Alcohol and Eating Disorders

Risks of Combining Metformin and Alcohol

Bulimia Nervosa & Alcohol Use Disorder

People with bulimia nervosa binge eat and then purge food by vomiting to prevent the calories they consume from contributing to weight gain. If you have bulimia, you might tend to overeat privately, throw it up again, and then feel intense guilt or shame.  

Unlike people with anorexia, those with this disorder are not excessively thin but are still preoccupied with body image and weight. However, people with bulimia drink for similar reasons as those with other eating disorders do, such as for emotional self-medication related to the condition itself or other co-existing mental health issues.

Binge Eating Disorder & Alcohol Use Disorder

Binge eating disorder involves rapid and extreme overeating, usually accompanied by a lack of control and feelings of shame and sadness. Binge eating can be dangerous, depending on how often the person binges and whether the person is active and healthy or significantly overweight. Unlike anorexia or bulimia, binge eating can lead to obesity because this condition does not involve compensatory behaviors like purging. 

If you have a binge eating disorder, you might eat when not hungry and may not even be aware of how much food you consume. And you may eat alone to avoid being embarrassed about your eating habits around others.

The Connect Between Binge Eating & Binge Drinking

A few theories might explain why eating disorders involving binging often co-occur with binge drinking:

1. Both eating and drinking activate the brain’s reward pathways. This reason is based on our biological reactions to pleasure, but it doesn’t necessarily explain why someone would do either to such a destructive extent.
2. As previously noted, self-medication is a common reason people drink excessively or overeat. People with these disorders often struggle with underlying mental health conditions, such as depression, anxiety, or trauma.
3. Also, some research has suggested that there may be a genetic link between eating disorders and alcoholism. 
4. Finally, both binge eating and alcoholism have been associated with poor impulse control. For example, one study found that women with bulimia and alcohol use disorder had a higher impulsivity score than those with bulimia alone.

Adverse Interactions Between Alcohol & Eating Disorders

It is widely accepted that eating disorders and alcoholism tend to have risk factors in common. For example, experts believe both conditions can arise from emotional turmoil, such as anxiety and depression, or psychological trauma, such as childhood abuse. Other risk factors include a genetic propensity toward addictive behaviors, low self-esteem, and vulnerability to social pressure. 

Although an eating disorder could arise from alcoholism, it’s much more likely that it would be the other way around. Or, both problems could emerge simultaneously or independently. Unfortunately, if you have an eating disorder and try to self-medicate with alcohol, doing so can be detrimental to your well-being if a dependence develops.

Like virtually everyone, repeatedly using drugs or alcohol can subject you to persistent brain changes that lead to tolerance, dependence, and full-blown addiction. A habit that may innocently start as a way to escape negative feelings can rapidly devolve into a pattern of dysfunctional behavior, with each problem feeding into the other.

To illustrate the problem’s gravity, it is estimated that half of those with eating disorders also use alcohol or illegal drugs, five times the rate of the rest of the population. Furthermore, more than one-third (35%) of alcohol- or drug-dependent individuals have also had eating disorders, 11 times the rate of the rest of the population.

While these numbers are unfortunate, they are also evidence that you are not, by any means, struggling alone. And the good news is that both conditions are very treatable.

How Treatment for Alcohol Dependence & Eating Disorders Can Help

If you have one or both of these disorders, the good news is that you can experience significant improvement. Research has shown that those participating in integrated addiction treatment programs experience higher recovery rates, as both conditions are addressed simultaneously.

For example, failure to treat an eating disorder along with alcohol dependence will likely result in a return to maladaptive eating behaviors—and a greater potential for relapse—following discharge. 

Because similar risk factors, motivations, and overlapping behaviors reinforce and perpetuate each other, these conditions can be challenging to disentangle. Fortunately, comprehensive treatment can effectively address the disorders’ inter-complexities and all aspects of a person’s physical and emotional health and well-being.