For many Americans, eating disorders (EDs) and substance use disorders (SUDs) are not separate challenges. Many live with both.
Indeed, more than one in four people with an ED would also meet criteria for a co-occurring SUD. Similarly, up to 35 percent of people with an alcohol use disorder or other SUDs have eating disorders. These co-occurring conditions occur at higher rates among women. Research shows that approx Half of all women with ED also have SUDand approx 16 percent of women with a SUD report that has ED.
The co-occurrence of these conditions is a pressing public health problem with profound implications for individuals and their families. They are intertwined in ways that can make recovery feel overwhelming – but not out of reach.
People need to receive compassionate, comprehensive care for both disorders in order to have the best chance of recovery. This aligns with that of President TrumpMake America Healthy Again (MAHA)initiative and its commitment to addressing the chronic disease epidemic affecting Americans. Evidence-based, whole-person approaches to treating co-occurring EDs and SUDs will advance MAHA’s vision for a healthier, more resilient America.
Understanding the relationship between ED and SUD
Co-occurring EDs and SUDs often share underlying causesincluding genetic predisposition, trauma, and affective dysregulation (difficulty managing emotions and feelings). Factors such as adverse childhood experiences and norms also contribute. Both disorders involve compulsive behaviors, cravings and use of food and/or substances as a coping mechanism. Traits such as impulsivity and perfectionism can exacerbate the risks for both conditions.
SUDs and EDs can exacerbate each other, creating a cycle that complicates recovery for both. For example, people with binge eating disorder may abuse prescription stimulants or use illegal stimulants for appetite suppression, perpetuating a dangerous cycle.
Early recognition of symptoms is critical. Early intervention gives individuals the best chance for permanent recovery. Delayed treatment increases the risks of serious health consequences and complicates recovery efforts.
Comprehensive care paves the way to recovery
Treating both disorders together is crucial to improving outcomes. A SAMHSA advisory was recently released Evidence-based care for clients with co-occurring substance use and eating disorders contains information to help health care providers identify clients who have potential co-occurring SUDs and EDs. makes appropriate referrals; Create recovery-friendly, supportive treatment environments. and help clients maintain recovery from both SUDs and EDs.
Comprehensive care treats EDs and SUDs simultaneously through holistic, person-centered approaches. By considering physical, mental and emotional health – including evidence-based treatments and medical and nutritional support – comprehensive care plans reduce the risk of return to misuse and promote long-term recovery.
Recovery from co-occurring SUD and ED is possible with the right resources and support. Normalizing conversations about dual diagnoses helps reduce stigma and encourages more people to seek the help they need.
Community and Family involvement is also a key component of recovery. Peer support services play a vital role in the recovery journey of people who have SUDs and EDs. These services provide a sense of connection, encouragement and hope, allowing people to work with peer support partners who have had similar experiences and understand the challenges associated with these conditions. Peer support promotes empowerment, reduces stigma and helps individuals build the confidence and resilience needed for long-term recovery.
Resources for people with eating disorders, substance use disorders, or both
If you or someone you know is struggling with an eating disorder, substance use disorder, or both, don’t wait to get help. Educate yourself and others about the realities of co-existing ED and SUD. Share resources, participate in community events, and advocate for comprehensive and inclusive treatment approaches that address the complexities of these dual diagnoses.
The US Department of Health and Human Services (HHS) offers a wealth of resources for people with SUDs and EDs, as well as for families and caregivers:
- Substance Use – a comprehensive resource where you can learn about substances, prevention, treatment and recovery.
- SAMHSA: Substance Use Disorder Treatment – a comprehensive resource with substance use information, resources, and treatment options for substance use disorders and co-occurring disorders.
- SAMHSA: Eating Disorders – a resource that provides information about eating disorders and how to get help.
- Office on Women’s Health: Eating Disorders – a resource that contains information about specific eating disorders, including their impact on pregnancy and breastfeeding.
- NIH National Institute of Mental Health: Eating Disorders – a resource consisting of eating disorder research, outreach materials and links to resources.
- AHRQ: Eating Disorders Resources for Clinicians and Patients – a website with information about eating disorders and links to resources for clinical providers and people with eating disorders.
- FindSupport.gov – designed to help people identify available resources, explore unbiased information about various treatment options, and learn how to get support for mental health or substance use issues.
- FindTreatment.gov – a confidential and anonymous resource for people seeking treatment for mental health conditions and substance use disorders.
- 988 Suicide & Crisis Lifeline – a lifeline for people who need support or are in crisis. Call or text 988 or chat988lifeline.org.
Each of us can help build a world where recovery is possible for all. By supporting people on their recovery journeys, we honor their courage and resilience. The time for action is now – together, we can make a difference. Let’s work together to create a future where recovery is possible for all.
