes evaluation of nutritional status, medical stability, severity of eating disorder, previous substance use, and any co-existing mental health conditions. Medical stabilization is frequently a required initial step before further treatment.
- Evidence-Based Therapies: We offer a wide range of evidence-based therapy modalities to support recovery, including Dialectical Behavior Therapy (DBT), which has demonstrated effectiveness in treating emotional dysregulation and impulsive behaviors that commonly occur in people with co-occurring eating disorders and substance use disorders.[13] DBT promotes the development of emotional regulation skills, distress tolerance skills, and mindfulness skills that directly relate to alleviating the emotional issues inherent in both disorders.
- Nutritional Support: Recovery from an eating disorder requires nutritional rehabilitation along with psychological treatment. A multidisciplinary team develops a personalized nutrition plan as part of each client’s individualized treatment plan to ensure the physical needs of each client are met as they recover.
- Medication Management: Clients may benefit from taking prescription medication to help alleviate symptoms such as depression, anxiety, OCD, or other co-occurring mental health conditions that frequently occur with eating disorders.[14] Our psychiatrists develop medication plans for each client in collaboration with our addiction treatment staff.
Amanda Stevens is a highly respected figure in the field of medical content writing, with a specific focus on eating disorders and addiction treatment. Amanda earned a Bachelor of Science degree in Social Work from Purdue University, graduating Magna Cum Laude, which serves as a strong educational foundation for her contributions.
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Recovery From Both Is Possible
Addiction and eating disorders are serious issues requiring specialized, combined treatment. If you or someone you love is struggling with an eating disorder and using substances to manage it, there is hope. At Agape Detox Center, our admissions team is available around the clock to answer your questions and help you or your loved one take the first step toward recovery from both.
Frequently Asked Questions About Eating Disorders and Addiction Treatment
How common is a co-occurring eating disorder and substance abuse?
Research has demonstrated repeatedly that people who have an eating disorder, especially bulimia nervosa and binge eating disorder, have higher rates of substance use disorders than those who do not. People often consume alcohol to suppress their appetite and manage feelings of anxiety surrounding food.
Can Agape treat eating disorders alongside addiction?
Yes. We have developed an integrated dual diagnosis program at Agape, where we treat the eating disorder and the co-occurring substance use disorder at the same time. Our clinical team will coordinate medical care, nutritional support, psychiatric evaluations, and therapeutic services during the entire length of your time at Agape.
What types of eating disorders does Agape treat?
Our dual diagnosis program provides treatment for anorexia nervosa, bulimia nervosa, binge eating disorder, Avoidant Restrictive Food Intake Disorder (ARFID), Other Specified Feeding or Eating Disorder (OSFED), and other eating disorder presentations in conjunction with a co-occurring addiction.
Why do eating disorders and addiction co-occur?
Both conditions share similar underlying psychological factors, including impaired impulse control, emotional dysregulation, distorted thinking, and the use of behaviors and substances as coping mechanisms for internal pain. Due to this similarity, stimulants and alcohol are most typically misused alongside eating disorder behaviors to suppress appetite for weight management or emotional regulation.
Sources
[1] American Psychiatric Association. (n.d.). What are eating disorders? https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders
[2] [3] [5] National Institute of Mental Health. (n.d.). Eating disorders. https://www.nimh.nih.gov/health/topics/eating-disorders
[4] van Hoeken, D., & Hoek, H. W. (2020). Review of the burden of eating disorders: Mortality, disability, costs, quality of life, and family burden. Current Opinion in Psychiatry, 33(6), 521–527. https://doi.org/10.1097/YCO.0000000000000641
[5] [14] National Institute of Mental Health. (n.d.). Eating disorders. https://www.nimh.nih.gov/health/topics/eating-disorders
[6] [8] Bahji, A., Mazhar, M. N., Hudson, C. C., Nadkarni, P., MacNeil, B. A., & Hawken, E. (2019). Prevalence of substance use disorder comorbidity among individuals with eating disorders: A systematic review and meta-analysis. Psychiatry Research, 273, 58–66. https://doi.org/10.1016/j.psychres.2019.01.007
[7] [10] [11] [12] Gregorowski, C., Seedat, S., & Jordaan, G. P. (2013). A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders. BMC Psychiatry, 13, 289. https://doi.org/10.1186/1471-244X-13-289
[9] National Eating Disorders Association. (2024). Eating disorders and prescription stimulants. https://www.nationaleatingdisorders.org/eating-disorders-and-prescription-stimulants/
[13] Bankoff, S. M., Karpel, M. G., Forbes, H. E., & Pantalone, D. W. (2012). A systematic review of dialectical behavior therapy for the treatment of eating disorders. Eating Disorders, 20(3), 196–215. https://doi.org/10.1080/10640266.2012.668478