People have different views of and levels of connection to food. People use food as a way of connecting with other people, including family members and friends, and many eat specific foods as guilty pleasures or self-care. The way that some people use food to manage their mental states can cause them to develop eating disorders.
People who study binge eating disorder (BED) debate calling the condition of food addiction because the causes, associated behaviors and effects of binge eating are like those of substance use disorders. Men and women who struggle with binge eating disorder may binge eat for many of the same reasons that some people use harmful drugs or alcohol.
When people binge on food, surging levels of dopamine can temporarily counter feelings of depression and anxiety. Other neurochemical effects of food can lead to feelings of comfort and safety. When these effects are no longer enough to counter worsening mental health symptoms, people with BED may abuse drugs or alcohol.
Drug Abuse as a Hindrance to Binge Eating Disorder Treatment
Treatment for binge eating disorder often includes individual and group therapy, support groups and nutrition counseling. These different interventions address a person’s relationship with food as well as the underlying emotional causes of the disorder.
To make progress in treatment, a person with binge eating disorder needs to be able to connect to their emotions and maintain awareness of triggers for binging and related behaviors. The disinhibiting effects of substances increase the likelihood that someone in treatment for binge eating disorder will resume binging.
Altering feelings with drug use makes it hard for a person to process work in therapy on an emotional level. Substance abuse can also alter cognition and block awareness of thinking and behavior. Most commonly abused substances also interfere with the psychiatric medications that are used to treat BED. These medications include selective serotonin reuptake inhibitors (SSRIs) and drugs like Topamax or topiramate.
Effects of Substance Abuse on Binge Eating Symptoms
Both drug and food binges are often followed by negative feelings, including those of depression and anxiety. Withdrawal and post-use effects are significantly intense for people who combine binge eating episodes with substance abuse.
People with binge eating and substance use disorders often feel shame because of the social stigma attached to these disorders. People can get caught up in a worsening cycle as they use food or drugs to cope with these feelings, only to feel more ashamed after they binge or use a substance.
In treatment, people learn the behaviors associated with their disorders do not reflect moral shortcomings. However, before a person enters recovery, they might absorb social messages that these behaviors make them a bad person. This can cause people to use substances after binging, or binge after using substances, to overcome feelings of shame or guilt.
Both binge eating and substance use disorders can cause medical complications, including increased blood pressure and gastrointestinal problems. These issues can arise more rapidly and intensely for people with co-occurring binge eating and substance use disorders. Adding health problems can worsen comorbid depression and anxiety and increase the risk of self-destructive behavior and suicide attempts, which are already heightened for people with binge eating and substance use disorders.
Statistics on Binge Eating Disorder and Drug Abuse
Around 3 percent of people in America have a binge eating disorder, making it significantly more common than anorexia and bulimia, even when rates for those disorders are combined. The lack of recognition for binge eating disorder means it is treated significantly less often. Approximately 44 percent of people with BED receive treatment for their disorder.
Nearly 25 percent of people with binge eating disorder have also had a substance use disorder at some point in their lives. Compared to 3 percent of people in the general population, as many as 35 percent of people with a substance use disorder also have an eating disorder.
Binge Eating and Alcohol
People with binge eating disorder may be more disposed to developing an alcohol use disorder than any other kind of substance use disorder. Unlike most other drugs, alcohol can also be a replacement for food or liquids. Some people with alcohol use disorders get most of their calories through alcohol and even develop secondary eating disorders as they try to restrict food calories to accommodate the amount of alcohol they are consuming.
People typically drink and eat in the same settings. In addition to its depressant qualities, alcohol can trigger many of the same physical and mental side effects as food, such as feelings of comfort and social connection. For these and other reasons, people who binge on food may naturally start combining food and alcohol binges.
Engaging in both binge eating and alcohol use can have many negative consequences. People who consume large amounts of high-calorie food and alcohol are prone to developing diabetes, high blood pressure and other health problems. The disinhibiting effects of alcohol can make food binges more intense and lead to more severe symptoms of anxiety and depression between periods of drinking and binge eating.
Marijuana Abuse and Binge Eating Disorder
While the effects of marijuana vary widely, many people find that using marijuana triggers food cravings and episodes of overeating. For many people, this effect is relatively benign, but it can have serious consequences for people with BED. Often, the foods associated with marijuana-induced cravings are high in calories and low in nutrition, making binges even more consequential.
Marijuana use can trigger episodes of binge eating in two different ways: inducing food cravings and causing anxiety symptoms. Binge eating and marijuana use can trigger changes in hormone levels and brain function that cause longer-term appetite changes. This can lead to more frequent episodes of overeating and weight gain.
Binge Eating Disorder and Stimulants
People with eating disorders frequently use stimulants to help them control their appetites and increase their metabolism. People who combine binge eating and stimulants may try to use stimulants to counteract the effects of binges, causing them to develop a cycle of binging and purging. People who develop a stimulant use disorder may use any one of the following drugs, or a combination of them:
- MDMA, or ecstasy
- Prescription stimulant drugs like Adderall
- Synthetic stimulant drugs like bath salts
Using cocaine and ecstasy is more common in social contexts, while people often use Adderall and amphetamines to help them complete tasks at work or school. For people BED, stimulants can drive them through periods of calorie restriction and compensatory exercise.
While any stimulant can decrease appetite and induce feelings of empowerment, these short-term effects come at a cost. Even for people who have not developed stimulant dependence, periods between use are typically marked by dysphoria. People who have mood disorders or symptoms of depression usually experience worsening levels of depression in response to chronic stimulant use.
Long-term stimulant use can be especially serious for people with BED, who typically suffer from depressive symptoms after episodes of binging. Stimulant use also tends to increase symptoms of anxiety and may trigger reckless and disinhibited behavior. When combined with depression, these impulsive behaviors can become self-destructive and may include suicidal ideation.
Drug Abuse as a Cause of Binge Eating
A binge eating disorder can develop at any point in a person’s life, including as a secondary condition to a substance use disorder. Many substances reduce impulse control and can trigger episodes of binge eating. In vulnerable individuals, these isolated instances can become chronic and develop into BED.
While it’s more common for someone with BED to abuse substances to enhance the neurochemical effects of food binges, the reverse can also occur. People may find that they prefer the side effects of binging on food to the risks that come with substance abuse.
For example, someone with an alcohol use disorder might start trying to reduce how much they drink and substitute food for alcohol. People with histories of alcohol dependence often prefer foods with a high sugar content and may start binging on cookies or ice cream to compensate when they are drinking less.
Treatments for Binge Eating with Co-Occurring Substance Use Disorders
For people with any combination of co-occurring substance use and mental health disorders, integrated treatment is important, but it might be even more essential for people with comorbid binge eating disorder and addiction.
Integrated treatment is the coordination of separate services under a unified treatment plan. Ideally, all interventions are provided by the same organization, but any clinicians who coordinate and communicate with one another can effectively help someone who struggles with co-occurring disorders.
People with BED often require medical treatment and nutrition counseling in addition to therapy, support groups and behavior modification. When they are recovering from both BED and a substance use disorder, it is even more important that all treating professionals are aware of medical implications and risk of any recurrence of binging or substance use.
A combination of individual and group therapy is usually best for people with co-occurring disorders. Group processes can facilitate unique insights, while individual therapy allows people to explore subjects that may be too delicate or intimate for the group setting. Group and individual counseling can treat both disorders.
There are three different styles of therapy that have been shown to be most effective for people with BED:
- Cognitive behavioral therapy (CBT)
- Interpersonal psychotherapy (IPT)
- Dialectical behavior therapy (DBT)
While these three therapy options can effectively treat both binge eating and substance use disorders, research suggests that DBT can be especially effective for people with co-occurring disorders because it focuses on overall strategies to improve emotional regulation and coping. DBT also helps people recover from feelings of shame by teaching them how to accept thoughts and feelings without reacting to them in self-destructive ways.
For people with co-occurring binge eating disorder and an addiction to drugs or alcohol, knowing where to turn to receive appropriate medical care can be challenging. Fortunately, many programs now offer integrated treatment for people with dual-diagnosis. The Recovery Village operates rehab facilities across the United States that provide both addiction and mental health treatment. To learn more about how these specialized services can help you heal, contact The Recovery Village.