Eating Disorders and Drug Addiction in Women

Eating disorders go hand in hand with female alcoholism and drug addiction, but no one knows exactly why.  The rate of eating disorders among all women is about 4%.  However, among female substance abusers, the rate is somewhere between 15% and 50%.

About three percent of all women are bulimic, which means they go on eating binges and then purge themselves by self-induced vomiting, laxatives, dieting, fasting or intense exercise. Bulimics are at much greater risk for substance abuse. Most studies indicate that almost half of all bulimics use alcohol two or more times a week. High school-aged bulimics are more likely to smoke, drink and use marijuana. Studies of college-aged females found relationships between severity of dieting and use of cigarettes, alcohol and drugs.  One study concluded that 50% of bulimics abuse alcohol by age 35.

About 1% of women are anorexic, which is characterized by extreme self-starvation.  The anorexic always "feels fat" even when she is thin or below normal weight.  This disease has up to a 22% death rate. As with bulimics, the incidence of alcoholism and drug abuse is also high among anorexics, upwards of 23%.

Often the eating disorder comes before the substance abuse.  One theory is that drug addiction develops as a stronger form of the original eating disorder, which in itself is a form of addiction. Again, for reasons that scientists do not fully understand, women who have family histories of substance abuse usually come from families with histories of being overweight.  It may be that these women try to control their weight in adolescence with cigarettes and diet pills.  These drugs in turn become "gateway drugs" to cocaine and alcohol, which they use as adults to stay thin.  Some women start out by controlling their weight with mild stimulants such as Ritalin and Adderall, and then "graduate" to harder ones like methamphetamine. Scientists do know that women with eating disorders tend to abuse amphetamines rather than opiates.

Eating disorders and substance abuse may be expressions of the same problem - underlying anxiety related to sexual and physical abuse. One study found that half of all female alcoholics had been sexually abused, and 80% of it was incestuous.  Female drug addicts also have a high prevalence of panic disorders and phobias, making it harder for them to recover, because when they abstain from drugs, their memories and phobias resurface.

Eating disorders and drug addiction produce similar patterns of behaviors.  The person abstains either from eating or using drugs, and then experiences self-blame if she eats or uses drugs again.  This behavior pattern is similar for both women with eating disorders and women with substance abuse problems, which may indicate that both have similar causes: anxiety, depression, phobias, panic disorders. 

Another theory explaining why eating disorders are linked to drug addictions is that depriving yourself of food leads to drug abuse. Studies have shown that people who do not take in enough calories tend to increase their use of tobacco and drugs.  It is also possible to induce drug abuse among animals by depriving them of food.

Women tend to deny that they have eating disorders.  They are more likely to enter treatment for drug addiction or alcoholism than for eating disorders.  However, it is best for them to address both problems within their treatment programs. Most residential treatment centers are equipped to handle both issues at once.  Women who suffer from both these problems often benefit by entering same sex treatment centers and working with female counselors.