Link Between Alcoholism And Eating Disorders

Eating disorders and alcoholism are commonly co-occurring disorders. As with any dual diagnosis of a psychiatric disorder and substance abuse, an integrated treatment approach and proper healthcare offer the best chance of lasting success.

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Dr. Manish Mishra, MBBS

Medically Reviewed By: Manish Mishra, MBBS


Eating disorders (ED) rarely exist as a sole diagnosis. When an ED is diagnosed, co-occurring conditions are often discovered. Anxiety disorders and alcoholism are some of the most frequent.

Evidence suggests that co-occurring alcohol abuse and eating disorders may share an underlying cause linked to changes in brain chemistry, just like alcoholism and other co-occurring disorders.

The theory is that these changes are linked to increased impulsivity and make both disorders more likely.

Which Develops First: Alcohol Abuse Or Eating Disorders?

Alcohol abuse and eating disorders share a number of risk factors. They are also risk factors for each other.

That is why there is no clear answer regarding the order of development.

Factors That Contribute To Co-Occurring Eating Disorders And Alcoholism

There are countless factors that could contribute to co-occurring eating disorders and alcoholism. Each condition has its own list of risk factors, and there’s significant overlap between those lists.


Post-traumatic stress disorder (PTSD) is a known risk factor for eating disorders. The correlation is especially strong with bulimia nervosa.

Research targeting women with bulimia nervosa revealed that about 33% of participants met the criteria for lifelong PTSD.

The numbers were less dramatic with other disordered eating behaviors but still significant. Depending on the disorder, rates range from 12 to 20%.

Trauma and PTSD are also known risk factors for alcoholism. In these cases, PTSD is often considered the shared, underlying cause for both the alcohol use disorder and the eating disorder.


Anxiety disorders are associated with an increased risk of alcohol dependence. The evidence suggests that this correlation is largely the result of self-medication with alcohol abuse to attempt to solve anxiety.

The use of alcohol as a temporary treatment for anxiety symptoms is not uncommon. People with an anxiety disorder are especially prone to use alcohol to relax in uncomfortable situations.

Unfortunately, this short-term solution is incredibly destructive. Long-term alcohol dependence worsens anxiety symptoms and could lead to the development of other health issues.

Alcohol Abuse Suppresses Appetite

In cases where alcohol abuse predates an eating disorder, it is possible that the eating disorder is a result of the substance use disorder.

Alcohol may be empty calories, but it contains a lot of them. Despite the lack of nutritional value, drinking heavily convinces your empty stomach and your brain that you’ve eaten.

If you’re dealing with alcohol addiction, then you’re unlikely to feel hungry at regular intervals. Without hunger and without proper nutrition, you could easily develop an eating disorder.

Anorexia nervosa and binge eating disorders are both more commonly associated with alcoholism.


“Drunkorexia” is a poorly chosen term that refers mainly to college-aged women who engage in extreme dieting, purging, or exercise to offset the calories of planned binge drinking.

While the trend is most prominent in college-aged women, it can affect anyone in the general population. Men of a similar age are particularly prone to engage in similar behaviors.

Under these conditions, an eating disorder and alcohol abuse develop simultaneously in response to each other.

Signs And Symptoms Of An Eating Disorder

There are a wide variety of eating disorders, and they can present in a number of different ways.

Dramatic Weight Loss

Dramatic weight loss is most often associated with anorexia nervosa and bulimia nervosa. In both cases, you feel like you’re overweight and are doing everything to restrict calories.

With anorexia it’s more common to reduce total calorie intake and to increase exercise. With bulimia it’s more common to binge and then purge or abuse laxatives.

Some eating disorders have the opposite effect, resulting in dramatic weight gain.


In eating disorders that restrict nutrition, dizziness is a common symptom. It is extremely serious and marks extreme malnutrition with dangerous health risks.

If your eating disorder has progressed to this point, you may require hospitalization.

Social Withdrawal

Many eating disorders are accompanied by a sense of shame. You may be embarrassed by your binging, your purging, or your own body image.

In situations where you feel ashamed of your condition, you’re more likely to withdraw from social interactions. By withdrawing you’re reducing the risk that someone will notice.

Unfortunately, this is also a temporary, dangerous fix. If you have an eating disorder, you need help. Sometimes the easiest way to get it is to have a loved one hold your hand and lead the way.

How Alcoholism And Eating Disorders Are Treated

Alcoholism and eating disorders have very different presentations despite sharing underlying factors.

In order to address both disorders, you will need to be in an integrated addiction treatment program where you have a variety of options.

What works for one person may not work for the other, but you will find something that resonates with you in the right rehab program.

You may find dual diagnosis treatment for alcohol addiction and eating disorders in an inpatient rehab facility.

Motivational Interviewing

Motivational interviewing is a form of therapy that opens a conversation between you and your therapist.

You have the chance to talk and just have them listen. They will help you to expand on your thoughts to allow you to come to your own conclusions.

If you’re unsure of your ability or desire to change existing behaviors, then motivational interviewing may work for you.

Dialectical Behavior Therapy

Borderline personality disorders often co-occur with alcoholism and eating disorders. Dialectical behavior therapy is arguably the best option if you’re dealing with all three.

This form of behavioral therapy focuses on coping strategies. You will learn ways to help handle stress and regulate intense emotions.

This approach is successful in both individual and group settings.

Cognitive Behavioral Therapy

Cognitive behavioral therapy is two-fold.

On the cognitive side, you will learn to recognize and challenge self-destructive thoughts. On the behavioral side, you will learn to recognize and address harmful patterns of behavior.

Cognitive behavioral therapy has proven effective with alcohol addiction as well as a variety of mental health disorders.

Find Dual Diagnosis Treatment At Bedrock Recovery Center

At Bedrock Recovery Center in Massachusetts, we offer all of these treatment options in inpatient and outpatient settings.

If you’re willing to get help for your alcoholism and eating disorder, give our treatment center a call. You’ll be surprised what your life can look like when you finally get the help you’ve always needed.

  1. Addictive Behaviors Volume 112
  2. National Center for Biotechnology Information
  3. National Eating Disorders Association
  4. National Institute of Alcohol Abuse and Alcoholism
  5. National Library of Medicine
  6. National Library of Medicine

Written by Bedrock Recovery Center Editorial Team

© 2024 Bedrock Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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