There is a high prevalence of eating disorders among those who struggle with substance abuse, and the reverse is true as well.
For example, Comprehensive Psychiatry demonstrated a prevalence of substance use disorders in 22 percent of individuals with binge eating disorders that co-occur with other mental health disorders.
One of the reasons that binge eating disorder and other substance abuse disorders often occur together is because of the similar ways in which they affect the body. The systems of the brain that are implicated in the changes that lead to addiction when drugs or alcohol are abused are the same ones that activate in binge eating events. This commonality makes it possible that people who are susceptible to substance abuse may also have the potential to develop binge eating disorder under certain circumstances, and vice versa.
The Definition of Binge Eating Disorder
Most simply, binge eating is defined as consuming more food in a short period of time than is typical for normal hunger. People who binge eat often eat past the point at which they feel full, to the point of physical discomfort. As state above, while most people binge eat on occasion, binge eating disorder implies a chronic compulsion to binge eat. It is also referred to as compulsive eating.
Binge eating disorder occurs in approximately 1.4 percent of the global population, according to a study in Biological Psychiatry, making it the most common eating disorder. Information from the National Institutes of Health indicates that it is even more common in the US, occurring in 2.8 percent of people. It is more common in females than in males, and the average age at which it occurs is about 25 years old.
Causes of Binge Eating Disorder
As with addiction and substance abuse, the causes of binge eating disorder are not fully understood; however, there are emotional, mental, social, or genetic factors that may contribute. Some studies, such as one from Psychosomatic Medicine, demonstrate that there is a high correlation between binge eating disorder and past trauma or abuse. Binge eating also often co-occurs with other mental health disorders, such as depression, anxiety, and schizophrenia.
According to the National Health Service in the United Kingdom, the risk of binge eating may also increase under the following conditions:
- Low self-esteem or lack of social network
- Mood or other mental health disorders like depression or anxiety
- A genetic or family history of eating disorders
- Differences in brain chemistry compared to others
One of the chemicals implicated in eating disorders, as described in an article from WebMD, is dopamine, a neurochemical that controls feelings of pleasure and reward. This brain system is also implicated in substance abuse, which could be a major contributor to the fact that eating disorders and substance abuse often co-occur.
Recognizing Binge Eating
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) – the standard guide used to identify and diagnose mental health disorders – symptoms of binge eating disorder include:
- Repeated incidents of overeating, including eating up to or past the point of discomfort
- Feeling a lack of control over eating behavior
- Eating faster than is typical
- Overeating even when not hungry
- Eating alone because of embarrassment about overeating
- Extreme emotional response about overeating, including feeling disgusted or guilty about eating
- Episodes of binge eating that occur at least once a week over three months
- Binge eating without also indulging in purging or self-restriction behaviors as in bulimia or anorexia
While binge eating disorder is not addiction, there are enough factors in common between binge eating and substance abuse that the behavioral symptoms of both can be similar, such as:
- Unhealthy focus on eating
- Giving up other activities based on eating habits
- Trouble in relationships based on eating
- Inability to stop binge eating habit, even when negative consequences arise
Binge Eating and Substance Abuse
As discussed in the opening of this article, there is a high prevalence of co-occurring substance abuse and binge eating disorder. In many cases, while it may not be possible to determine which issue came first, they often will become inextricably linked over time, requiring both to be resolved in order to avoid relapse of either issue.
An article from Social Work Today discusses the fact that the prevalence of substance abuse is higher in those with eating disorders than in the general population. With 22 percent of those who have binge eating disorder also having some form of substance use disorder, there is definitely a need for both disorders to be treated together when they co-occur.
Sometimes, co-occurring disorders can feed one another, creating a spiral in which it becomes necessary for both disorders to be treated in order to expect resolution of either disorder. In the case of binge eating disorder, the issues of guilt, disgust with one’s own behavior, and frustration with lack of control can lead to a person choosing to self-medicate with drugs or alcohol in order to diminish the depressive or anxious feelings that might arise. Also, if weight gain is a result of binge eating, a person might decide to take stimulants, such as methamphetamine or cocaine, to try to diminish appetite and lose weight, resulting in severe physical problems caused by the drug use.
Because of these effects of co-occurring binge eating and substance abuse, it is important for people in these circumstances to get treatment from professionals experienced in managing these disorders together.
Treatment for binge eating disorder generally involves Cognitive Behavioral Therapy that can help the person learn to recognize the undesirable behaviors, understand the triggers that lead to a binge eating event, and intervene in the event before it happens, inserting more desirable behaviors. Based on an article from the National Institute on Alcohol Abuse and Alcoholism, Dialectical Behavior Therapy can also be effective for binge eating disorder. In this treatment, recognition of behaviors is paired with developing coping skills, which help to diffuse an event before it happens.
These therapies are both also used in substance abuse treatment, and they can be powerful allies in treating these co-occurring disorders. In addition, there are some medications, such as antidepressants, that can help treat the symptoms of binge eating disorders while therapy is ongoing. Of course, in this case, care must be taken to avoid transfer of addiction to these drugs.
Working with a reputable, research-based treatment center and skilled personnel trained in treating co-occurring disorders is the first step toward finding help for binge eating disorder that occurs with substance abuse. With a comprehensive treatment program involving medical treatment, therapy, peer support, and other elements of care provided on a continuum of care, it is possible to manage these disorders and move forward into long-term recovery.