Dual Diagnosis: Eating Disorders and Substance Abuse

Effective Treatment for Co-Occurring Disorders

It is said that around half of individuals with an eating disorder use illicit drugs or alcohol. Sometimes, substance abuse begins before an eating disorder starts. Other times, substance use disorders come first. If you have an eating disorder and experience concerns related to substance abuse, what can you do? A dual diagnosis program can treat both conditions and help you find long-term success.

Keep reading to find out more about effective means of treating co-occurring eating disorders and substance abuse and how Icarus Behavioral Health can help you onto a path of lasting recovery!

What is A Dual Diagnosis Program?

Dual Diagnosis Program

The term “dual diagnosis” means that a person lives with both a substance use disorder and another mental illness. A dual diagnosis program is a treatment program that addresses both mental health disorders and addiction.

Dual diagnosis programs are special because they consider the full spectrum of a person’s symptoms and help people build a sustainable, fulfilling life without turning to either disorder. This can be crucial, as there are times when a person may turn to one disorder when attempting to heal from the other.

Dual diagnosis programs provide coping skills and relapse prevention plans for clients. If you live with a substance use disorder and a co-occurring eating disorder, dual diagnosis treatment can be life-changing.

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Do Eating Disorders And Substance Use Disorders Go Hand In Hand?

The rates of eating disorders are growing. Eating disorders and substance abuse have many risk factors in common. Low self-esteem, trauma, family history, and even certain personality traits can raise the risk of eating disorders and substance abuse disorders.

More often than not, people with substance abuse problems have other co-occurring disorders. The same is true for eating disorders. If you have an eating disorder, you’re more likely to face a range of other mental health disorders. These include but aren’t limited to substance use disorders like alcohol use disorder.

In fact, research suggests that:

  • 12-18% of adults with anorexia nervosa have a substance use disorder
  • 30-70% of adults with bulimia nervosa have a substance use disorder
  • Around 25% of adults with binge eating disorder have a substance use disorder

Unfortunately, both substance abuse and eating disorders can come with a range of health problems and a substantially increased risk of mortality. Together, the combination of eating disorder behaviors and abusing substances can be particularly fatal – especially if left untreated.

Like substance use disorders, one of the most crucial facts to understand about eating disorders is that they are complex and can affect anyone, regardless of gender, background, socioeconomic status, or body size.

What are the Types of Eating Disorders?

Eating disorders are diagnosed with criteria in the Diagnostic and Statistical Manual (DSM) of mental and behavioral disorders. Currently, the most recent version of the DSM is the DSM-5. In the DSM-5, there are various eating disorder diagnoses. Icarus Behavioral Health treats a range of these conditions, including the following common eating disorders.

Anorexia Nervosa (AN)

Anorexia nervosa is characterized by ongoing patterns of food restriction. Patterns of food restriction seen in those with anorexia may result in dangerous weight loss or lack of adequate growth in children. It is possible to have atypical anorexia (usually diagnosed under the category of OSFED), where a person is not underweight but suffers from the same symptoms and faces the same consequences as others with the disorder.

Binge Eating Disorder (BED)

Binge Eating Disorder

Binge eating disorder is characterized by recurring episodes of binge eating without compensatory behaviors such as vomiting. Binge eating refers to eating abnormally large quantities of food, often rapidly and to the extent that it causes notable physical discomfort. When people binge eat, they feel a loss of control. Binge eating disorder is diagnosed when you experience marked binge eating episodes at least once weekly for three months or more.

Bulimia Nervosa (BN)

Bulimia nervosa is characterized by ongoing patterns of binge eating episodes followed by compensatory behaviors like self-induced vomiting, laxative use, or excessive exercise. Bulimia nervosa is diagnosed when you experience marked binge eating episodes followed by compensatory behaviors at least once weekly for three months or more.

Avoidant restrictive food intake disorder (ARFID)

Avoidant restrictive food intake disorder (ARFID) is characterized by persistent patterns of extreme picky eating and/or disinterest in eating. A child or adult person with ARFID (the condition is more commonly found in children and adolescents but is a growing concern for many adults as well) may lack interest in food, avoid food due to sensory characteristics (e.g., texture or taste), or they may avoid food due to concerns about adverse consequences of eating, such as getting ill.

Unlike other restrictive eating disorders, people with AFRID don’t face symptoms as a result of body disturbance. However, the restrictive nature of the disorder can lead to problems at school or work and medical consequences similar to those seen in other eating disorders, like nutrient deficiencies. Our informal ARFID quiz resource can help you determine if this condition may be affecting you (or a loved one) by examining and identifying the primary symptoms.

Other specified feeding or eating disorders (OSFEDs)

Other specified feeding or eating disorder is diagnosed when an individual has a clinically significant eating disorder but does not meet the criteria for other eating disorder diagnoses. OSFED is not less serious than other eating disorders, and it can be just as fatal.

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How Dual Diagnosis Eating Disorder And Addiction Treatment Works

What can you expect when you enter a dual-diagnosis treatment program for eating disorders and addiction? In substance use and eating disorder treatment, you may engage in numerous helpful activities. These include but aren’t limited to:

Individual therapy

Individual therapy refers to one-on-one sessions with a therapist, psychologist, social worker, or counselor. Depending on the facility you attend for substance abuse and eating disorder treatment, you will have a specific number of individual therapy sessions per week. A host of therapeutic modalities, such as cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT), can be used.

Group therapy

Group therapy

Group therapy is therapy conducted in a group setting. You will meet with a therapist, psychologist, social worker, or counselor, as well as other clients at the treatment facility you attend. Like individual therapy, modalities used in group therapy can differ. For example, processing groups and skill-building groups are both common.

Family therapy

Family involvement is known to aid recovery from both substance abuse and eating disorders. Family therapy sessions are an opportunity for family members to support your recovery process, improve family dynamics and communication, and work on other goals as a collective unit. Treatment professionals can also educate family members on substance use disorders, eating disorders, and the recovery process. Often, you will have pre-planned days for family visits in your treatment program.

Recreation activities

Recreation activities are proven effective for the treatment of both substance use disorders and eating disorders. Art therapy, music therapy, animal therapy, yoga, meditation, and community outings are all examples of recreational activities you might engage in during treatment.

Exposure to recreational activities in treatment provides an opportunity to build skills to transfer to real-life settings. They also have the potential to help you build confidence and act as a healthy coping mechanism.

Medication management

Medication can be used for many disorders, including conditions that frequently co-occur with eating disorders and substance use disorder diagnoses. For example, generalized anxiety disorder, bipolar disorder, or depression.

If you are someone who requires medication, you will meet with a qualified member of your treatment team for medication management services. If you are in an inpatient rehab or residential facility, the nursing staff will provide your medication daily or as prescribed.

Medical detox

Medical detox allows you to go through withdrawal symptoms while supervised by healthcare professionals. Some people with substance use disorders attend medical detox prior to inpatient, residential, or outpatient rehab. This will depend on the level of severity of substance use, and can also determine whether a residential program is recommended.

A Dual Diagnosis Treatment Program Built Around You

Eating disorder treatment programs

Icarus Behavioral Health offers eating disorder treatment programs for people with anorexia nervosa, bulimia nervosa, and other common eating disorders. Our dual-diagnosis treatment programs help individuals with substance abuse and co-occurring disorders find health and healing.

We utilize the most evidence-based treatments to create an individualized treatment plan for every client. Medical detox, inpatient, outpatient, and long-term rehab programs are all available.

Icarus Behavioral Health understands that treatment can be costly, and we take many forms of insurance to accommodate the financial needs of clients and their families. Before you start treatment, we will help you verify your insurance. We proudly accept Western Sky and many forms of Centennial Care, and most major providers, so don’t let doubts about coverage hold you back!

For a confidential discussion of costs and your options, please reach out today to our welcoming Admissions team, and get started on a path to a new life in recovery now!

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FAQs on Dual Diagnosis Eating Disorders and Substance Abuse

What is the relationship between addiction and eating disorders?

There are many similarities between alcohol or drug addiction and eating disorders. First, people with an eating disorder are at a higher risk of substance use disorders and vice versa. Second, both substance abuse and eating disorder behaviors can be used as coping mechanisms. That said, this is not where the connection ends.

Some experts suggest that eating disorder behaviors are addictive in nature. For example, preoccupation with food and eating patterns, withdrawal symptoms when a person’s unable to engage in behaviors, high relapse rates, and continuation of behaviors despite negative consequences are all similar to what we see in drug and alcohol addiction.

As discussed, many risk factors for eating disorders and substance use disorders overlap. Seeking treatment for mental health conditions like eating disorders and substance use disorders is nothing to be ashamed of, and it may save your life.

What disorders are often comorbid with eating disorders?

Statistically speaking, most people with eating disorders have co-occurring conditions. Disorders that co-occur with eating disorders can include but aren’t limited to:

Is substance abuse associated with anorexia nervosa?

Yes. Substance abuse is significantly more prevalent among individuals with anorexia nervosa and other eating disorders than it is in the general population. Sometimes, symptoms of the two disorders can go together. For example, someone may misuse drugs or alcohol to avoid eating. It is also common to cope with emotions and pain associated with another condition through the use of substances.

What percentage of anorexics are also likely to have a substance use disorder?

The exact rates of people living with anorexia nervosa who also have a substance use disorder are unknown, largely because not all cases are diagnosed or equally researched. However, a large body of research confirms that people with eating disorders are more likely to have a substance use disorder. It is suggested that about 16% of people with anorexia have a substance use disorder.


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