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Alcohol Use Disorder and Eating Disorders: The Link and Risks

Alcohol Use Disorder and Eating Disorders: The Link and Risks

There may be a link between alcoholism and eating disorders. Learn about the relationship, as well as how to get treatment, here.

Alcohol misuse can lead to alcohol addiction and various long-term health problems. One lesser known complication is the link between alcoholism and eating disorders. For some people, the two conditions can go hand-in-hand. So, what is the relationship between alcohol and eating disorders? Learn the answer, as well as information about alcohol rehab and medication assisted treatment for alcohol use, below. 

What Are Eating Disorders?

Eating disorders are mental health conditions that involve severe disturbances in eating behaviors and the thoughts and emotions surrounding food. These conditions are serious and potentially fatal. People who live with eating disorders are preoccupied with weight, body shape, and food. 

People typically develop eating disorders during adolescence or young adulthood. There are different types of eating disorders, and prevalence can vary based upon the specific disorder.

For example, within a given year, 1.2% of U.S. adults will experience binge eating disorder, and 0.3% will experience bulimia. The lifetime prevalence of anorexia is 0.6%, and this eating disorder is 3 times more common in women compared to men. 

A significant portion of individuals with eating disorders have a co-occurring psychiatric disorder. Anxiety and mood disorders are particularly common among those with an eating disorder. 

Types of Eating Disorders 

There are three primary eating disorder diagnoses, each of which are described in more detail below.

Anorexia Nervosa 

People with anorexia severely restrict food intake, and they see themselves as being overweight, even when they are dangerously thin. There is a high risk of death with anorexia nervosa, because of health complications arising from starvation. 

Signs And Symptoms Of Anorexia Nervosa 

A person who has anorexia nervosa will show some or many of the following symptoms of the disorder:

  • Highly restrictive dieting
  • Appearing extremely thin or emaciated
  • Fixation on thinness with an unwillingness to maintain a healthy weight
  • Extreme fear of gaining weight 
  • Having a distorted body image (ie: viewing oneself as being overweight and being in denial that one is actually dangerously underweight)
  • Deriving self-esteem from body weight/shape
  • Physical evidence of anorexia, including muscle wasting and weakness, brittle hair and nails, dry skin, and growth of a fine hair over the body 

It is also helpful to understand that there are two subtypes of anorexia: the binge-purge subtype and the restrictive subtype. Individuals with the binge-purge subtype of anorexia severely restrict their calories, but they will have binge/purge episodes during which they consume excessive amounts of calories and then purge the calories by vomiting, misusing laxatives, or excessively exercising.

The restrictive subtype of anorexia involves severe food restriction without binge/purge episodes. 

Bulimia Nervosa 

Bulimia nervosa is characterized by episodes of binge eating, during which a person consumes large quantities of food, followed by purging behaviors like fasting, vomiting, misusing laxatives, or exercising excessively. 

Signs And Symptoms Of Bulimia Nervosa

Those who have bulimia will show the following signs and symptoms associated with this eating disorder:

  • Consuming significantly large amounts of food over the course of two hours (binging)
  • Feeling a loss of control when binging
  • Repeatedly using compensatory behaviors like laxative misuse, excessive exercise, vomiting, or fasting to compensate for calories consumed while binging 
  • Binging and purging at least two times per week, on average, over a period of three months
  • Basing self-esteem on body weight/shape
  • Physical signs like sore throat, swollen jaw, and decaying teeth from binging and purging 

Binge Eating Disorder 

Binge eating disorder, like bulimia, involves a loss of control over food consumption. People with this condition eat excessively large amounts of food (binge eating), but unlike those with bulimia, they do not compensate for binges through purging behaviors. 

Signs And Symptoms Of Binge Eating Disorder 

The signs and symptoms of binge eating disorder are as follows:

  • Repeated binge eating episodes, during which a person consumes excessively large amounts of food
  • Eating despite not being hungry
  • Eating rapidly
  • Eating to the point of being uncomfortably full
  • Eating in secrecy because of being ashamed or embarrassed of the amount of food consumed
  • Feeling distressed or ashamed about binge eating 

Other Eating Disorders

While anorexia, bulimia, and binge eating disorder are the three most common types of eating disorders, there are other conditions that fall under the eating disorder umbrella:

  • Avoidant/Restrictive Food Intake Disorder: This condition typically occurs in middle childhood, and people who have it will restrict the types of food they will eat. For instance, they may only eat a few “safe” foods. A person with this disorder may show little interest in food, and they do not consume enough calories to function or develop properly. Unlike individuals with anorexia, those with avoidant/restrictive food intake disorder are not fearful of gaining weight and do not have a distorted body image.
  • Pica: A person with this eating disorder will repeatedly consume things that are not food. They may eat soap,chalk, or paper. This condition is most often diagnosed in childhood. 
  • Rumination Disorder: Those with rumination disorder will repeatedly regurgitate and rechew their food. After swallowing food, they regurgitate it, and then they either chew it again or spit it out. 
  • Other Specified Feeding and Eating Disorder: People who fall under this diagnostic category have distorted body image or disturbances in eating behavior, but their symptoms do not meet the full criteria for a condition like anorexia or bulimia. Despite not meeting full diagnostic criteria for anorexia or bulimia, a person with this diagnosis will experience significant distress. 

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Understanding The Link Between Alcohol Use And Eating Disorders

People sometimes wonder about the link between alcohol and eating disorders, and researchers have put a considerable amount of effort into exploring this link. Studies have found that individuals with eating disorders are at a higher risk of developing an alcohol use disorder, which is the clinical term for an alcohol addiction. 

Some research suggests that individuals with eating disorders may use alcohol to cope with symptoms of anxiety, but the relationship between alcohol and eating disorders can vary based upon the specific eating disorder. Learn more below.

Alcohol Use And Anorexia

Anorexia and alcohol misuse may be less common when compared to alcohol misuse rates among other eating disorders. Some studies have found no link between anorexia and alcohol misuse. Other studies have found a link between anorexia and alcohol use disorder. 

The research indicates that alcohol misuse is more common among those with the binge-purge subtype of anorexia, and women with both anorexia and alcohol use disorder are more likely to show impulsive personality traits and to show symptoms of depression or borderline personality disorder. 

Alcohol Use And Bulimia 

Multiple studies have shown that there is a significant link between bulimia and alcohol use disorder, meaning that individuals with bulimia are more likely to have an alcohol use disorder when compared to those who do not have bulimia. Studies with both European American and African American women have found that there may be genetic factors that are linked to both bulimia and alcohol misuse.

Alcohol Use And Binge Eating 

Alcohol use disorder is relatively prevalent among those with binge eating disorder. One study found that 19.9% of people with binge eating disorder also experienced an alcohol use disorder at some point during their lives. Individuals with binge eating disorder were also 1.5 times more likely to have an alcohol use disorder compared to those without binge eating disorder. 

Both binge eating disorder and alcohol use disorder are linked to difficulty with emotional regulation. Individuals who struggle to cope with negative emotions may engage in binge eating and alcohol misuse as a coping mechanism.

Complications Caused By Alcohol Use Disorder And Eating Disorder

Both alcohol misuse and eating disorders can damage the body and lead to medical complications. When a person has both an eating disorder and alcohol use disorder, medical complications may be even more severe. 

Research with individuals who have co-occurring eating disorders and substance use disorders have shown that these individuals tend to have worse eating disorder symptomatology, more medical problems, greater risk of psychiatric problems, longer recovery times, and a higher risk of relapse.

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Frequently Asking Questions

If you’re asking, “Do eating disorders and alcoholism go hand-in-hand?” the answers to the following questions are also helpful.

Does Alcohol Use Disorder Make You Lose Your Appetite?

There is some evidence that people with alcohol use disorder may have a lower appetite. Studies have shown that long-term alcohol use reduces the amount of food that people consume. This may reflect a reduction in appetite, or people may simply replace calories from food with calories from alcohol.

What Counts As An Eating Disorder?

Eating disorders are diagnosed using criteria in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). A professional, such as a physician, psychologist, or clinical social worker can diagnose an eating disorder using this manual. A person who meets diagnostic criteria for a specific eating disorder will be diagnosed.

How Do You Know If You Have An Eating Disorder?

If you spend a significant amount of time worrying about how much food you consume, and you engage in abnormal behaviors, such as consuming excessive amounts of food or severely restricting food, you may have an eating disorder. You cannot self-diagnose this condition, so it’s important to see a physician or a mental health professional to determine if you have an eating disorder.

What Does Not Eating Do To Your Body?

Severely restricting food, like what is seen in cases of anorexia, has a negative effect on the body and can be fatal. Individuals with anorexia can experience multiple health complications from starvation, including osteoporosis, severe constipation, low pulse and blood pressure, heart damage, organ failure, brain damage, infertility, and low body temperature. 

Does Alcohol Affect Eating Habits?

Chronic drinking can lead people to consume less food, as they may consume most calories from alcohol rather than food. Some research has shown that people who drink alcohol tend to have lower-quality diets, meaning their eating habits are less nutritious.

What Are Three Things That Can Cause Eating Disorders?

Eating disorders are caused by a combination of risk factors. Three risk factors that can contribute to eating disorders are genetics, disturbances in brain activity, and psychological factors. 

Treatment For Alcohol Use And Eating Disorders 

Since alcohol misuse and eating disorders can both interfere with daily functioning and lead to medical complications, it’s important to seek treatment. Best practices for treating eating disorders and alcohol use disorders suggest that the two conditions should be treated together, using a multidisciplinary approach. This means that people with co-occurring eating disorders and alcohol use disorders may require medical treatment, psychological interventions, and nutritional interventions. 

Therapeutic interventions for the treatment of co-occurring eating disorders and alcohol misuse can include education on risk factors and symptoms, counseling to help people change distorted thinking patterns, and skill-building activities to allow people to develop healthier coping mechanisms. It is also common for people to work with a dietician for nutrition education and planning and to participate in relapse prevention programs. 

Other Healthy Coping Mechanisms To Release Stress

In some cases, drinking and eating disorders occur together because both behaviors are a method of stress relief, or a coping mechanism for dealing with negative emotions. Part of the recovery process is learning other healthy coping mechanisms, which may include the following:

  • Seeking social support from friends or family members who are skilled at lending a listening ear
  • Following a nutritious diet
  • Relaxing your muscles with strategies such as a warm bath, gentle stretching, a massage, or progressive muscle relaxation
  • Following an adequate, consistent sleep schedule 
  • Practicing meditation to relieve stress and promote healthier sleep
  • Making time for exercise
  • Spending time outdoors
  • Participating in activities that you enjoy

When To Seek Medical Attention

In some cases, people with co-occurring eating disorders and alcohol use disorders may require medical stabilization before they can participate effectively in other treatments, like counseling. If you have been chronically misusing alcohol and engaging in eating disorder behaviors, you may require immediate medical attention.

Some signs that indicate a need for medical attention include experiencing severe withdrawal symptoms when not drinking, suffering from severe constipation, dealing with dizziness or weakness from low blood pressure or muscle wasting, or being in poor health as a result of eating disorder symptoms and alcohol misuse. 

Recover With Support From Confidant Health 

If you’re looking to recover from alcohol use disorder and an eating disorder, Confidant Health could be a part of your journey. We offer online alcohol rehab services, including medication assisted treatment for alcohol use. Once you have been medically cleared and treated for any complications arising from eating disorders and alcohol misuse, you can participate in online medication assisted treatment to help you stay committed to recovery. 

Download our app today on either the App Store or Google Play Store to begin. 

This article has been medically reviewed by
Erin Hillers
Erin Hillers
Erin Hillers
Nurse Practitioner

Erin is a Nurse Practitioner with 8 years of experience in midwifery and women's health. She has spent the past 5 years specializing in the treatment of opioid and alcohol use disorders.

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