What Are Feeding and Eating Disorders?
Feeding and eating disorders are conditions characterized by severe disturbances in eating behaviors and related thoughts and emotions. These are serious mental health conditions—not lifestyle choices—with profound physical and psychological consequences. For families, eating disorders are often as hidden as addiction itself, involving secrecy, shame, and elaborate deception.
Understanding Feeding and Eating Disorders
Anorexia Nervosa
Restricted food intake leading to significantly low body weight, intense fear of gaining weight, and distorted body image. The binge-purge subtype carries high risk for substance use.
What it looks like:
- Dramatic weight loss and preoccupation with calories, dieting, and thinness
- Cutting food into tiny pieces, hiding food, lying about eating
- Using stimulants like cocaine or diet pills to suppress appetite
Bulimia Nervosa
Recurrent binge eating followed by compensatory behaviors—vomiting, laxative misuse, fasting, or excessive exercise. Individuals show a pattern of impaired impulse control followed by shame.
What it looks like:
- Evidence of bingeing—large amounts of food disappearing, hidden wrappers
- Frequent bathroom trips after meals, signs of purging
- Using alcohol to numb the shame cycle or facilitate purging behaviors
Binge-Eating Disorder
Recurrent episodes of eating large quantities rapidly, often in secret, with complete loss of control. Unlike bulimia, there are no compensatory behaviors—but shame and distress are equally severe.
What it looks like:
- Eating unusually large amounts in short periods, often until painfully full
- Eating in secret, hiding food, eating when not physically hungry
- Using substances to numb emotional distress or as compulsive behavior
Dual Diagnosis Stats:
Prevelance: Approximately 9% of the U.S. population will experience an eating disorder in their lifetime¹
Co-Occurrence: Up to 50% of individuals with eating disorders use alcohol or illicit drugs—5 times higher than the general population²
Relapse Risk: Eating disorders have the second-highest mortality rate of any mental illness, after opioid addiction³
How Feeding and Eating Disorders Contribute to Relapse
Eating disorders and addiction share the same brain reward systems, the same patterns of compulsion and loss of control, and often the same underlying emotional pain. When one is untreated, the other cannot heal.
- Both Disorders Serve the Same Function
Restricting, bingeing, purging, and substance use all numb or escape overwhelming emotions. - Substances Are Used to Manage the Eating Disorder
Stimulants suppress appetite; alcohol numbs shame; laxatives become their own dependence. - Without Treating Both, Relapse Is Likely
When substances are removed, eating disorder behaviors intensify—and vice versa.
How Feeding and Eating Disorders Are Identified & Diagnosed
Eating disorders are frequently hidden—individuals become expert at concealing behaviors, and many maintain normal weight despite severe illness. Substance use can mask eating disorder symptoms, and eating disorder behaviors can be mistaken for consequences of addiction. Accurate diagnosis requires time and careful observation.
What proper diagnosis requires:
- Comprehensive assessment of eating behaviors, body image, and relationship with food
- Monitoring during sustained sobriety to distinguish eating pathology from substance effects
- Medical evaluation for physical consequences often hidden by the individual
"We see clients who stopped using substances only to have their eating disorder spiral out of control—or who recovered from anorexia and immediately relapsed on stimulants. These conditions share the same roots and require integrated treatment."
Long-Term Treatment for Feeding/Eating Disorders and Addiction
Eating disorders and substance use disorders share neurobiological pathways, emotional functions, and patterns of compulsion. Recovery needs time for both conditions to be diagnosed, treated, and stabilized. Our long-term, progress-based model provides the extended structure needed for genuine healing.
- Time to Identify Hidden Eating Pathology
Eating disorders are often concealed for months; long-term treatment allows patterns to emerge. - Integrated Treatment for Connected Conditions
Both disorders must be treated together to reduce the risk of relapse. - Measuring Progress by Behavioral Change, Not Days
Clients advance when they show healthier relationships with food.
² Food for Thought: Substance Abuse and Eating Disorders (National Center on Addiction and Substance Abuse at Columbia University, 2003), cited via NEDA.
³ Mortality rates in patients with anorexia nervosa and other eating disorders: A meta-analysis of 36 studies (Arcelus et al., 2011), Archives of General Psychiatry.
