The disease of substance addiction is a powerful adversary. Unfortunately, many people who are battling substance dependency find themselves waging war on multiple fronts, one of which is eating disorders. There is mounting evidence to support the strong connection between addiction and eating disorders. But what exactly is the link?
The Neurobiological Connection
Despite the large amount of evidence to indicate a strong link between substance addiction and eating disorders, the mechanisms of the relationship are still relatively little understood. However, researchers increasingly believe that an important factor driving both disorders is the functioning of the reward centers of the brain.
Researchers have found that drug and alcohol addiction and eating disorders are all associated with changes in dopamine signaling in the brain’s limbic system, the area responsible for emotional regulation and impulse control (1, 2, 3). These studies suggest that variations in brain function lead those who have eating disorders and/or addictions to engage in behaviors they understand are dangerous to their health and detrimental to their life goals not because they want to, but because their brain, for all intents and purposes, requires them to.
As disheartening as such findings may at first seem, this by no means suggests that we are helpless victims of our neurobiology. Rather, in understanding the neurological basis of these disorders, we can take recovery to the next level through more effectively addressing addiction and eating disorders as commonly co-occurring conditions (1). Further, if both substance use disorder (SUD) and eating disorders derive in whole or in part from changes in dopamine signaling, then therapeutics aimed at regulating neurotransmitter production, cycling, and absorption can offer new hope for the treatment of these conditions.
A Matter of Genetics
The comorbidities of SUD and eating disorders appear to have a substantial genetic basis as well as a neurobiological one. For instance, genomic association studies have found a particularly significant relationship between genetics and the development of both bulimia and alcohol use disorder (AUD) (4, 6, 7, 8). In twin studies, researchers found that genetics do, indeed, appear to play at least a moderate role in co-occurring eating disorders and substance addiction. For example, in a recent twin study, Munn-Chernoff and Baker found that genetics may contribute to the development of binge eating disorders and SUD (5).
Just as with biology, though, it’s imperative not to mistake a genetic predisposition as a sort of predetermination. Munn-Chernoff et al. argue that understanding the genetics of co-occurring eating disorders and SUD makes recovery strategies more effective, particularly in the ability to more readily identify and intervene in emerging disorders once you understand the relationships between conditions. In other words, if you’re diagnosed with bulimia, then healthcare providers can be more alert to and proactive in detecting, treating, or working to prevent alcohol addiction.
While current research suggests that genetics and biology have a powerful influence over the development of comorbid conditions, the fact is that the origins of such conditions are highly complex. They can’t be distilled down to genetics and/or biology alone. For instance, Munn-Chernoff and Baker found that genetics appears to work in conjunction with environment to give rise to these co-occurring disorders. Additionally, a significant body of research suggests that those who experience SUD and disordered eating, binge eating disorders in particular, are slightly more likely than the general population to have a first-degree relative with AUD and/or SUD (9).
Importantly, the research suggests that these relationships between familial SUD and comorbid eating disorders and SUD are not entirely based on heredity. Bunn et al. examined the impact of parenting style on the development of behavioral disorders in adolescents. The researchers evaluated teens’ perceptions of their parent’s behavior and found that those adolescents who described high levels of maternal and paternal control were more likely to experience depression, anxiety, disordered eating, AUD, and SUD (10). This bears out much of what is already well-known about the relationship between mood disorders and the development of addiction.
The link between mood disorders and co-occurring eating disorders and substance addiction can be better understood if you see both disordered eating and addictive behaviors as compensatory. Unhealthy eating, excessive drinking, and substance dependency may link to the effort to control anxiety and depression, at least in the early phases of the disorders. Once those patterns begin to emerge, then the neurobiological mechanisms that perpetuate the compensatory behaviors trigger the addiction. For instance, in their study of subjects with eating disorders, Jen et al. found a strong correlation between disordered eating, alcohol misuse, and anxiety (11).
Perhaps nowhere is the connection between eating disorders and substance addiction more apparent than in research on elite athletes. Studies show that elite athletes may be at greater risk for both mood disorders and disordered eating, which may then lead to the abuse of substances as a compensatory mechanism. For example, Piacentino et al. found an increased risk of anabolic-androgenic steroid misuse, mood disorders, and eating disorders among high-level athletes (12).
You don’t have to be an elite athlete to experience the correlation between substance use disorders and eating disorders. Savino et al. found that both professional and amateur athletes were at an increased risk for the comorbidities of disordered eating and substance abuse and misuse (13). They found that athletes were more likely to turn to both licit and illicit substances to help them cope with depression and anxiety, as well as issues associated with body image. Athletes who wish to increase stamina while rapidly dropping weight and decreasing appetite may develop dependency not only on over-the-counter dietary supplements but also on illicit drugs, such as cocaine or methamphetamines.
How Bayshore Can Help
At Bayshore, we treat the person, not the addiction. That means we are deeply committed to helping our clients achieve a state of complete wellness, mind, body, and spirit. If you or someone you love is suffering from co-occurring substance use disorder and disordered eating, Bayshore’s multidisciplinary team of addiction recovery specialists, mental health professionals, and nutritional and holistic health experts can help design a treatment plan to address your unique needs. This includes helping you to identify the underlying factors that might have triggered and may be fueling co-occurring eating disorders and substance dependency. Contact us today to discuss how Bayshore can help you or someone you love address these challenges and rediscover a healthy, happy, sober life.