The Link Between Eating Disorders and Substance Use: What You Need to Know
Written by Brooke Thomas, MHC-LP
Eating Disorders (EDs) and Substance Use Disorders (SUDs) are often talked about as separate mental health conditions—but in reality, they are closely connected. Many individuals struggling with one are also dealing with the other, sometimes without even realizing how intertwined the two have become. Understanding this relationship is essential for recognizing the signs early, reducing stigma, and finding effective, lasting treatment.
A Hidden but Significant Overlap
One of the most important facts to understand is just how common this overlap is. Studies show that up to 50% of people with eating disorders also abuse alcohol or illicit drugs—a rate that is five times higher than the general population. This statistic alone highlights why it’s so important to approach these conditions together rather than in isolation.
For many individuals, substance use and disordered eating behaviors develop as coping mechanisms. They may start as ways to manage stress, anxiety, or emotional pain, but over time, they can evolve into deeply ingrained patterns that are difficult to break without support.
Similarities Between Eating Disorders and Substance Use Disorders
Eating disorders and substance use disorders share many behavioral and psychological similarities, which helps explain why they often co-occur. Both conditions can involve:
Compulsive behaviors that feel out of control
Escapism, using food-related behaviors or substances to numb difficult emotions
Secretive habits, often hidden from friends, family, or healthcare providers
Tolerance and withdrawal, where increasing amounts of a substance or behavior are needed to achieve the same effect
Negative impacts on relationships, work, and daily functioning
Triggers linked to stress, emotional distress, or life transitions
Because these patterns are so similar, someone who is vulnerable to one type of behavior may be more likely to develop the other. In some cases, one disorder may even replace or mask the other, making it harder to identify what’s really going on beneath the surface.
Shared Risk Factors
There are also several overlapping risk factors that increase the likelihood of developing both eating disorders and substance use disorders. These include:
Trauma or adverse life experiences, such as abuse, neglect, or significant loss
Mental health conditions like anxiety, depression, or PTSD
Perfectionism or high levels of self-criticism, often tied to unrealistic expectations
Difficulty coping with overwhelming emotions, leading to reliance on external behaviors for relief
Family history or genetic predisposition to either condition
These underlying factors often create a foundation where both disorders can take hold. Without addressing these root causes, it can be challenging to achieve long-term recovery.
How EDs and SUDs Reinforce Each Other
One of the most complex aspects of co-occurring eating disorders and substance use disorders is how they can reinforce and perpetuate each other. For example, someone might use substances to suppress appetite, reduce anxiety around eating, or cope with guilt after a binge. On the other hand, disordered eating behaviors may be used to “compensate” for substance use or regain a sense of control.
This creates a cycle that can be difficult to break. Each condition feeds into the other, making symptoms more severe and recovery more complicated. That’s why effective treatment must address both disorders at the same time. Treating one without acknowledging the other often leads to incomplete healing and a higher risk of relapse.
Integrated treatment approaches—those that consider both eating behaviors and substance use—are essential for helping individuals build healthier coping strategies and address the underlying emotional and psychological drivers of both conditions.
Understanding “Drunkorexia”
In recent years, the term “Drunkorexia” has gained attention, particularly among young adults and college populations. While it is not a formal clinical diagnosis, it describes a pattern of behavior where individuals engage in:
Restrictive eating
Skipping meals
Excessive exercise
…in anticipation of consuming alcohol.
The goal is often to “save” calories for drinking or to offset the calories from alcohol. This behavior is especially common in social settings where heavy or binge drinking is normalized.
However, “Drunkorexia” can have serious consequences. Restricting food intake before drinking can lead to faster intoxication, increasing the risk of alcohol poisoning, impaired judgment, and dangerous situations. Over time, it can also contribute to nutritional deficiencies, weakened physical health, and worsening mental health symptoms.
Why Awareness and Early Intervention Matter
Recognizing the connection between eating disorders and substance use disorders is a critical step toward better outcomes. When both conditions are identified early, individuals have a greater chance of receiving the comprehensive care they need.
Awareness also helps reduce stigma. Many people feel shame around their behaviors, which can prevent them from seeking help. Understanding that these conditions often share common roots—and are more common than many realize—can make it easier to start the conversation.
If you or someone you know is struggling with disordered eating, substance use, or both, it’s important to seek support from qualified professionals who understand the complexity of co-occurring disorders. Recovery is possible, especially with a treatment plan that addresses the full picture—not just one piece of it.
Brooke is a skilled, Licensed therapist who can see clients virtually in New York. If you are interested in reaching out for a free fifteen minute consultation about eating disorder therapy, fill out this contact form or text us here: 917-283-2389.
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