Substance use disorder (SUD) and eating disorders often seem like two separate struggles. One centers around drugs or alcohol. The other focuses on food, weight, or body image. But, research and clinical experience show that these two conditions are deeply connected—often overlapping in ways that complicate diagnosis, treatment, and recovery.
At 12 South Recovery, we frequently treat individuals experiencing both challenges simultaneously. This combination is known as a co-occurring disorder or dual diagnosis. These disorders not only influence each other but also increase the risk of severe health consequences if left untreated.
This article explains the relationship between eating disorders and substance use, highlights the most common overlaps, and outlines how integrated treatment can lead to effective, long-term healing.
Why This Topic Matters
Eating disorders and addiction both carry high risks—and high levels of stigma. Many individuals suffer in silence, unsure how to seek help or even how to explain what they’re going through. When both conditions exist together, the situation can feel even more overwhelming.
Understanding the connection between these two disorders allows people to see the whole picture. It helps families recognize warning signs earlier and empowers professionals to deliver care that treats the entire person—not just part of the problem.
Common Ground: What Eating Disorders and Substance Use Share
Although they focus on different behaviors, SUD, and eating disorders share several underlying causes and characteristics.
Emotional Regulation Difficulties
Both disorders often emerge as unhealthy ways to cope with emotional pain. People who feel overwhelmed by sadness, anger, anxiety, or trauma may turn to food restriction, bingeing, or substances to numb their feelings or regain a sense of control.
Co-occurring Mental Health Disorders
Many people with eating disorders or substance use disorders also struggle with anxiety, depression, trauma-related disorders, or personality disorders. These overlapping mental health issues make recovery more complicated if only one condition is treated.
Compulsive and Secretive Behavior
Both disorders can lead to obsessive thought patterns, rituals, secrecy, and shame. People may hide their drinking, drug use, or eating behaviors from loved ones, reinforcing isolation and delaying treatment.
Body Image and Control
Substance use can be driven by attempts to alter one’s appearance or body image, especially among those struggling with eating disorders. Stimulants like cocaine or methamphetamine may be misused for weight loss. Alcohol may be consumed in place of meals, a pattern often referred to as “drunkorexia.”
Social and Environmental Triggers
Social pressure, trauma, bullying, or family conflict can contribute to the development of both disorders. Genetics also play a role—family history of addiction or eating disorders increases personal risk.
Common Types of Eating Disorders Associated With Substance Use
Several types of eating disorders frequently overlap with substance use disorders. Understanding their characteristics can help identify when someone may need dual diagnosis treatment.
Anorexia Nervosa
Anorexia involves extreme food restriction, intense fear of gaining weight, and a distorted body image. Individuals with anorexia may use substances like laxatives, diet pills, or stimulants to control their weight, adding further health risks.
Bulimia Nervosa
Bulimia is marked by cycles of binge eating followed by purging behaviors such as vomiting, fasting, or excessive exercise. Alcohol or drug use may be used before or after binges to cope with guilt, anxiety, or stress.
Binge Eating Disorder (BED)
BED involves repeated episodes of consuming large amounts of food, often quickly and in secret. This may be followed by deep shame or distress, but without purging. Some individuals use substances to suppress appetite or ease emotional discomfort between episodes.
Avoidant/Restrictive Food Intake Disorder (ARFID)
While ARFID is less connected to body image concerns, it can still coexist with substance use—especially when food avoidance stems from anxiety or trauma.
How Substance Use Complicates Eating Disorders
When addiction and disordered eating appear together, each condition can make the other worse. For example:
- Alcohol may reduce inhibitions and lead to uncontrolled eating behaviors or missed meals.
- Methamphetamine may reduce appetite to dangerous levels, increasing the risk of starvation or heart complications.
- Opioids can disrupt digestion and lead to constipation or reduced appetite, worsening nutritional issues.
- Cocaine and stimulants may be misused for appetite suppression, increasing the risk of addiction and malnutrition.
This combination puts physical health at risk and affects the brain’s ability to recover. Nutrient deficiencies, sleep disruption, and long-term substance use can alter brain chemistry, making therapy and healing more difficult without full medical support.
The Role of Integrated Dual Diagnosis Treatment
Treating just one disorder is rarely effective when both are present. Integrated treatment is essential to lasting recovery.
At 12 South Recovery, we specialize in dual diagnosis care—helping individuals with both substance use and eating disorders address the full scope of their challenges.
Our programs offer:
Medical and Nutritional Support
Clients can access medical professionals who monitor physical health, withdrawal symptoms, and nutritional deficiencies throughout recovery.
Individual Therapy
Personal sessions allow clients to work through emotional pain, trauma, and behaviors driving both addiction and disordered eating.
Group Therapy
Support from peers creates a safe space to discuss body image, shame, cravings, and coping skills without judgment.
Cognitive Behavioral Therapy (CBT)
CBT helps individuals replace negative thought patterns with more realistic and constructive beliefs.
EMDR Therapy
Many clients with eating disorders or substance use issues have unresolved trauma. EMDR therapy helps process these memories and reduce emotional triggers.
Family Therapy
Family members often play a key role in recovery. Our programs help families rebuild trust and learn how to support loved ones without enabling harmful behavior.
Holistic Support
Recovery goes beyond symptom control. Holistic practices—like movement, mindfulness, and nutrition counseling—support long-term well-being.
Treatment Options at 12 South Recovery
We provide multiple levels of care to meet individuals at different stages of readiness and recovery. ILWU members, Optum clients, and others with insurance coverage may have access to the following programs:
- Residential & Detox for medically monitored care and stabilization
- Partial Hospitalization Program (PHP) for full-day treatment and clinical support
- Intensive Outpatient Program (IOP) for part-time therapy with more flexibility
- Outpatient and Continuing Care for ongoing counseling and relapse prevention
- Alumni Support to maintain progress long after formal treatment ends
Each level is built to address both substance use and co-occurring conditions like eating disorders, anxiety, or depression.
Warning Signs to Watch For
If you or someone you love is showing any of the following signs, dual diagnosis treatment may be needed:
- Sudden changes in weight, eating habits, or body image
- Secretive behavior around food or drug use
- Mood swings, irritability, or social withdrawal
- Obsessive talk about appearance or calorie control
- Using substances to manage appetite, emotions, or stress
- Withdrawal symptoms or physical signs of substance use
- Lying about food, exercise, or substance intake
These behaviors may signal deeper issues that require clinical attention. Early intervention can save lives and prevent long-term damage.
Call 12 South Recovery Today!
Eating disorders and substance use often work hand in hand—but they don’t have to control your life. With the proper treatment and support, healing is possible.
At 12 South Recovery, we understand the challenges of dealing with both conditions. Our compassionate, experienced team is here to help you regain control, rebuild your health, and move forward with strength and clarity.
Contact us today at 866-257-5551 to learn more about our programs, verify your insurance, or schedule a confidential consultation.Please share this article with anyone you know who may be struggling. You never know whose life you might help change.
