September 25, 2018

The Link between Eating Disorders and Other Mental Health Diagnoses

The Link between Eating Disorders and Other Mental Health Diagnoses

One thing that makes eating disorders so difficult to live with and to treat is that they often do not exist in isolation. A very large number of people suffering from eating disorders may also suffer from another illness. For instance, it is extremely common for someone with an eating disorder to have significant anxiety—and there is likely a biological relationship between eating disorders and anxiety symptoms. Depression is also extremely common in relation to eating disorders. This may be related to biological traits that are similar; however, it may also be related to the change in brain chemistry that occurs with starvation, binging, purging, and/or other eating disorder behaviors. Or it may exist as a completely separate diagnosis.

It’s also common for an eating disorder to exist alongside a substance use disorder. Some people with eating disorders use substances as a way of dealing with the pain of the disorder or past abuse, but others may have a more complicated relationship with drugs and alcohol with a less clear “cause and effect” relationship.

Addressing a history of trauma is also critical for the treatment of eating disorders. Unfortunately, we live in a world where trauma is common and many individuals with eating disorders have witnessed trauma or been subjected to it. Again, the biological relationship of 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 those 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. Our current understanding is that the eating disorder should be addressed prior to the trauma because trauma treatment may worsen eating disorder behaviors. However, there is no one-size-fits-all solution and treatment programs at The Emily Program directly address individuals who may be suffering from both trauma, related symptoms, and an eating disorder.

For many, having a second or third co-occurring condition in addition to the eating disorder will complicate treatment. It is essential that every issue is addressed. If treatment does not apply to an individual’s other mental health issues, such as anxiety, depression, obsessive-compulsive disorder or attention issues, it’s likely that the treatment will not be successful. This is why eating disorders require a full treatment team and often a higher level of care.

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.



Mark Warren, MD

Mark Warren is the chief medical officer of The Emily Program. He is also one of the original founders of the Cleveland Center for Eating Disorders, which became The Emily Program – Cleveland in 2014. A Cleveland native, he is a graduate of the Johns Hopkins University Medical School and completed his residency at Harvard Medical School. He served as Chairman of the Department of Psychiatry at Mt. Sinai Hospital and Medical Director of University Hospital Health System’s Laurelwood Hospital. A past vice-chair for clinical affairs at the Case School of Medicine Department of Psychiatry, he continues on the Clinical Faculty of the Medical School, teaching in both the Departments of Psychiatry and Pediatrics. He is currently a faculty member and former chair of the Board of Governors at the Gestalt Institute of Cleveland. Dr. Warren is a Distinguished Fellow of the American Psychiatric Association, 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 leads the Males and Eating Disorders special interest group for the Academy of Eating Disorders.

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