Eating Disorders and Substance Abuse

Eating disorders and substance abuse often go hand in hand. If you are concerned your teen may be struggling with substance abuse or eating disorders you may want to know the facts correlating the two. Keep reading to learn common risk factors and effects of both.

Teens are among the group most vulnerable to both eating disorders and substance abuse, and some teens struggle with both problems. Parents and others who are concerned about a teen should understand some of the connections between eating disorders and substance abuse.

Research seems to show a strong link between eating disorders and substance abuse. According to Social Work Today, up to half of females with an eating disorder also have a substance abuse problem, and over a third of those with a substance abuse problem also have an eating disorder. These numbers are much higher than rates among the general population.

Some facts that may be good to know if parents are concerned about a struggling teen:

  • Substance abuse is more common among teens who binge and purge than those who are anorexic.
  • Alcohol, tobacco or nicotine, amphetamines, and cocaine are among the most commonly abused drugs used by people with eating disorders. These drugs may be used because they cause weight loss, or they make trigger eating disorders because of the way they effect the mind. Alcohol may be the most commonly abused of these drugs.
  • Teens who are bulimic may resort to laxative abuse to try to purge their systems. This actually purges fluids, not foods, and can lead to serious health problems.
  • Teens with eating disorders may turn to drugs to relieve depression or other psychological problems
  • Teens who start with a substance abuse problem that leads to an eating disorder may also have other psychological problems such as phobias or panic disorder. They are also more likely to abuse multiple substances
  • Having an early onset of either problem may increase the risk of developing the other

The exact cause for the relationship between eating disorders and substance abuse is still unknown, but they share some common risk factors, such as:

  • Low self esteem
  • Depression or anxiety
  • History of trauma or abuse
  • Negative peer pressure
  • Inability to manage stress or daily problems
  • Parenting that is inconsistent, lax, or uninvolved
  • Family history of substance abuse or eating disorders
  • Susceptibility to messages from the media
  • Tendency to become addicted
  • Difficulty controlling impulsive behavior

Not everyone with the risk factors will develop one or both problems, but they may need extra intervention to deal with the underlying problems before they lead to a destructive behavior.

Some ways to help teens who have or are at risk for eating disorders and substance abuse include:

  • Talk to the teen and listen to what they have to say. Try to spend time every day with your teen, such as eating a meal together. This may help you identify problems early so they are more likely to be successfully treated.
  • Get treatment for any underlying mental or physical health problems a teen has, including depression or anxiety, or a history of abuse or trauma.
  • Set rules that are clear and fair, and enforce the rules consistently with reasonable consequences. Include rules about not abusing drugs, and explain to teens that this is because you care about them and don't want them to be hurt.
  • Be positive towards teens. Praise their accomplishments, encourage positive behaviors, and focus on positive traits instead of negative ones. Don't put a focus on their appearance or pressure them to be something they are not.
  • Set a good example by not abusing substances and by having healthy eating and exercise habits.
  • Talk to teens about false messages they might get from the media or hear from friends about appearances or substance abuse and why some of those messages may be untrue.

Treatments for eating disorders and for substance abuse are usually different, but both should start with a visit to a doctor who can help diagnose the problems and recommend treatments. The doctor can treat the health problems associated with these disorders, while a counselor or therapist may help with the psychological issues. Cognitive behavioral therapy is one type of therapy that may help some people with both problems, but it is only one of several types of therapy that may be best for a teen depending on his or her situation.


Adrienne Ressler, Social Work Today, "Insatiable Hungers: Eating Disorders and Substance Abuse" [online]
Annsley Heidtke, Vanderbuilt University Psychology Department, "Eating Disorders and Substsance Abuse" [online]
SAMHSA's National Mental Health Information Center, "Eating Disorders" [online]
National Eating Disorders Association, "Laxative Abuse" [online]

Related Article: Warning Signs of Eating Disorders >>