Alcohol and Eating Disorder Treatment

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Disordered eating and alcohol use disorders frequently co-occur, requiring specialized treatment at a dual diagnosis rehab center. According to data provided by the National Eating Disorders Association, as many as 50% of those with an eating disorder also abuse alcohol. Bulimia, binge eating disorder, and anorexia are most frequently liked with an alcohol use disorder.  Eating disorders are an illness that affects the lives of millions of Americans of all ages. Despite the opinions of some, disordered eating is not a struggle that is “by choice” or “in the head” of the person who is suffering. The statistics from the National Association of Anorexia Nervosa and Associated Disorders or ANAD indicate how widespread the prevalence of disordered eating is in the United States.

Eating disorders are complex mental health challenges that lead to significant physical and psychological consequences. It is not uncommon for someone who struggles with disordered eating to experience a co-occurring disorder or dual diagnosis. The most effective and successful way to address dual diagnosis conditions is to treat both conditions simultaneously at a treatment facility.

Regardless of the intensity of the treatment program, if only one condition is addressed, it can increase the risk of recurring symptoms and relapse.

Treating Alcohol Addiction and Eating Disorder

Seeking treatment for alcohol addiction and disordered eating requires choosing a treatment facility equipped to manage dual diagnosis conditions. However, unlike other mental illnesses, disordered eating therapy requires specialized treatments designed to help heal one's relationship with food. When seeking treatment for disordered eating, it may be necessary to seek medical treatment before beginning a therapeutic program. Medical intervention may be essential to help stabilize any significant physical challenges which may have developed out of an extended period of poor nutrition. Once you are medically stable, it is possible to begin the therapeutic portion of a mental health and addiction treatment program.

Although many dual diagnosis programs begin with alcohol detox or detoxification, the order of treatment may change if medical intervention is necessary before therapy can begin. Detox may occur as part of a hospital stay if you seek medical attention to heal from immediate physical dangers associated with disordered eating. If not, the first step in your treatment program would be comprehensive detox under medical supervision.

Once detox is complete, the therapeutic portion of a program can begin. The treatment team at a dual diagnosis treatment center will work with you to develop a treatment plan designed around your unique treatment needs and goals. Using comprehensive and evidence-based therapy techniques, you will learn how to examine and understand the thought patterns and behaviors that lie at the root of both alcohol addiction and disordered eating. Once you better understand your thoughts and behaviors, it is possible to replace them with healthier, safer methods of coping with triggers and the harmful thoughts that may arise in the future.

It is vital to choose a treatment program equipped to address both conditions simultaneously. Regardless of the specific diagnosis, an eating disorder is a complex and potentially dangerous illness that, without comprehensive treatment, can lead to lasting physical and psychological effects. Your treatment program must provide valuable insight and education on relapse prevention skills and techniques that you can use in the future. Additionally, many of the same relapse prevention skills will be beneficial as you navigate the challenging waters of newfound and ongoing sobriety.

What Is Disordered Eating?

Disordered eating or eating disorders are complex mental illnesses characterized by abnormal and harmful eating behaviors. The effects of disordered eating do not stop at weight loss or gain. They can have a significant and detrimental impact on mental, physical, and psychological health. More than ten thousand Americans lose their lives to complications directly related to disordered eating each year. Additionally, as many as five percent of those who struggle with an eating disorder will attempt suicide.

There is no one “cause” of disordered eating. Researchers believe a combination of genetic, social, cultural, and environmental factors contributes to the development of an eating disorder. Like alcohol for someone with an alcohol use disorder, someone who struggles with disordered eating manipulates food intake to manage stress and feel a sense of control over their environment.

Understanding Common Eating Disorders

There are several eating disorders listed in the Diagnostic Manual for Mental Disorders. The most common include anorexia nervosa, bulimia nervosa, and binge eating disorder.

Anorexia nervosa

Someone who suffers from anorexia nervosa is motivated by the need to stay thin. Some of the common symptoms of anorexia nervosa include low blood pressure, anxiety, dehydration, low body weight, mismatched body weight perception, and altered eating habits. Without mental health treatment, the effects of anorexia nervosa will have a significant and dangerous impact on the physical and mental health of the individual.

Anorexia nervosa has the highest mortality rate of all forms of disordered eating. Some statistics show it has the highest of all mental illnesses. Recent data shows as many as 4% of all women (regardless of age) are diagnosed with anorexia nervosa in their lifetime. Although anorexia nervosa can occur at any age, the average age of onset is in one's early teens or about the beginning of puberty. A study conducted some years ago of female teens with anorexia nervosa indicated they were 56 times more likely to attempt or commit suicide than those without the disorder. Additionally, females diagnosed with anorexia nervosa are more than twelve times more likely to die from complications linked to anorexia than women without the illness.

Bulimia nervosa

Anorexia is characterized by severely restricted food intake. Bulimia nervosa, on the other hand, is characterized by instances of binging and purging. Someone with bulimia nervosa will binge on food and then forcibly purge the food from their body.  Purging is often accomplished by laxative use or (more commonly) self-induced vomiting. Other symptoms someone with bulimia nervosa may exhibit include anxiety, bad breath, weight changes, food aversions, hunger, and problems with dental hygiene. Bulimia is believed to affect as many as three percent of women and less than one percent of men. It is almost nine times more likely to occur in women than men and has a mortality rate of around four percent.

Binge Eating Disorder

Binge eating disorder is frequently confused with bulimia nervosa, but they are two distinct illnesses. Someone with a binge eating disorder will consume excessive amounts of food within a short time (usually a few hours or less). But, unlike bulimia nervosa, someone with a binge eating disorder will not purge after food is consumed. To meet the diagnostic criteria for binge eating disorder, excessive food intake must occur at least once per week for three months to receive a formal diagnosis.

Statistically, binge eating disorder is the most common eating disorder in the United States. Researchers believe it affects up to 5% of women and approximately 2% of men; however, the statistic for males is likely far higher as many men do not seek treatment to address disordered eating. For individuals seeking weight loss treatments (such as surgical interventions), binge eating disorder is the most common form of disordered eating seen by medical professionals. In this case, it affects as many as 40% of individuals.

What is an Alcohol Use Disorder?

Alcoholism, now commonly referred to as an alcohol use disorder, is the most severe form of alcohol abuse. It is characterized by the inability to stop or manage drinking regardless of how hard one tries or how motivated one is to get sober. Someone struggling with an alcohol use disorder believes they cannot function "normally" without consuming alcohol. Regular, ongoing excessive alcohol use leads to a range of physical, psychological, and emotional challenges. Additionally, alcohol addiction can lead to significant personal and professional struggles, including loss of relationships, employment, and significant changes to one social circle.

Alcohol use disorders are generally categorized as mild, moderate, or severe. Each level of severity has unique symptoms and can lead to significant, sometimes irreversible, side effects. Without comprehensive alcoholism treatment at an addiction treatment center, alcohol abuse can lead to loss of life.

The Connection Between Alcohol and Eating Disorders

Data from the National Eating Disorders association indicates the link between disordered eating and alcohol abuse is substantial. According to statistics released by the association, the lifetime rate of disordered eating among someone who struggles with substance abuse is nearly 11 times that of those who do not. The substance abuse rate among specific eating disorders is also quite staggering. As many as 18% of those with anorexia nervosa also have a substance use problem period for those who struggle with bulimia; that number is as high as 50%. Rates of alcohol use open parentheses or drug use close parentheses among those with binge eating disorders false somewhere in the middle at about 25%.

Like alcohol, people turned to food to help regulate mood or reduce the symptoms of another mental or physical illness. Many people who struggle with disordered eating and alcohol addiction also have backgrounds of abuse, history, or neglect. They often turn to alcohol or, in the case of disordered eating, food to help reduce the intensity and severity of the emotional stress associated with their experiences. A wide range of stressors can lead to co-occurring alcohol addiction and disordered eating, including anxiety, depression, relationship problems, challenges at home, challenges at work, or domestic or physical violence histories.

Specifically, people who have bulimia nervosa also struggle with impulsive personalities. For most, the "pattern" of bending and purging begins as a way to control their weight. It is important to note that many with bulimia are average weight or overweight. However, they still experience significant weight fluctuations due to the habit of bingeing and purging. The behaviors of someone with bulimia nervosa and the behaviors of someone who struggles with alcohol addiction are similar—both used food or alcohol to numb or reduce the intensity of emotions such as guilt or shame. Someone with bulimia may also drink excessive amounts of alcohol to induce vomiting. This can lead to a range of dangerous physical complications, including alcohol poisoning and death.

Binge eating disorder is the second most common form of disordered eating to co-occur with alcohol abuse. Similar to someone with bulimia, someone with a binge eating disorder eats excessive amounts of food. However, their eating behavior is not followed by purging. Episodes of bingeing can lead to feelings of shame, self-loathing, and other negative feelings. It is not uncommon to turn to alcohol to reduce the intensity of these feelings and produce feelings of happiness and pleasure - if only for a short time.

The connection between alcohol and anorexia adds to the already complex nature of anorexia nervosa. Alcohol is inevitably high in calories and can complicate someone with anorexia's effort to reduce their calorie restrictions. Researchers indicate this may be one reason why alcohol abuse and anorexia do not co-occur at the rate of alcohol and bulimia or binge eating disorders. However, the effects of alcohol may be appealing to someone struggling with the emotional and physical effects of anorexia. Excessive alcohol consumption can lead to feelings of pleasure and relaxation. It can also help someone with anorexia feel more comfortable in social situations and allow them to maintain a connection to others which is often difficult for someone with anorexia to accomplish.

A More Dangerous Connection

Both disordered eating and alcohol addiction share one other, highly dangerous side effect: malnutrition. When someone drinks to excess, it is not uncommon for them to neglect their diet, leading to significant deficits in nutrition. Heavy drinking can also lead to harmful damage to organs responsible for processing food and releasing nutrients into the body. Disordered eating shares many of the same harmful effects. Combining the physical harms of disordered eating and alcohol addiction can become life-threatening. Without treatment, dangerous medical situations such as liver and kidney damage, heart failure, irregular heartbeat, heart failure, and sudden death can occur.