Alcohol abuse and eating disorders: a common combination

We have all heard about teen drinking, and it’s probably high on the list of every parent’s  greatest concerns – especially binge drinking and drunk driving. But alcohol becomes an even larger concern for parents who have a child who has an eating disorder, as studies estimate up to 50% of people who have eating disorders also have a problem with drug or alcohol abuse.

To understand the correlation between alcohol and eating disorders, you have to look closely at the true reason for an eating disorder. While the surface reason is to achieve a physical result, the deeper reason for an eating disorder is to avoid or numb the person to protect against uncomfortable feelings and emotions. Eating disorders are developed to avoid feelings of sadness, loneliness, anxiety, and depression. Alcohol serves a very similar purpose for people: when a person is drunk, she is less likely to feel unhappy or stressed.

Some facts about teenage drinking

  • By age 15, about 33 percent of teens have had at least 1 drink.
  • By age 18, about 60 percent of teens have had at least 1 drink.
  • In 2015, 7.7 million young people ages 12–20 reported that they drank alcohol beyond “just a few sips” in the past month.
  • 5.1 million young people reported binge drinking (for males 5 or more drinks and for females 4 or more drinks on the same occasion within a few hours) at least once in the past month.
  • 1.3 million young people reported binge drinking on 5 or more days over the past month.

Eating disorders and alcohol use can create a vicious cycle in which the person avoids uncomfortable feelings and fails to adopt healthy coping mechanisms. Instead of learning to process stress and discomfort, those of us who have eating disorders rely on our coping behaviors of not eating, binging, purging and drinking to avoid them.

People who have eating disorders and people who have problems with alcohol have common personality traits, including impulsive and dramatic dispositions, anxiety and perfectionism. These personality traits are often considered the foundation on which eating disorders and alcoholism are founded. Many researchers believe that we are seeking to modulate and regulate our emotional state by self-medicating with our eating disorders and alcohol.

The signs of eating disorders and alcohol abuse are very similar

  • Changes in mood, including anger and irritability
  • Academic and/or behavioral problems in school
  • Rebelliousness
  • Changing groups of friends
  • Low energy level
  • Less interest in activities
  • Problems concentrating and/or remembering
  • Coordination problems

People who have eating disorders and people who have trouble with alcohol also have something else in common: they increase their reliance on their behavior despite the signs that their behavior is working against them. Everyone has heard of the alcoholic who wakes up with tremendous remorse and regret following a night of drinking and promises to stop drinking forever, only to begin again later that same day.

Similarly, someone who has an eating disorder may awake feeling disgusted by her binge and purge episode the night before. She feels ashamed of her need for this devastating behavior and promises to stop. But later that same day, after a morning of restricting food, she will likely return to binging and purging in a shame-inducing cycle. Both the person with the eating disorder and the person with the problem drinking recognizes that they have a problem, and feels ashamed of the problem, but also feels compelled to continue the behavior despite this knowledge.

The known causes of eating disorders and problem drinking are very similar

  • Genetics
  • Accessibility
  • High stress
  • Social factors, such as media and advertising or the influence of peers
  • Depression
  • Anxiety disorder
  • Abuse, neglect, or other traumatic experiences in childhood
  • Family history

Just like with eating disorders, trauma is highly linked to substance abuse. Some surveys show that more than 70% of adolescents who are being treated for substance abuse have a history of trauma. Teenagers who are exposed to physical or sexual abuse are even more likely (3x) to struggle with substances. And more than half of teens who have been diagnosed with Post Traumatic Stress Disorder (PTSD) develop substance abuse problems.

With all of this information, it’s important for parents to carefully watch for the co-occurrence of eating disorders and alcohol abuse. Talking to your child’s treatment team about alcohol abuse and the potential for trauma is important at the very beginning of treatment. It also needs to be revisited regularly.

Trauma, a problem for both eating disorders and alcohol abuse, often lies in silence or is vociferously denied, so it must be re-addressed on an ongoing basis. Some therapists report patients who do not disclose a traumatic event until several years into therapy.

Studies also show that a person who has fully recovered from an eating disorder can turn to alcohol or other substances at a later time. Alcohol can be an easy substitute for a child whose parents are watching their eating behavior carefully but is still seeking numbing behavior.

The bottom line is that if we want our children to be healthy and avoid a lifetime of eating disorders and alcohol abuse, we must approach their treatment from the standpoint of replacing unhealthy coping behaviors (numbing and avoidance) in exchange for healthy emotional processing tools.

Ginny Jones is on a mission to empower parents to raise kids who are free from eating disorders and body hate.

She’s the editor of and a Parent Coach who helps parents handle their kids’ food and body issues.


Alcohol Use Disorder Comorbidity in Eating Disorders: A Multicenter Study

How do eating disorders and alcohol use disorder influence each other?

Eating Disorders and Addictions Cause a Deadly Combination

Alcohol and Trauma: Drinking as a Way to Cope with the Past

Dual Diagnosis – Addiction and Eating Disorders

National Institute on Alcohol Abuse and Alcoholism

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