Food for Thought: Substance Abuse & Eating Disorders | CASAColumbia

Food for Thought: Substance Abuse and Eating Disorders

Food for Thought: Substance Abuse and Eating Disorders

Published: December 2003

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This report constitutes an extensive analysis of the state of knowledge on the link between eating disorders and substance abuse. Eating disorders, which include anorexia nervosa, bulimia nervosa and binge eating disorder, affect more than 5 million Americans. Millions more display some configuration of symptoms, if not the full-blown disorder. Eating disorders can have devastating physical and mental health consequences, not the least of which is the increased potential for substance use and abuse.  


Findings from this 3-year study were based on analyses of national data sets and on a review of nearly 500 articles, books and reports.


The exhaustive report found that anorexia nervosa and bulimia nervosa were the eating disorders most commonly linked to substance abuse and, for the first time, identified the shared risk factors and characteristics of both sets of disorders.                                               

Individuals with eating disorders were up to 5 times as likely as those without eating disorders to abuse alcohol or illicit drugs, and those who abused alcohol or illicit drugs were up to 11 times as likely as those who did not to have had eating disorders. Specifically, up to 50% of individuals with eating disorders abused alcohol or illicit drugs, compared to 9% of the general population. Conversely, up to 35% of individuals who abused or were dependent on alcohol or other drugs have had eating disorders, compared to 3% of the general population. 

Although only 15% of girls were overweight, 40% of girls in grades 1 through 5 and 62% of teenage girls were trying to lose weight. These girls were especially vulnerable to eating disorders and substance abuse problems.

Other notable findings included:

  • Middle school girls (10-to-14-year-olds) who dieted more than once a week were nearly 4 times as likely to become smokers, compared to non-dieters
  • Girls with eating disorder symptoms were almost 4 times as likely as girls without eating disorder symptoms to have used inhalants and cocaine
  • 12.6% of female high school students took diet pills, powders or liquids to control their weight without a doctor’s advice
  • Bulimic women who were alcohol-dependent reported a higher rate of suicide attempts, anxiety, personality and conduct disorders and other drug dependence than bulimic women who were not alcohol-dependent
  • Hispanic girls were slightly more likely than Caucasian girls and significantly more likely than African American girls to report having fasted for 24 hours or more and having vomited or taken laxatives to lose weight
  • As many as 1 million men and boys suffer from an eating disorder; gay and bisexual men and boys were at increased risk for such disorders


The report found that reducing the growing rates of eating disorders and substance abuse, particularly among young people, would require increasing public awareness of the problem, improving prevention and treatment efforts, conducting needed research and changing policies and industry practices.

It also found that parents, schools, health professionals, the media and policymakers could help young people fight the pressures placed on them to engage in unhealthy substance use and weight-control behaviors.

The report recommends steps the following groups could take to address this health problem, including:

  • Parents
  • Schools
  • Health professionals
  • Advertising, marketing and entertainment industries   
  • Policymakers
  • Researchers

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