The Eating Disorder and Substance Abuse Dual Diagnosis

Eating disorders are a well documented and wide reaching issue among people living in Florida and the throughout the wider United States. Approximately 8 million citizens in the United States suffer from documented cases of some kind of eating disorder and that is only what we know about. Surely thousands of other cases exist. The stigma that comes with eating disorders may keep many people suffering from the disorder from getting help. This is especially true of those who suffer from a dual diagnosis of addiction to drugs or alcohol. But the deadly effects of both eating disorders and substance abuse makes treatment for either disease imperative – when you combine the two disorders, the need for treatment grows exponentially. The first course of action for someone suffering from both an eating disorder and substance abuse must be to seek out alcohol and drug detoxification and alcohol and drug rehabilitation. South Florida drug detox centers and rehabilitation centers should be able to treat both disorders effectively through medical and therapeutic means.


More so than any other mental health disorder, eating disorders are highly deadly. A study from the National Association of Anorexia Nervosa and Associated Disorders tells the reader that five to ten percent of those who struggle with anorexia nervosa die after about ten years of suffering from the disease eighteen to twenty percent sucuum to the disease after twenty years. Others who suffer from the disease will die early through suicidal means. The recovery rate is not encouraging with only thirty to forty percent of people dealing with an eating disorder ever fully recover from the disorder. Maybe that is because only about ten percent of those who suffer from eating disorders ever receive treatment from the disease. Whether this is a matter of the cost of treatment availability or the stigma that comes along with the disorder the numbers are tragic.


According to American Psychiatric Association “Eating disorders are illnesses in which the people experience severe disturbances in their eating behaviors and related thoughts and emotions. People with eating disorders typically become preoccupied with food and their body weight.”


3 Most Common Eating Disorders

Anorexia Nervosa – Someone who suffers from anorexia nervosa likely views themselves as overweight regardless of what their body weight is in reality. The person likely will become obsessed with their weight weighing themselves on a scale sometimes multiple times a day. This eating disorder has the highest fatality rate of any eating disorder. Many people die of complications due to the disorder like depressed cardiac function or starvation but many others die by suicidal means. Especially with women anorexia kills more people than any other mental health disorder.


Signs & Symptoms of Anorexia Nervosa:

  • Highly restricted diet
  • Extreme emaciation
  • Obsession with becoming thinner
  • Body dysmorphia or a distortion of the way one’s body looks
  • Low self esteem
  • A sense of self loathing
  • Anemia
  • Brittle nails and hair
  • Dry and yellowing skin
  • Osteoporosis
  • Constipation from dehydration
  • Diminished brain function
  • Extreme lethargy
  • Exhaustion
  • Infertility
  • Malnutrition
  • Irregular body temperature
  • Organ failure
  • Irregular menstrual periods


Bulimia Nervosa – Unlike anorexia nervosa a person who struggles with bulimia nervosa is less focused on not eating and more focused on purging the food and calories from their system that they consume. They frequently have incidents of eating substantial amounts of food in short periods of time. These sorts of binge eating episodes causes the person suffering from bulimia nervosa to feel out of control. This disorder like all eating disorders is not a choice that the afflicted person can just decide to stop choosing. Therefore it causes many feelings of self hatred and self loathing especially after binging and purging occurs. Purging after the person has overeaten in a binge can look like many different activities including self induced vomiting use of a laxative or diuretic prolonged fasting periods of extreme exercise or a combination of any of these activities. Unlike the emaciation of anorexia nervosa bulimia nervosa victims can usually maintain a more normal appearing body weight.


Signs & Symptoms of Bulimia Nervosa:

  • Unrelenting raw throat
  • Swollen glands like the salivary glands in the neck and throat
  • Damaged teeth causing diminished enamel and tooth decay
  • Heightened sensitivity in the person’s teeth due to self induced vomiting
  • Cavities
  • Severe dehydration
  • Constipation
  • Acid reflux
  • Gastrointestinal complications
  • Electrolyte imbalance
  • Stroke
  • Cardiac and Heart complications
  • Anxiety
  • Depression
  • Heartburn
  • Guilt
  • Mood swings
  • Bad breath
  • Abnormal menstrual periods


Binge Eating Disorder – Binge eating disorder is characterized by a loss of control around a person’s eating habits. Binge eating disorder is unlike bulimia nervosa in that the person suffering from binge eating disorder though they binge eat does not purge afterward there’s no fasting vomiting or intense exercise in an effort to counteract the calories. As a result the person suffers from different side effects including being overweight or obese.


Signs & Symptoms of Binge Eating Disorder:

  • Episodes of binging large amounts of food in a short period of time
  • Eating past a feeling of fullness and into a feeling of discomfort
  • Rapid eating habits
  • Eating in secret
  • Hiding food
  • Feelings of self loathing shame & guilt
  • Frequent often unsuccessful dieting
  • Obsession with weight loss without making progress toward a healthy weight
  • Diabetes
  • Heartburn
  • Exhaustion
  • Anxiety
  • Depression
  • Irregular menstrual periods


3 Lesser common Eating Disorders

Pica – Pica is an eating disorder that is characterized by the afflicted person eating things like paint hair mud or chalk. To be diagnosed with Pica someone must have persistently eaten substances like these that do not offer nutritional value for more than a month long period. This eating disorder usually accompanies another mental health disorder such as an intellectual disability schizophrenia or can sometimes be concurrent with autism spectrum disorder. Though people with pica habitually consume non foods they are not necessarily opposed to eating food like someone with anorexia nervosa would be.


Signs & Symptoms of Pica

  • The consistent consumption of non-food elements such as

    • paper
    • soap
    • chalk
    • hair
    • string
    • cloth
    • wool
    • paint
    • gum
    • metal
    • charcoal
    • ash
    • clay
    • starch
    • ice
    • soil
    • string
    • talcum powder
    • pebbles
    • rocks
  • Anemia
  • Intestinal blockage
  • Gastrointestinal issues
  • Complications due to the toxicity of the consumed element


Rumination Disorder – Rumination disorder is characterized by someone who frequently and repeatedly regurgitate their undigested or partly digested foods, rechew the substance, then either spit it out or swallow it again. Regurgitation happens within half an hour of every occurance of eating food and usually without intention.  Food is brought back up the esophagus and into the mouth via a subconscious trigger. The person suffering from rumination disorder does not experience nausea in the process of regurgitation. The Mayo Clinic reports that:

“The precise cause of rumination syndrome is unknown, but it’s clear that rumination is a subconscious behavior, not a conscious decision. Rumination syndrome is frequently confused with bulimia nervosa, gastroesophageal reflux disease (GERD) and gastroparesis. Some people have rumination syndrome and constipation caused by a rectal evacuation disorder.The condition has long been known to occur in infants and people with developmental disabilities, which may be related to an unvoiced desire to reject food. But it can also occur in other children, adolescents and adults”


Avoidant or Restrictive Food Intake Disorder – Unlike anorexia nervosa, avoidant or restrictive food intake disorder is not characterized by an anxiety around weight gain. This eating disorder, rather, is often the result of an anxiety around the consequences of eating food such as possible choking, poison, or the outside chance of allergic reaction. The person may also avoid food due to an avoidance of particular colors, textures, smells or tastes.


Signs & Symptoms of Avoidant or Restrictive Food Intake Disorder

  • Extreme weight loss
  • Extreme emaciation
  • Organ Failure
  • Highly restricted diet
  • Brittle nails and hair
  • Anemia
  • Dry or yellowing skin
  • Osteoporosis
  • Infertility
  • Abnormal menstrual periods
  • Malnutrition
  • Irregular body temperature
  • Exhaustion
  • Lethargy
  • Constipation


Treating Dual Diagnosis in Florida

The difficult aspect of treating a dual diagnosis that many people don’t realize is that you have to treat both the eating disorder,  in this case, and the substance use disorder at the same time. A person struggling to recover from both disorders will find that treating just one of them in an effort to simplify recovery, will only lead to an ebb and flow of one disorder and the other, but never truly reaching remission with either disorder. The two disorders will feed off of one another. If not treated the two disorders will build up one another until the symptoms are increasingly life threatening. Especially in the case of eating disorders which are highly fatal, not treating the eating disorder, substance abuse dual diagnosis is a kind of proverbial playing with fire.


The way in which society has stigma that comes along with both the mental health disorder of eating disorders and an addiction to drugs or alcohol make it difficult for someone afflicted with this kind of dual diagnosis to be honest about their struggles, ask for help, and seek treatment. They may have a sense of hopelessness and worry that their eating disorder would be untreatable at a drug detox center. South Florida’s FHE Health is staffed with some of the most qualified licensed medical staff and experienced therapists who can work with the person struggling with drug and alcohol abuse as well as an eating disorder and will create a personalized plan of treatment that addressed their unique needs for recovery. Call FHE today to learn more.


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