Alcoholism and eating disorders might be different from one another, but they often occur alongside each other. In fact, these two problems are often diagnosed with other personality and psychiatric problems. Because of these incidences, experts believe that alcoholism and eating disorders may share some common factors – thus explaining why they commonly happen with each other.
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What are Eating Disorders?
According to the National Institute on Mental Health, eating disorders are fatal conditions and not mere ‘lifestyle choices.’ They can affect a person’s eating behaviors, as well as his/her emotions and thoughts. In some people, eating disorders are marked with problems with body weight, shape, and food intake.
Types of Eating Disorders
There are 3 common eating disorders, namely:
This occurs when a person sees himself/herself as overweight, even if he/she is actually underweight.
Anorexic individuals are known to restrict food intake. They exercise excessively and weigh repeatedly. They may also induce vomiting or use laxatives to lose weight. Because of these actions, anorexic people are known to be emaciated or extremely thin. Because of their distorted body image and intense fear of weight, they keep on trying to lose weight, even if they are already skin and bones.
Due to their fragile state, anorexic individuals can develop complications. They may have muscle weakness, low red blood cell count (anemia), and brittle hair and nails. They can also have yellowish dry skin, constipation, low blood pressure, and organ failure, to name a few.
Because of the aforementioned complications – and the suicidal ideations that come with the disorder – anorexia nervosa bears a high mortality rate.
Bulimics often have a lack of control when it comes to eating large portions of food. They then compensate for this overeating through several ways. Bulimics often end up exercising excessively, fasting. These people even force vomiting. At times, they may use diuretics (water pills) or laxatives.
Bulimics come in all shapes and sizes – they may be underweight, of normal weight, or overweight. They often manifest the following signs:
- Sore throat
- Swollen salivary glands
- Worn tooth enamel or decayed teeth
- Severe dehydration
- Acid reflux disorder or other digestive conditions
- Intestinal problems due to laxative abuse
- Deranged levels of calcium, sodium or potassium that can precipitate a heart attack or stroke
Binge eaters have no control over their eating habits. Unlike bulimics, they do not exercise, fast, or purge. As such, binge eaters often turn up overweight, if not obese. As the most common eating disorder in the US, binge eating comes with the following symptoms:
- Eating large servings of food in a certain period
- Eating quickly during binge episodes
- Consuming food even if full or not hungry
- Eating by oneself to avoid shame
- Feeling guilt, embarrassment or distress after a binge episode
- Constant dieting without positive results
Alcohol Use and Eating Disorders
As mentioned, alcohol use and eating problems often occur with each other. According to the National Institute on Alcohol Abuse and Alcoholism, bulimia nervosa occurs in 8 to 41% of people with substance use disorder. As for anorexia nervosa, the co-occurrence rate is lower at 2 to 10%.
A study has shown that alcoholic women were more likely to have attitudes and behaviors that lead to eating disorders. According to experts, food deprivation may lead the person to consume more substances such as alcohol. Additionally, the lack of food can rewire the brain in such a way that alcohol and other substances turn out to be more rewarding and pleasurable.
Fluctuations in serotonin levels, a hormone that is also linked with food and alcohol intake, have been linked with the two disorders as well. This is the main reason why drugs such as Selective Serotonin Reuptake Inhibitors (SSRI) are prescribed in people with eating disorders.
Impulsivity, anxiety, and affect instability may also explain why alcoholism occurs with eating disorders.
Impulsiveness is common in people with eating disorders. According to Fahy and Eisler, it is more pronounced in bulimics compared to anorexics. Since alcohol can increase impulsiveness in individuals, it can further magnify the severity of eating disorders.
Anxiety, on the other hand, commonly occurs in people with eating disorders. It can also result in drinking, as users deem alcohol to be some sort of stress reliever. Alcohol ends up worsening anxiety and subsequent eating disorders. After all, it can affect the serotonin concentration in the brain.
Affect instability is defined as the tendency to experience swift mood swings that are difficult to control. Unmanageable mood changes dictate eating problems and alcoholism. These may explain why they often occur with each other.
What Can Be Done
Since people with eating disorders often have alcohol or substance abuse disorders, treatment is usually tailored according to the person’s needs. Generally, alcohol use and eating disorder treatments involve the following:
Also known as talk therapy, psychotherapy is a treatment that aims to address emotional difficulties and mental illnesses. According to the American Psychiatric Association, it can help control (if not eliminate) worrisome symptoms, such as those found in eating disorders. As such, psychotherapy can help an ill person heal and function better.
Cognitive-Behavioral Therapy is a form of psychotherapy often prescribed to people with eating disorders. It can help the person identify his/her negative thinking patterns so that his/her mindset is changed for good.
Several types of drugs can be used to treat people with eating disorders. Antidepressants may be prescribed to decrease depression and anxiety. After all, these often occur in afflicted individuals. Prozac or Fluoxetine, an SSRI, is an FDA-approved drug for bulimia.
Antipsychotics, which are used to treat bipolar disorder and other psychotic symptoms, may be given to anorexics as well. According to Marzola et al., atypical antipsychotics, such as aripiprazole and olanzapine, may be effective as adjunct treatment. According to the study, the aforementioned drugs were deemed to be effective in controlling quirks such as eating preoccupations and rituals.
Mood stabilizing drugs such as Topiramate may help with eating disorders as well. As per Milano et al., Topiramate can reduce purging and binge eating. It can also promote weight loss, which is vital for bulimics and binge eaters.
In a Nutshell
Alcoholism and eating disorders often occur with each other. Food deprivation, which rewires the brain, makes alcohol a more rewarding option for people with eating disorders. Changes in serotonin levels may also explain why the two disorders co-exist often. Despite the setbacks, both problems may be addressed with psychotherapy and medications.