At a glance, alcohol addiction and eating disorders are vastly different illnesses, but the overlap between individuals who struggle with both is significant. Almost half of those struggling with an eating disorder have also struggled with or currently struggle with alcohol addiction.
By: Samreen Khan
This may be attributed to the fact that eating disorders and alcohol use disorders affect the brain similarly. The combined effects of eating disorders and alcohol addiction on the body can cause intense damage, but understanding how the two types of illnesses correlate can help effectively treat patients dealing with both.
Eating disorders and alcohol addiction are more intertwined than most people think. More than 40% of all individuals with eating disorders have alcohol or substance use disorders. Of this demographic, individuals with bulimia are twice as likely to suffer from alcohol addiction than those with other eating disorders³. Alcohol may be used to numb out to cope with trauma, anxiety, or low self-esteem. Both are commonly associated with other mood disorders such as depression and anxiety, and both are frequently experienced as familial or generational illnesses.
Although it is not a medically recognized disorder, “drunkorexia” is a colloquial term used to describe one way eating disorders and addiction can interact. Encouraged by party culture, it runs rampant in college and university communities. The pressure to remain thin while drinking excessive amounts of alcohol leads to individuals restricting their caloric intake in anticipation of drinking. Alcohol consumption can also be used to self-induce vomiting and dehydration after eating. But consistently drinking on an empty stomach poses extreme dangers. It affects the rate at which alcohol is absorbed into your bloodstream (making it easier to become drunk faster) and can also cause permanent damage to your digestive organs.
Co-occurring eating disorders and alcohol use can leave lasting damage to one’s body and brain. Malnutrition and digestive dysfunction are already prevalent in individuals with eating disorders. Adding overindulgence in alcohol to the mix can increase the risk for digestive organ failure (affecting the liver and digestive tracts), cardiovascular issues, and related complications to vitamin B1 deficiencies. Vitamin B1 plays a crucial role in energy breakdown within cells, so inadequate amounts of vitamin B1 can degrade and alter neurological pathways, damaging the hypothalamus and causing memory loss².
Reward and stress pathways within the brain are modified by eating disordered behaviors and consistent alcohol overconsumption in similar ways. Dopamine, which is heavily involved in feelings of satisfaction, undergoes abnormal release patterns in the presence of alcohol¹. In individuals with eating disorders, irregular amounts of dopamine influence the obsessive feelings of desire and dread surrounding food and one’s body. As a result, the reward system, in which dopamine is a primary neurotransmitter, becomes altered and functions in a manner that makes it difficult to break free from addictive or disordered habits without experiencing very negative emotional states. Studies also show that alcohol use and disordered eating can result in a hyperactive HPA axis, a stress pathway involved with cortisol production¹. Increased levels of stress and anxiety contribute to a cycle in which one engages in these harmful behaviors to self-medicate. Still, the impacts of these behaviors on the body only increase stress and anxiety.
Understanding the prevalence of alcohol addiction among eating-disordered individuals is essential to effective treatment. Both disorders are already difficult enough to recover from on their own; when an individual suffers from both, starting treatment for only one is often not productive for a sustained recovery. Pursuing recovery from an eating disorder means abstaining from a primary coping mechanism, which can open the floodgates to a stream of negative emotions. But engaging heavily in other unhealthy coping mechanisms, such as alcohol use, is counterproductive to the process. Treating one disorder and neglecting the other increases chances of relapse for both disorders. Eating disorder patients who struggle with substance use disorders often undergo medically supervised detoxes and screenings to monitor eating disorder and addiction symptoms. With an increased awareness of how alcohol addiction and eating disorders interact, the quality of support for patients through treatment can be maximized.
BALANCE is also excited to host a Toxic Relationship: Alcohol and Eating Disorders webinar, featuring BALANCE’s own Lead Admissions Therapist Laura Haelsig (she/her), and Intake Coordinator Jillian Sucher (she/her) on Friday, June 24th, 2022 at 12:00 pm EST. We will be touching on topics such as early signs of substance use, talking about alcohol use, and discovering your way out. Click here to register for the webinar.
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Looking for eating disorder treatment programs or services in the New York City area? Learn more about our options at BALANCE eating disorder treatment center™ here or contact us here.
This post was written by BALANCE Blog Contributor, Samreen Khan (she/her/he/him).
Samreen is a senior high school student with an ardent drive to de-stigmatize mental illness and eating disorders. Born and raised in the Bay Area, she experienced the harmful effects of “fitspo” culture firsthand for most of her childhood. Throughout her own recovery journey, she became passionate about deconstructing diet culture and raising awareness about eating disorders in her everyday life. Samreen began extending her own ideology of intuitive eating and body neutrality to others by publishing her own writing online when she was fourteen, and has since received several awards for her prose and poetry. She has conducted research on the biological and evolutionary implications of familial mental illness, and is currently taking college-level Sociology and Psychology courses with hopes to delve further into the social and cultural constructs that bolster disordered eating, especially within marginalized communities. She’s grateful for the opportunity to combine two of her strongest passions — writing and mental health — by working with BALANCE!
References
- Gilpin, Nicholas W, and George F Koob. “Neurobiology of Alchohol Dependence.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, https://pubs.niaaa.nih.gov/publications/arh313/185-195.htm#:~:text=Alcohol’s%20effects%20on%20neurotransmitter%20systems,i.e.%2C%20activating.
- Oscar-Berman, Marlene, and Ksenija Marinkovic. “Alcoholism and the Brain: An Overview.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 2003, https://pubs.niaaa.nih.gov/publications/arh27-2/125-133.htm.
- Reed, Susanne. “Eating Disorders and Alcoholism: 41% of People with Ed Have an Addiction.” Alcoholics Anonymous, Alcoholics Anonymous, 7 Mar. 2022, https://alcoholicsanonymous.com/mental-health/alcoholism-and-eating-disorders/.
