The Link Between Eating Disorders and Other Mental Health Diagnoses
Eating disorders are complex illnesses for both the individuals who experience them and the professionals who seek to treat them. Among the complicating factors is that they seldom exist in isolation. Many people suffering from anorexia, bulimia, BED, and other eating disorders also experience other mental health conditions, such as anxiety, depression, substance use disorders, or a history of trauma.
The high prevalence of anxiety and depression among those with eating disorders hints at a biological connection between these conditions. Further research is needed to fully understand this relationship—to discern whether anxiety and depression are distinct diagnoses independent of eating disorders or if they are intricately intertwined outcomes of the same underlying biological factors. It’s also possible that these conditions are correlated to the change in brain chemistry that occurs with starvation, bingeing, purging, and/or other eating disorder behaviors.
Substance use disorder can often exist alongside an eating disorder as well. For some, substance use serves a way of coping with the distress caused by the disorder or past abuse. Others may have a more multifaceted relationship with drugs and alcohol with a causal relationship not always clearly defined. Substance use could also manifest as an eating disorder behavior. An example is “drunkorexia,” an unofficial term used to describe behaviors such as calorie restriction, excessive exercise, and/or purging to compensate for alcohol consumption.
A history of trauma is also common among those with eating disorders. Again, the biological relationship between trauma and eating disorders is complex and often not well understood. However, many report that their eating disorder started or worsened after a traumatic episode. We also know that individuals with this dual diagnosis often don’t feel fully well until the eating disorder and the effects of the trauma have been addressed and treated. For some individuals, treating the eating disorder prior to the trauma is recommended due to the possibility that trauma treatment may worsen eating disorder behaviors. However, there is no one-size-fits-all solution. The Emily Program’s treatment programs personalize treatment for individuals who may be suffering from both trauma, related symptoms, and an eating disorder.
The high presence of co-occurring conditions alongside eating disorders adds complexity to treatment, emphasizing the need to address each issue comprehensively. If treatment does not apply to an individual’s other mental health issues, it’s likely that it will not result in the best outcomes. This is why it’s so important that those with eating disorders are treated by a professional multidisciplinary team at the level of care that’s right for them. By prioritizing the treatment of co-occurring conditions, individuals with eating disorders can receive the holistic care they deserve, leading to improved overall well-being and long-term recovery.
Although eating disorders can be difficult to fight with one or more co-occurring mental health conditions, recovery is still within reach. Together we can find the path that leads you there.
If you or a patient are coping with an eating disorder with or without a co-occurring condition, please reach out to The Emily Program at 1-888-364-5977 or complete our online form.
ABOUT THE AUTHOR
Mark Warren, MD, MPH, FAED
Dr. Mark Warren is the Chief Medical Officer of Accanto Health, the parent company of The Emily Program and Veritas Collaborative. He looks at how Accanto Health can increase our patients’ safety and how we can treat both the physical and psychological side of eating disorders. He works with the executive team and all of the medical staff to help all of our patients take a journey towards a meaningful life full of joy.
Dr. Warren is a Distinguished Fellow of the American Psychiatric Association, a Fellow of the Academy of Eating Disorders, where he co-founded the SIG in Professionals and Recovery and the SIG for Males and Eating Disorders. He is a two-time recipient of the Exemplary Psychiatrist Award of the National Alliance for the Mentally Ill, and a winner of the Woodruff Award. He has published and spoken extensively on Males and Eating Disorders, Professionals and Recovery, and DBT and FBT in the treatment of eating disorders.
Dr. Warren was a founding member and co-chair of the Academy of Eating Disorders Medical Care Standards Committee and serves on the FEAST Medical Advisory Board and The Visiting Committee of the Case Western Francis Payne Bolton School of Nursing.
As someone who experienced an eating disorder as a young man, Mark feels very privileged to be working in the field of eating disorders.