By Lauren Greenway, MS, LPC

Whenever a person presents to treatment for problems with substance-related issues, rarely does he or she suspect that it would be essential or relevant to address issues with body image and food. While it may seem that substance use disorders and eating disorders are two separate issues, they are, in fact, inextricably linked for many individuals. People who abuse alcohol or illicit drugs are 11 times more likely to have an eating disorder.

For people who struggle with both issues, their eating disorder is often described as their “first addiction.” These men and women usually express issues with dieting, binge eating or purging that developed in their life years before they began to experiment with substances. Late childhood and early adolescence are prime times for individuals to start experiencing body-image concerns and, therefore, manipulating food intake and exercise. Oftentimes as these individuals continue living with both issues, they will use substances as a distraction from obsessing about food or body image, or they will begin using substances to aid in weight loss. (Stimulant drugs are used not only for the “high,” but also for the added bonus of appetite suppression.) By this time, body image and food have become linked with their use of substances. The eating disorder and the substance use disorder have also become self-destructive methods of coping with life.

When these men and women seek treatment for substances, it is vital to address issues with body image and food if needed. When the substances are removed as a method for coping, it is extremely common for the urge to restrict, binge, diet or over-exercise to become “loud” or resurface. A person’s history with body image and food can be a shameful and intimate topic, which can prevent him or her from reaching out for the help he or she so desperately needs. For those who do choose to embark on this courageous journey, they often report achieving “a deeper level of recovery” and develop the tools and insight needed for long-term sobriety.