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Those With Eating Disorders Likelier To Abuse Alcohol And Drugs

(NEW YORK, NY; December 18, 2003) Food for Thought: Substance Abuse and Eating Disorders-the first comprehensive examination of the link between substance abuse and eating disorders - reveals that up to one-half of individuals with eating disorders abuse alcohol or illicit drugs, compared to nine percent of the general population.  Conversely, up to 35 percent of alcohol or illicit drug abusers have eating disorders compared to three percent of the general population. The 73-page report was released by The National Center on Addiction and Substance Abuse (CASA*) at Columbia University.

"For many young women, eating disorders like anorexia and bulimia are joined at the hip with smoking, binge drinking and illicit drug use," said CASA president and former US Secretary of Health, Education and Welfare, Joseph A. Califano, Jr.  "This lethal link between substance abuse and eating disorders sends a signal to parents, teachers and health professionals - where you see the smoke of eating disorders, look for the fire of substance abuse and vice versa."

This comprehensive report finds anorexia nervosa and bulimia nervosa as the eating disorders most commonly linked to substance abuse.  It also identifies the shared risk factors and shared characteristics of both afflictions.

Substance Abuse and Eating Disorders
Shared Risk Factors Shared Characteristics
  • Occur in times of transition or stress
  • Common brain chemistry
  • Common family history
  • Low self esteem, depression, anxiety, impulsivity
  • History of sexual or physical abuse
  • Unhealthy parental behaviors and low monitoring of children's activities
  • Unhealthy peer norms and social pressures
  • Susceptibility to messages from advertising and entertainment media
  • Obsessive preoccupation, craving, compulsive behavior, secretiveness, rituals
  • Experience mood altering effects, social isolation
  • Linked to other psychiatric disorders, suicide
  • Difficult to treat, life threatening
  • Chronic diseases with high relapse rates
  • Require intensive therapy
The report lists caffeine, tobacco, alcohol, diuretics, laxatives, emetics, amphetamines, cocaine and heroin as substances used to suppress appetite, increase metabolism, purge unwanted calories and self-medicate negative emotions.

The report found that because health professionals often overlook the link between substance abuse and eating disorders, treatment options are virtually nonexistent for these co-existing conditions.

"The public health community, parents and policy makers must educate our children about healthy body images from a very young age, and treatment and prevention programs must address the common co-occurrence of substance abuse and eating disorders," stated Susan Foster, vice president and director of policy research and analysis at CASA, who spearheaded the project.

"Advertisers put children at greater risk of developing an eating disorder through the portrayal of unrealistic body images," noted Mr. Califano. "The average American woman is 5'4" tall and weighs approximately 140 pounds, but the average model that purportedly epitomizes our standard of beauty is 5'11" tall and weighs 117 pounds."  The report found that women's magazines contain more than ten times more ads and articles related to weight loss than men's magazines, which is the same gender ratio reported for eating disorders.

The report finds that while only 15 percent of girls are overweight, 40 percent of girls in grades one through five and 62 percent of teenage girls are trying to loose weight.  These girls are especially vulnerable to eating disorders and related substance abuse problems.

Other notable findings include:

  • Middle school girls (10 - 14 year olds) who diet more than once a week are nearly four times likelier to become smokers.

  • Girls with eating disorder symptoms are almost four times likelier to use inhalants and cocaine.

  • 12.6 percent of female high school students take diet pills, powders or liquids to control their weight without a doctor's advice.

  • Bulimic women who are alcohol dependent report a higher rate of suicide attempts, anxiety, personality and conduct disorders and other drug dependence than bulimic women who are not alcohol dependent.

  • Hispanic girls are slightly more likely than Caucasian girls and significantly more likely than African-American girls to report having fasted for 24 hours or more and having vomited or taken laxatives to lose weight.

  • As many as one million men and boys suffer from an eating disorder; gay and bisexual males are at increased risk of such disorders.

The National Center on Addiction and Substance Abuse (CASA) at Columbia University is the only national organization that brings together under one roof all the professional disciplines needed to study and combat all types of substance abuse as they affect all aspects of society.  CASA's missions are to: inform Americans of the economic and social costs of substance abuse and its impact on their lives; assess what works in prevention, treatment and law enforcement; encourage every individual and institution to take responsibility to combat substance abuse and addiction; provide those on the front lines with tools they need to succeed; and remove the stigma of substance abuse and replace shame and despair with hope.  CASA is the creator of the nationwide Family Day initiative-The Fourth Monday in September-that promotes parental engagement as a simple and effective way to reduce children's risk of smoking, drinking and using illegal drugs.

Created: 12/18/2003  -  Donnica Moore, M.D.

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