Recovery from an eating disorder is difficult enough on its own. Unfortunately, for many people, other addictions or debilitating conditions are also part of the picture. In a series of articles, we’ll explore a few of the most common co-existing conditions and some of the issues that come up when these are combined with compulsive overeating, restricting food, or body image problems.
Through my consulting work at The Recovery Village Treatment Center, I have been especially focused lately on helping people who have both substance use disorders and eating disorders, so we’ll start there.
Because eating issues can flare up after putting down the alcohol and drugs, it’s important to have a team of clinicians that can address both. For example, at The Recovery Village, we have meal support so people can feel safe with their meals while working on recovery from substance addiction.
In an article on the website of the National Eating Disorders Association (NEDA), Amy Baker Dennis and Bethany Helfman wrote, “Research suggests that nearly 50% of individuals with an eating disorder (ED) are also abusing drugs and/or alcohol, a rate 5 times greater than what is seen in the general population.”
Conversely, up to 35% of alcohol/illicit drug abusers have eating disorders, compared to 3% of the population (The National Center on Addiction and Substance Abuse at Columbia University, December 2003).
Why is there so much overlap? One reason may be that substance abuse disorders and eating disorders have similar developmental factors, such as environment, beliefs and attitudes from family, social/cultural influences, and biology/genetics.
A lot of times alcohol, in particular, can be a gateway drug to overeating, really loosening inhibitions, and leading to a “What the heck,” perspective. When drinking, people don’t feel motivated to stay with their health goals.
When determining what issue to treat first, safety is the first concern and that generally means getting someone physically stable. Sometimes that requires inpatient treatment, sometimes it can be done with a combination of outpatient treatment, support groups, therapy, and other regenerative activities.
Some of these are things people can do at home, such as yoga, meditation and mindfulness. It may be very difficult for someone in early recovery from substance use to sit still, but they can do little bits. At the same time, they can be learning and practicing the basics of good nutrition. Eating healthy will help fuel their body and provide strength for the recovery process, and get the person back to a balanced state of body, mind and emotion.
Trying to walk through the challenges of life without using anything can be an extraordinary challenge for someone who has no other coping strategies. We don’t have to label everything a problem, especially not right away. As clinicians we look for signs of impairment or loss, to identify what is really impacting the person’s ability to function.
Anything that’s set aside will still be there to address later. Everyone has their own timetable for recovery, and must be far enough along in the stages of change to do what’s going to be necessary to change that particular behavior.
In the next post we’ll look at another difficult issue that sometimes co-exists with an eating disorder.