Eating disorders and alcoholism frequently co-occur — and recent findings from neuroscientists suggest there could be a direct neural link. Disordered eating and addictive behaviors have more in common than you may think, but there is hope for recovery.

To understand the connection between alcoholism and eating disorders, it’s important to first take a close look at each type of disorder.

Alcohol Use Disorders

Alcohol use disorder is exceptionally common, affecting more than 29 million people in the United States each year. Like many other types of substance use disorders, people with alcoholism can develop lasting brain changes in the reward network that make it more difficult to feel enjoyment or pleasure from activities other than alcohol use.

This quickly becomes a self-destructive spiral. Without other rewarding activities to engage in, people drink more, which makes it progressively more difficult to find healthy alternatives to drinking.

Any number of risk factors can contribute to the development of an alcohol use disorder. Some of the more common risk factors include:

• Early onset of drinking
• Genetic factors
• Lack of healthy alternatives
• Peer pressure
• Cultural norms
• Trauma
• Co-occurring mental health concerns

These risk factors don’t guarantee that a person will go on to develop an alcohol use disorder. But when a person does, they face a number of other challenges associated with addiction, including:

• Invasive alcohol cravings
• Withdrawal symptoms if alcohol use suddenly stops
• Loss of interest in hobbies or activities that used to be important
• Worsening physical and mental health symptoms
• Growing tolerance to alcohol
• Alcohol use interferes with work, school, or home life
• Multiple failed attempts to stop drinking or reduce consumption

Most people living with alcohol use disorders struggle to cut down or stop drinking on their own. However, there are several evidence-based treatment methods that can help people overcome alcohol withdrawal symptoms, learn healthier coping mechanisms, and build healthier lives in recovery.

Eating Disorders

There are a number of different eating disorder diagnoses, each with a unique set of symptoms and challenges. The most common forms of eating disorders include:

• Binge eating disorder
• Anorexia nervosa
• Bulimia nervosa
• Avoidant/restrictive food intake disorder (ARFID)
• Pica

In terms of a connection between eating disorders and alcoholism, the most common co-occurrence happens in individuals with binge eating disorder, anorexia nervosa, and bulimia nervosa. These disorders are more common in women than men, making the comorbidity of alcoholism and eating disorders also primarily seen in women.

Binge eating disorder is a pattern of behavior where people frequently eat more food than recommended during a brief period and feel like they cannot control or lose control of their eating. This experience can be incredibly distressing.

Bulimia nervosa has a similar pattern of extreme overeating in a short window but is followed by compensatory behaviors. This could be self-induced vomiting, misuse of laxatives, or excessive exercise. There is often a sense of body dysmorphia in people living with bulimia nervosa as well.

Anorexia nervosa also includes body dysmorphia, but people with this disorder tend to highly restrict their food intake. They often have dangerously low body weight for their height and may experience intense distress and fear about gaining any weight.

The Co-Occurrence of Alcoholism and Eating Disorders

Both clinical experience and academic research have shown that there is an exceptionally high level of co-occurrence of alcoholism and eating disorders. 

People in substance use treatment are substantially more likely to have an eating disorder diagnosis, and those in eating disorder treatment are substantially more likely to have a substance use disorder.

Among many other potential causes, there are genetic factors that increase a person’s risk of developing alcohol use disorders and eating disorders. HAs with most dual-diagnosis conditions, it is not known if one disorder directly causes the other, we do know that a vareity of factors including ACEs, family history, and more can contribute and perpetuate both

For example, engaging in eating disorder behaviors can provide a pleasurable yet harmful feedback loop that can encourage some people to continue the behavior. Therefore, depending on the specific eating disorder diagnosis, engaging in restrictive, binge, or compensatory behaviors can help people find relief from mental health challenges or a feeling of pleasure.

When a person is living with co-occurring alcoholism and eating disorders, the two sets of symptoms can often influence one another. For example, a person may feel shame about their eating habits and attempt to relieve that shame through the use of alcohol. 

Drunkorexia

Drunkorexia is a colloquial term for a pattern of restrictive eating habits that revolve around alcohol use. Most commonly seen in young adult women, people experiencing drunkorexia may restrict calorie intake from food to account for the calories of alcohol.

In drunkorexia, people avoid eating healthy and nutritious foods in order to meet a specific calorie goal. Prioritizing calories from alcohol often leads to severe nutrient deficiency and can cause a number of medical health challenges.

Neural Correlations of Eating Disorders and Alcoholism

One of the more interesting findings from neuroscience studies is the neural correlations between eating disorders and alcoholism, specifically with binge eating disorders. In both alcohol use disorder and binge eating disorder, the brain experiences structural changes in the reward network, making it difficult for people to find enjoyment outside of drinking or binge eating.

Binge eating provides a surge of dopamine, similar to what people experience when drinking alcohol or using other addictive substances. 

When the brain becomes sensitized to these high levels of dopamine, it adjusts in such a way that other rewarding activities become less pleasurable. A person experiencing this may return to binge eating and drinking alcohol to feel a sense of reward that they no longer get from other activities. In a way, binge eating mimics the effects of addictive substances like alcohol.

Treatment Options

Treating co-occurring alcohol and eating disorders requires specialized treatment by a team that is equipped to deal with both disorders simultaneously. If an alcohol use disorder is left untreated in a person with eating disorders, or vice versa, the mental health symptoms of either disorder can lead to a relapse.

Thankfully, there are evidence-based treatment options that can help. Specifically, people with co-occurring disorders should seek a style of mental health care known as dual-diagnosis treatment, which is equipped to treat co-occurring substance use and other mental health conditions simultaneously. 

Dual-diagnosis treatment integrates both mental health and alcohol treatment into a holistic mental health model. It starts with a medical alcohol detox, which can help ameliorate many of the uncomfortable and life-threatening symptoms of alcohol withdrawal.

Following detox, patients begin evidence-based mental health treatment that can help with both eating disorders and alcohol use disorders. This includes treatment methods such as:

• Cognitive-behavioral therapy
• Family therapy
• Trauma-informed therapy
• Recreation therapy

Together, these styles of treatment can help teach people healthier coping mechanisms to use in their everyday lives, resist alcohol or eating disorder relapse, and provide healthy and rewarding alternatives to addictive or disordered behaviors.

These services are typically provided in a residential setting, providing people with a safe space to heal, where they can focus their full energy on the work of achieving recovery.

After graduating from residential treatment, aftercare programs can help our patients sustain their progress and maintain healthy patterns. These programs provide accountability, direct connection to mental health providers, and continued social support for recovery.

Start Treatment at Lakeview Health

Lakeview Health offers a comprehensive suite of services to help people with various mental health conditions. Reaching out to our team can help you determine the best path to recovery for you, and our team will be there to support you every step of the way.