Many people struggling with drug addiction feel as if their lives are spiraling out of control. In an effort to regain some sense of stability, people often try to manipulate the areas of their life they can control. Sometimes they turn to behaviors which make them feel more comfortable in the moment. The innate desire to feel in control can sometimes manifest itself as an eating disorder, in which individuals engage in extremely unhealthy eating patterns. Rarely do these behaviors offer any relief from a person’s problems. Rather they often serve to intensify their feelings of powerlessness. Conversely, an eating disorder may precede substance abuse. Most often, someone struggling with an eating disorder bases their self-value on their weight and appearance. Certain drugs may be appealing because they diminish appetite or inhibit weight gain. They may also offer temporary relief from anxiety or depression, both of which are commonly tied to both eating disorders such as anorexia and drug addiction.
Although most dual diagnoses involve drug or alcohol addictions and a co-existing mental disorder, rehabilitation professionals are seeing an increasing occurrence of drug addictions alongside eating disorders. Many people think of drug addiction and eating disorders as distinct and separate issues, but research continues to show a significant correlation between the two. In fact, the National Center on Addiction and Substance Abuse (CASA) at Columbia University reports that up to 50% of individuals with eating disorders also struggle with drug or alcohol abuse. This rate is almost 5 times that of the general population. Additionally, up to 35% of drug abusers have an eating disorder.
The most commonly abused substances by individuals with eating disorders include alcohol, laxatives, diuretics, emetics, heroin, amphetamines and cocaine. Although there are a variety of different eating disorders, here we will focus on anorexia and its connection with drug addiction. Anorexia and drug addiction share a number of common risk factors. For this reason, effective treatment methods should address each issue concurrently rather than independently.
What is Anorexia?
Anorexia Nervosa, also called anorexia, is a psychological and potentially life-threatening eating disorder. Those suffering from this eating disorder typically have an extremely low body weight relative to their height and body type. Individuals with anorexia typically exhibit extreme patterns of eating, exercise and sometimes personality traits which can indicate an issue. Those struggling with anorexia frequently fear gaining weight and have a distorted body image. Many individuals often believe they are way heavier than they actually are.
Both men and women can suffer from anorexia. However, women tend to be the dominant group within this eating disorder. There are two common types of anorexia.
- Binge/Purge — People with this type of anorexia often purge after eating. This can relieve the fear of gaining weight and offset some of the guilt associated with eating food that is “off-limits” or highly restricted. These individuals may also purge by exercising in excess, vomiting or abusing laxatives.
- Restrictive— Individuals with restrictive anorexia are typically highly-disciplined. They severely limit the quantity of food, calories, fat and sugar they ingest. Typically, they consume far fewer calories than is needed to maintain a healthy weight and healthy body functions. In essence, this is a slow and dangerous form of self-starvation.
Although both of these classifications exist within the anorexia eating disorder, they exhibit similar symptoms in an irrational fear of weight gain and extreme eating behaviors.
Contributors of Anorexia
Many things contribute to the development of anorexia. However, most research indicates a combination of genetics and environment as predisposing factors. Genetics’ role in anorexia is still being researched, but most evidence points to a significant correlation between the two. Additionally, irregular hormone functions can play a substantial role.
Examples of environmental factors which could trigger this genetic predisposition range from media pressure to childhood trauma. The effects of our culture’s obsession with being thin constantly reinforces the notion that thin people are the ideal image. Many prominent professions, such as ballet, modeling and acting, promote being thin as being beautiful and/or successful. Today’s culture obsessively promotes the idea that to be beautiful, one must also be thin. Additionally, family or childhood trauma can play a significant role. Childhood sexual abuse appears to be a common factor among those with eating disorders.
Individuals suffering from anorexia may show one or more of the following symptoms:
- Obsession with calories or fat content of food
- Rapid loss of weight or being substantial underweight or emaciated
- Chronic restrictive dieting or eating, outside of the norm
- Exhibiting ritualistic eating patterns, such as eating alone, hiding food or cutting food into tiny pieces
- Fixation with food and/or cooking, but refraining from partaking of meals with others
- Depression or lethargy
- Development of lanugo, i.e. fine, soft hair that grows on face and body
- Loss or thinning of hair
- Avoidance of social functions; isolation; withdrawal from family and friends
- Amenorrhea or abnormal/loss of menstruation
Another aspect unique to anorexia and other eating disorders, is that an individual’s self-esteem is dependent on their weight and appearance. Their self-worth is unduly influenced by the number on the scale and their body shape. In many cases, their self-loathing can reach a suicidal point. In fact, the suicide rate for individuals with anorexia is 57 times that of their respective age group. While most people would like to lose weight, what separates someone with an eating disorder is the compulsion to partake in extreme behaviors to achieve weight loss, whether through starvation, purging or exercise.
Anorexia and Drug Addiction
Both anorexia and drug addiction share many common risk factors, including family history, brain chemistry, low self-esteem, and anxiety. Additional common characteristics an include compulsive behaviors, social isolation and an increased risk of suicide. Addictions and eating disorders frequently develop during times of elevated stress. In an effort to cope with difficult emotions, individuals turn to these destructive behaviors rather than addressing some of the underlying mental health issues, such as anxiety or depression. Both diseases are chronic issues, displaying resistance to treatment and high relapse rates.
The Role of Drug Abuse
People with eating disorders often feel defeated, helpless and upset, so it’s easy to see why drug use might hold an appeal. The temporary feelings of euphoria may offer a bit of relief and a much-needed mood boost. Drugs may also offer added benefits for those with anorexia. Current research from Social Work Today shows that some drugs can work to suppress appetite, which can make the hunger cravings of anorexia easier to handle. Often, those with anorexia are desperately hungry, but determined to do anything to keep from giving in to their need to eat. Drugs that diminish those hunger signals may seem like useful tools to maintain weight loss.
Drugs may be enticing for any of these reasons. Substance abuse may seem to make living with anorexia a bit easier, or their underlying behaviors may seem to make drugs less dangerous. However, drug abuse is dangerous at any time, especially for those with eating disorders. Drugs change the brain’s chemistry in drastic ways, even though those abusing them do not realize the changes are happening. Substance abuse disorders can develop incredibly fast, even while the person thinks they have their drug use under control.
Co-Occurring Problems with Drug Addictions and Anorexia
All co-occurring disorders present significant risks and dangers, but the combination of a drug addiction with an eating disorder, specifically anorexia, can be especially serious. Anorexia weakens the body and its overall health, increasing the risk of negative side effects from drug use. Drugs can also intensify anorexia, making users feel stronger in their desire and commitment to continue engaging in their harmful eating patterns. Eating disorders can also be camouflaged by drug use, as symptoms of drug use can sometimes be more noticeable.
The Impact of Drugs on Recovery
Despite the similarities between these anorexia and drug addiction, there are a few key differences that affect the way a person recovers from an eating disorder versus a drug addiction. While someone abusing drugs can completely separate themselves from drug or alcohol use, those with eating disorders cannot abstain from food altogether. Instead, they face the unique and difficult challenge of developing healthy eating patterns and a healthy relationship with their food. They must learn to engage in daily meals and activities without relapsing. For this reason, eating disorder treatment programs face extra challenges— they must reorder a person’s eating habits and their broader relationship with food.
Additionally, having a substance abuse disorder on top of anorexia can make the healing and recovery process extra difficult. Often, those with addiction struggle with the ingrained cravings for the drugs they once regularly used. Their brain has been rewired via drug use and their brain and nervous system may not function as fully without the drugs for a time. Those cravings may be extra intense during times of increased stress — for example, the initial stages of rehabilitation.
Those recovering from an eating disorder may experience intense cravings for drugs during the moments at which they previously used. If they relied on drugs to reduce their cravings or eliminate anxiety during stressful situations, they may feel an added level of craving intensity. Those who give in to their cravings may find that recovering from eating disorders is much more complicated and difficult than many co-occurring disorders. Additionally, some drugs diminish a person’s sense of control and willpower, making it even easier to slide back into old habits or relapse, even when they’ve made great progress during recovery.
Treating Anorexia and Drug Addiction
The link between anorexia and substance abuse is often overlooked or misdiagnosed to the detriment of the individuals suffering. Recognizing that where an eating disorder like anorexia exists there is also often an addiction, and vice versa, is an important step in offering concurrent, integrative care. When treated separately, an individual may get help for either their eating disorder or their drug addiction, but when one goes into remission, the other condition reappears in full force. They may bounce between treatment facilities, believing they are making progress, only to find themselves stuck in a cycle of remission and relapse. Current research observes that these conditions are using as coping mechanisms. When new and effective coping skills are not introduced to deal with both conditions, along with an adequate support system, the individual will perpetually fight one condition or the other.
Fortunately, many dual diagnosis rehabilitation facilities are recognizing the high level of overlapping occurrence between drug abuse and eating disorders. They are beginning to develop programs which evaluate both disorders simultaneously, giving people the necessary coping skills to deal with triggers and cravings as they appear. Most of these facilities are now equipped to deal with patients who abuse laxatives, emetics and diuretics as well as illicit drugs. They work to help patients establish a healthy relationship with their food. Thankfully, recovery rates are high when both conditions are addressed together. With the right kind of therapy, most individuals come to understand the importance of good nutrition for a healthy body and a healthy body image.
Blu By the Sea
If you or a loved one is suffering from anorexia and drug addiction, do not wait to get help. Both are life-threatening disorders on their own, but when combined, the risk of harm and death are significantly increased. Call Blu By the Sea today to learn more about how you can regain control of your life and begin your journey to recovery today.