Bulimia nervosa is an eating disorder that plagues over 30 million people in the United States alone. An individual suffering from bulimia feels an intense desire to lose weight, which compels them to induce vomiting after meals, and during these meals, they often binge or overindulge. This condition affects people across racial, gender, and socioeconomic lines. In fact, a 2007 study in Biological Psychiatry reports that 1.5 percent of American women and 0.5 percent of American men will struggle with bulimia at some point in their lifetime. ???
While bulimia affects the lives of many Americans, many more struggle with health issues such as drug and alcohol addiction. According to a 2014 survey by the Substance Abuse and Mental Health Services Administration (SAMHSA), over 130 million Americans have used illicit drugs at some point in their life. While not every person who uses drugs becomes addicted, the high number of people who have used drugs suggests that some may struggle with both addiction and eating disorders.
Bulimia and Drug Abuse
The relationship between drug abuse and eating disorders is complicated. In 2012, SAMHSA reported that around 8.4 million Americans suffer from what are called co-occurring disorders. These individuals are struggling with substance abuse as well as another condition, and for some, that condition is an eating disorder. In these cases, the individual is at risk for serious mental and physical harm.
It is not clear whether bulimia contributes to the development of an addiction or vice versa. Either condition can develop at any time, whether the person is abusing drugs or actively in treatment to fight addiction. However, a 2013 study in Biological Psychiatry discovered that people with bulimia are more vulnerable to addiction than others, including individuals with other eating disorders like anorexia. Research suggests that this vulnerability could be due to shared neurobiological traits that trigger addiction and bulimia in a person.
For many living with bulimia and addiction, drug use is connected to weight loss. Stimulants that boost metabolism are popular, as well as substances that induce the release of waste (e.g., taking laxatives or drinking alcohol until they vomit). Individuals may seek out both legal and illicit substances, including:
- Prescription diet pills
According to the Canadian Journal of Gastroenterology, bulimia can cause considerable damage to the body, even if the individual only struggles with the condition for a brief time. Exposure to stomach acid (a result of the constant vomiting) damages the digestive system and throat and erodes the teeth. Low body temperature, fatigue, and constipation are also common side effects of bulimia.
Of course, things only become worse when an individual combines these effects with those of substance abuse. Individuals who abuse drugs or alcohol tend to experience immediate emotional changes. They become more antisocial and withdrawn, which can trigger feelings of anxiety and depression. Drug use can also exacerbate some of the physiological effects of bulimia, such as an irregular heartbeat.
If an individual continues using drugs and throwing up meals for a prolonged period, they will suffer innumerable physical side effects. Of course, the side effects of drug use will vary depending on the person’s drug of choice, but the long-term effects of bulimia are consistent across the spectrum. These include:
- High blood pressure
- Severe headaches
- Infertility in women
According to the Psychiatric Times, many people engage in behaviors like drug abuse and bulimia to cope with past emotional trauma. Not only is this a dangerous and unhealthy coping mechanism, but it does more harm than good, as bulimia and drug abuse can also irrevocably damage the brain’s neural pathways. Chronic bulimia can impede one’s ability to concentrate or make decisions. Also, both bulimia and substance abuse can contribute to depression and anxiety disorders, sometimes even driving an individual to the point of suicide.
Treating Co-Occurring Bulimia and Substance Abuse
The Journal of Substance Abuse Treatment once reported that bulimia and substance abuse (particularly alcoholism) were two sides of the same coin. This is to say that, whether someone is struggling with bulimia, drug abuse, or both concurrently, the ultimate goal is the same: to, as the researchers said, “minimize the impact of ego deficits.” The men and women living with eating disorders and addiction are struggling on both a physical and emotional level, and for this reason, their treatment must be comprehensive.
The ideal way to treat co-occurring disorders like bulimia and addiction is through an integrated treatment program. These programs bring together medical doctors, addiction specialists, and psychologists to ensure that an individual starts their recovery journey in a healthy and effective way. This process involves:
- Medical detox
- Psychological evaluation
- Developing a personalized treatment plan
- Therapy (a combination of one-on-one, group, and family therapy)
- Outpatient and aftercare treatment
If someone you know is struggling with addiction, bulimia, or both conditions, it is very important that they go through an integrated treatment program and that they have a sufficient support system when they enter aftercare. These individuals often leave treatment feeling incredibly vulnerable, which means they need your support more than ever. Also, the International Journal of Eating Disorders reports that prior substance abuse is the number one predictor of relapse in people with eating disorders. However, if the individual has a strong network of loved ones and medical professionals to lean on, it is possible to maintain health and sobriety long after treatment.