On their own, eating disorders and substance abuse can be devastating experiences for adolescents, teenagers, and adults. But when they occur simultaneously in the same person — a condition known as dual diagnosis — it’s hardly a surprise that the struggle can be exponentially more difficult.

What may be surprising to many, though, is how many people are dealing with a dual diagnosis of substance abuse and eating disorders.

A three-year study by the National Center on Addiction and Substance Abuse at Columbia University (CASA) revealed that about half of all people with an eating disorder also abuse alcohol or another drug. (Among the general population, the alcohol abuse rate is about 10 percent).

The CASA study, which was published in 2003, also noted that the connection works in the other direction, too. As many as 35 percent of those who are struggling with substance abuse also have an eating disorder — a rate more than 10 times higher than the 3 percent of the general population who have anorexia, bulimia, or a related condition.

The CASA researchers noted the following similarities between chemical dependency and disordered eating.

Shared Risk Factors

  • Occur in times of transition or stress
  • Common brain chemistry
  • Common family history
  • Low self-esteem, depression, anxiety, impulsivity
  • History of sexual or physical abuse
  • Unhealthy parental behaviors and low monitoring of children’s activities
  • Unhealthy peer norms and social pressures
  • Susceptibility to messages from advertising and entertainment media

Shared Characteristics

  • Obsessive preoccupation, craving, compulsive behavior, secretiveness, rituals
  • Experience mood-altering effects, social isolation
  • Linked to other psychiatric disorders, suicide
  • Difficult to treat, life-threatening
  • Chronic diseases with high relapse rates
  • Require intensive therapy

Though dual diagnosis presents significant challenges, many residential treatment programs have established treatment tracks specifically designed to treat patients who are struggling with more than one disease or disorder.

For example, at The Victorian — a residential eating disorder treatment program for women in Newport Beach, California — specialized dual diagnosis treatment is available for women whose eating disorder is accompanied by depression, anxiety, Post-Traumatic Stress Disorder (PTSD), chemical dependency, and substance abuse.

[Photo at top of post by Diane Finlayson.]