1. Eating Disorders & Drug Abuse
Rochelle, Mikayla, Helen

4. Commonly Abused Drugs in the U.S.
Nicotine
Suppresses appetite
Amphetamines
Marijuana
Painkillers/Prescription Drugs
Cocaine
Heroin
Benzodiazepines
Ex: Valium, Xanax

5. Pathophysiology Dependent on type of drug
Nicotine, marijuana, amphetamines and cocaine cause large amounts of dopamine to be released
This can alter the normal cycling of dopamine throughout the body
Malnutrition
Use substances to replace dietary needs
Negative health risks (Ex. CVD, stroke, cancer, etc.)
Liver damage
Gastrointestinal issues

6. Diagnosis Substance Abuse Disorders
Patterns of substance use will lead to impairment in one or more of the following ways:
Failure or inability to fulfill major role obligations at work, school, or home
Recurrent use of substance in situations that would be hazardous such as while driving, supervising small children, or operating machinery
Recurrent substance-related legal problems
Continuing to use a substance despite persistent interpersonal or social problems that result from using the substance

7. Diagnosis Eating Disorders Anorexia Nervosa
Person has reached a “significantly low weight”
Bulimia Nervosa
Binge eating and compensatory behaviors must occur once a week for at least three months

8. Diagnosis ED and Substance Abuse Co-occurring Disorder
A person has a mental disorder along with a substance use disorder
About half of all individuals with eating disorders struggle with substance use disorder
The risk for substance use disorder is prominent among those with bulimia nervosa and those engaging in binge/purge behaviors
Co-occurring disorders can be difficult to diagnose due to complexity of symptoms as both may vary in severity

10. Treatment Inpatient preferred
Healthcare providers have awareness of the comorbid diagnosis
Usually aggressive, integrated treatment based on individuals’ needs
Requires substance abuse professionals and ED professionals
Proper communication and teamwork
Treating comorbid patients for ONLY ONE disorder in isolation may trigger the OTHER disorder to exacerbate (worsen) current symptoms (Woodside & Staab, 2006)
“Address needs of the whole person, not just their abuse, addiction, or disorder.”

11. Treatment Roles of SUD (Substance Abuse Disorder) Professionals
Therapies and rehabilitation
Cognitive Behavior Therapy
Environmental and emotional dysregulation
Drug detoxification
Pharmacological treatments discouraged due to varied chemical dependencies and unpredictable processing of substances (Elmquist, J., et. al, 2015)
Roles of Eating Disorder Professionals
Must take caution when prescribing diet and exercise as treatment
Why? Regular diet and exercise can enhance recovery in addicted individuals, but those with compulsive disorders given dietary restrictions or exercise routines may worsen symptoms (Elmquist, J., et. al, 2015)

12. Recovery Much more complicated than recovering from just an ED
Treatment dropout common (Elmquist, J., et. al, 2015)
Prevent relapses
Relapse occurrences normal, individual to resume treatment or try something new (Volkow, 2018)
Seeing changes in deeply rooted, addictive behaviors
Decreased dependencies on drugs
Long term support to help individual maintain healthy relationship with food

13. Questions?

14. Content Questions
Which eating disorder has the highest prevalence of substance abuse?
Why do you think substance abuse goes hand in hand with eating disorders?
Why must eating disorder professionals take caution when prescribing treatment and how might it affect a person struggling with substance abuse?

15. References
Cowden, S., Gans, S (n.d.) It’s Now Easier to Be Diagnosed With an Eating Disorder. Retrieved from
Co-Occurring Disorders: Bulimia and Substance Abuse. (2018, October 17). Retrieved from
Elmquist, J., Shorey, R. C., Anderson, S., & Stuart, G. L. (2015). Eating disorder symptoms and length of stay in residential treatment
for substance use: A brief report. Journal of Dual Diagnosis, 11(3-4), 00. doi: /
National Institute on Drug Abuse. (n.d.). Treatment and Recovery. Retrieved March 5, 2019, from
On the path towards health and healing, it's important to help people address their eating disorder and substance abuse simultaneously.
(n.d.). Retrieved from
Herzog, D., Franko, D., Dorer, D., Keel, P., Jackson, S. & Manzo, M. (2006). Drug abuse in women with eating disorders. International
Journal of Eating Disorders 39,