Anorexic and Bulimics Anonymous (ABA) adapts the Twelve Step approach of AA for eating disorders.

Some studies find that 1 in 4 individuals diagnosed with an eating disorder will also develop a substance use disorder. Among adult women specifically with eating disorders, up to 50% report a history of substance abuse. Up to 35% of individuals with a substance use disorder also present with a co-occurring eating disorder. For context, that’s about 11 times higher the baseline of the general population.

It’s not so hard to see the connection between substances and appetite in general. Marijuana induces food cravings which can induce binge eating. Depending on the person, alcohol can increase or decrease appetite. Chronic heavy drinking can have long-term impacts on appetite and nutritional absorption. Nicotine and caffeine are widely used as appetite suppressants, hence the “European breakfast” consisting of coffee and cigarettes. There’s evidence of business in the early industrial eras providing their workers with those to avoid raising wages to cover a real breakfast. It should be noted though that studies about the effectiveness of their appetite suppression are mixed, and each person’s body will react differently of course. And by no means should you actually pick this up as a habit to lose weight, it’s not safe.

It should go without saying, but I’ll say it anyways: nothing on this site constitutes medical advice or should be seen as a substitute for consulting a medical professional. I’m just some dude looking at studies from actual experts. I do feel confident though in saying that you should not skip meals in favor of drugs.

From my understanding, at the level of peer support groups and recovery programs, treating the compulsive thoughts associated with eating disorders similarly to the cravings associated with addiction is a solid approach. Those with co-occurring disorders can apply recovery philosophies and tools throughout their lives, such as dealing with overlapping triggers at once.

On the other hand, unlike substances or many process addictions, no one can achieve complete abstinence from eating, so modified programs frame the issue as abstinence from the behaviors associated with their eating disorders.

Plus, while many recovering from substances do face nutritional imbalances, many in recovery tend to feel better simply through supplements and a restored appetite. That isn’t to say there isn’t a whole field and industry around remedying the ways substances interfere with nutritional absorption or deficits. However, for those with eating disorders, it’s far more likely that they will need medical professionals to assess physical complications that can stem from eating disorders. Starvation and purging cause different metabolic changes than chronic substance abuse, though both are real and serious. An alcoholic who hasn’t eaten a real meal in weeks might struggle to regain hold down food and return to their baseline appetite, but severely malnourished patients who attempt to return to baseline appetite can trigger fatal events. There are tragic stories you may have heard about Holocaust survivors who died from eating and drinking too quickly after being freed.

When the body begins to receive nourishment, it releases a surge of insulin that can drive essential minerals out of the bloodstream and into cells, triggering heart failures, respiratory arrest, and seizures. Sudden fluid shifts that produce electrolyte imbalances can trigger cardiac arrythmias in heart muscles that were weakened as they were broken down for energy. Stomach muscles that are responsible for pushing food through the intestines also atrophy, so eating can cause intense nausea and pain. I could keep going on, but I hope the point comes across: eating disorders require unique medical interventions from experts who know exactly how to calibrate meals and fluid ingestion, sometimes intravenously.

I’ve also been generalizing “eating disorders” as one group when they have extremely different characteristics. Anorexia nervosa can involve compulsions like addiction, but binge eating mimics substance use much closer since the body receives signals from the food as an external source.

Avoidant/Restrictive Food Intake Disorder (ARFID)

ARFID is an eating disorder that was introduced into the DSM-5 in 2013 where someone limits their food intake for reasons unrelated to body image or weight. Rather than anorexia or bulimia, it results from sensory sensitivity, past trauma, and a low drive to eat. To meet the criteria, there must be weight loss, nutritional deficiencies, dependence on tube feeding or nutritional supplements, and interference with regular social activities.

Eating Disorders in Men

There are countless women who have spoken about eating disorders and how it has affected their lives, and how systemic sexism in every layer of society plays a role in reinforcing harmful body standards. This section is not in any way intended to detract or denigrate their perspectives or the real data researchers have collected behind these standards. I only started with this section before Eating Disorders in Women because I’m a little more equipped to speak on standards of men.

While women are more likely to develop eating disorders than men, and that speaks to social gendered standards we all internalize, men still represent roughly 1 in 3 cases of eating disorders.

There are some notable differences in presentations, such as men being more likely to use excessive and compulsive exercise to compensate for calories while women are more likely to induce vomiting and abuse laxatives. Exercise can be a process addiction itself too, and one that many substance addicts can switch into in early recovery as a seemingly healthier substitute, but all things can be used in excess as an unhealthy crutch.

Also, men are less likely to be screened or seek help for eating disorders due to the assumption that it only impacts women, so when they do receive treatment, they tend to have more severe complications. Men who identify as LGBTQ+ are significantly more likely to experience issues with body image and eating disorders.

From 2000 to 2018, the prevalence of eating disorders across the world doubled and seems to continue rising, with men experiencing a faster growth rate than women. The post-pandemic tracking shows that the ratio of male-to-female cases has gone from 1:10 to 1:5 acccording to post-COVID pandemic data. The increase seems concentrated among 10 to 14 year old girls, but also 20 to 24 year old adults regardless of gender identification. Under the ARFID diagnostic category, we see a roughly equal gender split among the 6% of 10 year olds who meet the criteria.

Unquestionably, social media is

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Eating Disorders as Addictions

I’ll admit, I have little exposure to anything about eating disorders aside from what has been confided in me privately by people I’ve met. This section will thus rely heavily on what I found in the literature.

The general concept of disordered eating patterns is as old as the concept of habitual drunkenness, which is to say that you can find descriptions matching the disorders as far back as ancient Greece. Psychiatry as we know it emerged in the last couple centuries.

In 1868, Sir William Withey Gull, a doctor for Queen Victoria of England, observed a pattern of weight loss, cessation of regular periods, and dangerously low heart rates in young women that didn’t seem to result from any physical illness. In 1973, he used “anorexia nervosa” to mean a “nervous lack of appetite” and pointed towards a mental origin. The treatments he recommended involved removing patients from their old environments and implementing strict feeding schedules regardless of the patient’s appetite.

The term “eating addiction” was used in the 1930s to describe patients with patterns of binge eating. In the 1950s, the term “food addiction” was used. By the 60s and 70s, eating disorders were examined as their own psychiatric conditions beyond neurotic symptoms. In 1979, Gerald Russell

MankNotes

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Anorexic and Bulimics Anonymous

Avoidant/Restrictive Food Intake Disorder (ARFID)

Eating Disorders in Men

Eating Disorders as Addictions

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