Eating Disorders, Substance Abuse, and Substance Abuse Disorders

Thrive • March 24, 2022

By Thrive Reno Therapist Alexandra Corona, MFT-Intern, CADC-Intern

Eating disorders commonly co-occur with substance abuse and substance use disorders (SUD), which are behavioral health conditions that develop when addiction is present. Individuals with eating disorders most typically abuse alcohol, laxatives, emetics, diuretics, amphetamines, heroin, and cocaine. Although researchers are still exploring the relationship between eating disorders and substance abuse, the prevalence of co-occurrence is evident as exemplified in the statistics below. 

THE RELATIONSHIP BETWEEN EATING DISORDERS AND SUBSTANCE ABUSE

Both eating disorders and substance use disorders are extremely complex. When the two kinds of disorders co-occur, they become even more complicated, and researchers are still working to understand the associations between them.

Some individuals develop an SUD before an eating disorder, while others develop an eating disorder before an SUD. Furthermore, some theories identify disordered eating behaviors, such as binging and purging, as types of addiction in themselves. Eating disorders and SUD do share some of the same risk factors and characteristics which may help explain the high prevalence of co-occurrence.

Shared Risk Factors and Characteristics

  • Family history: Many individuals with eating disorders have a family member who also experienced one. The same goes for substance use disorders. Because stigma surrounds both illnesses, many families veil them in secrecy. As a result, individuals are frequently unaware that they have a loved one who has struggled with an eating disorder or substance abuse. 
  • A history of trauma, abuse, or neglect: Painful experiences involving trauma, abuse, or neglect increase the risk of developing both eating disorders and substance use disorders. Both drug abuse and disordered eating behaviors can be attempts by individuals to cope with emotional pain caused by trauma, abuse, or neglect.  
  • Brain chemistry: Eating disorders and substance use disorders are illnesses that affect the brain. Additionally, the behaviors associated with both illnesses can become ingrained within the brain.
  • Low self-esteem : Many individuals who struggle with substance abuse and/or eating disorders also struggle with low self-esteem, which can lead to feelings of worthlessness and drive unhealthy behaviors.
  • Lack of family and social connection: Commonly, individuals who develop substance abuse or eating disorders lack a healthy connection with their families. Additionally, individuals who struggle with substance abuse and/or eating disorders tend to withdraw from normal social interactions. To mitigate feelings of loneliness and increase feelings of support, most treatment programs for eating disorders and substance abuse emphasize the power of establishing healthy relationships with one’s family, friends, and community.
  • Impulsive personality types: Many individuals who struggle with substance abuse and/or eating disorders possess personalities that are prone to impulsivity and extremes, two characteristics of many behaviors associated with substance abuse and eating disorders.  
  • Compulsive behavior: Both substance abuse and eating disorders involve destructive behaviors that effectively overtake one’s life and interfere with their ability to carry out daily activities.
  • Social pressures: Both substance abuse and eating disorders tend to spread within social circles, and one’s peers can influence whether they begin to engage in behaviors associated with substance abuse and eating disorders.

THE DANGERS OF DRUNKOREXIA

At the intersection of eating disorders and substance abuse, drunkorexia is a colloquial term that describes the combination of disordered eating and binge drinking, seen most often in young adults. Individuals who engage in drunkorexia behaviors may restrict their food intake, use diuretics, purge their food, or exercise excessively in order to offset the calories taken in while drinking alcohol and/or increase the feeling of intoxication. When combined, these behaviors of food restriction and drinking can cause medical consequences including dangerous blood-alcohol levels, severe dehydration, vitamin depletion, and organ dysfunction. 

TREATMENT FOR EATING DISORDERS AND SUBSTANCE ABUSE

The stigma and secrecy that surrounds substance abuse and eating disorders alike can make it scary for individuals who are struggling with either or both to seek support. A simple conversation with a mental health professional, however, can put you on a path towards healing. At Thrive, we provide both outpatient and inpatient treatment that targets your mental, behavioral, and physical health. Reach out to learn more about our therapeutic services and treatment programs for co-occurring eating disorders and substance abuse. 

About the Author

Thrive Reno Therapist Alexandra Corona, MFT-Intern, CADC-Intern

Alexandra “Alex” Corona was born and raised in Reno, Nevada and boasts both a bachelor’s degree in human development and family studies (HDFS) from the University of Nevada, Reno and a master’s degree in marriage and family therapy (MFT) from Capella University. As a therapist at Thrive Wellness Reno, she currently supports clients who are struggling with eating disorders and perinatal mood and anxiety disorders (PMADs). Additionally, she offers outpatient therapy services for both individuals and families, specializing in trauma, anxiety, depression, and addiction. Alex is actively working towards becoming a licensed substance abuse counselor and certified sex therapist, as she is particularly passionate about helping others improve their lives in these aspects. She finds great fulfillment in encouraging individuals to form deeper connections with themselves and with their loved ones in order to reach their full potential authentically and unapologetically.

In her personal time, Alex enjoys living life to the fullest and adventuring with family, friends, and her three dogs.

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November 14, 2025
The Greenhouse at Thrive Wellness A New Chapter of Hope and Healing in Nevada On Friday, November 14 , we gathered with our partners at Molina Healthcare to share an important moment for our community. Together, we celebrated Molina’s generous $50,000 grant , an investment that is helping bring The Greenhouse to life. Their support is not only a financial contribution—it’s a statement of belief in the young people and families of Nevada who deserve access to compassionate, evidence-based mental healthcare close to home. This gathering marked the beginning of something we’ve dreamed about for years: a place designed specifically for adolescents and emerging adults to receive the care, connection, and support they need during some of the most vulnerable moments of their lives. Something New Is Growing In early 2026 , Thrive Wellness will open The Greenhouse , Nevada’s first residential treatment center devoted to adolescents and emerging adults navigating eating disorders, anxiety, and OCD . For too long, families have faced a heartbreaking dilemma—send their child far from home for treatment or go without the specialized care they need. The Greenhouse is our answer to that gap. It will be a place where young people can settle into an environment built for healing, where they are understood, supported, and surrounded by a team that believes in their capacity to recover. The Greenhouse represents a natural extension of our mission. It’s a living expression of our belief that recovery is possible—and that with the right support, families can find their footing again. 
November 11, 2025
Are you looking for a meaningful way to give back this holiday season? Thrive Wellness is excited to continue our 6th Annual Giving Tree Program in collaboration with Perenn Bakery this winter. This year, Thrive Wellness Reno and Perenn Bakery are proud to partner with Ronald McDonald House Charities® of Northern Nevada. The organization supports families with children receiving treatment at area hospitals, providing comfort, hope, and a home-away-from-home during challenging times. Ronald McDonald House Charities offers essential services, removes barriers, strengthens families, and promotes healing when children need healthcare the most. How It Works Simply take one (or a few) tags from the Giving Tree, each listing an item you can purchase and donate for residents of the Ronald McDonald House. Then, drop off your item(s) at one of our designated donation locations by Friday, December 19. Items Needed: Restaurant gift cards Walmart or Target gift cards Games, puzzles, and coloring books Toys (Barbie, Hot Wheels, Lego sets, craft sets, magnet blocks, baby dolls, action figures, journals, infant toys, etc.) Children's books (picture, chapter, and graphic novels) Toiletry sets (for adults) Lotion/self-care gift sets (for adults) Sweatshirts/hoodies (adults, XS-XXL) Scarves, gloves, fuzzy socks, pajamas (all sizes) Infant diapers, onesies, and baby bottles Bulk individually wrapped snacks (granola bars, chips, etc.) Please ensure all donations are new, in original packaging, and unwrapped. Donation Drop-Off Locations Please deliver donations by Friday, December 19, to one of the following sites: Thrive Wellness 491 Court St., Reno, NV 89501 201 W Liberty St., Suite 201, Reno, NV 89501 Perenn Grocery 7600 Rancharrah Pkwy, Suite 130, Reno, NV 89511 Perenn Rancharrah 7750 Rancharrah Pkwy, Suite 110, Reno, NV 89511 Perenn Midtown 20 St. Lawrence Ave, Reno, NV 89509 Claio Rotisserie 3886 Mayberry Dr., Suite D, Reno, NV 89519 Why We Give Back Through our Giving Tree program, we’re honoring one of our core values at Thrive Wellness: staying rooted in community. This annual tradition allows us to give back to those who need support most during the holiday season. We invite you to join us by taking a tag at any Thrive or Perenn location and helping spread kindness throughout our community. There’s no better way to embrace the holiday spirit than by supporting local families with thoughtful, heartfelt donations. We are deeply grateful for your generosity and continued support. Thank you for helping us make a difference!
September 22, 2025
Eating disorders are one of the most serious mental health concerns facing today’s adolescents. They can affect every aspect of a young person’s life, including their physical health, school performance, relationships, self-esteem, and more. According to the National Institute of Mental Health, about 2.7% of adolescents in the U.S. will experience an eating disorder in their lifetime, and many more engage in disordered eating behaviors that may not meet full diagnostic criteria. The good news is that providers are in an influential position to notice early warning signs, open conversations, and connect families to support before these patterns of behavior become too engrained. Why Early Intervention Matters The earlier an eating disorder is identified and treated, the better the treatment outcomes. Research shows that getting support quickly after the disorder’s onset is linked to faster recovery, lower relapse rates, and healthier long-term development (Treasure & Russell, 2011). Waiting too long to seek help can mean medical complications, deeply ingrained behaviors, and a more difficult path to healing. For many adolescents, a caring provider who notices the signs and advocates for treatment can make all the difference in recovery and can even save lives. Recognizing Early Warning Signs Adolescents may not always disclose their struggles directly, so providers should keep an eye out for a range of indicators: Physical signs: noticeable weight changes, menstrual irregularities, digestive issues, dizziness, or fatigue. Behavioral patterns: skipping meals, restrictive eating, excessive exercise, frequent dieting, eating in secret, or leaving for the bathroom after meals. Emotional and cognitive signs: preoccupation with weight or body shape, food rituals, heightened anxiety around eating, or perfectionistic tendencies. It’s important to remember that eating disorders don’t always “look” a certain way. Teens can be distressed about food and body image even if their weight appears to be within a “normal” range. Screening Tools and Assessments Using free screening tools available online can be an effective way to gauge a patient’s needs and gain further insight on treatment options for a possible eating disorder. Here are 4 free screening resources we recommend you use before making a referral for a higher level of care. EDE-Q (Eating Disorder Examination Questionnaire) : helps assess eating attitudes and behaviors. Nine Item Avoidant/Restrictive Food Intake disorder screen (NIAS) : helps to assess the signs of ARFID in children. Eat 26 Screening Tool : a screening measure to help you determine attitudes towards food and eating. BEDS-7 (Binge Eating Disorder Screener) : for situations where binge eating is suspected. When possible, gathering input from parents, teachers, or coaches can also help, as teens may minimize their experiences out of fear or shame. The Role of Primary Care and Pediatric Providers Routine checkups are often where eating disorders first come to light. Providers treating children, teen, and adolescents can: Incorporate simple questions about eating habits and body image into wellness visits. Track growth charts and weight trends while pairing them with questions about mood, anxiety, and behavior. Foster trust by creating a safe, nonjudgmental space where adolescents feel comfortable sharing sensitive information and know there will be no weight stigma. Coordinating Multidisciplinary Care Supporting a young person with an eating disorder works best when care is collaborative . In order to treat the whole person, there are usually multiple members of a treatment team needed, including: Medical support: monitoring vital signs, lab work, and physical health. Therapeutic care: evidence-based approaches such as family-based therapy (FBT) and cognitive-behavioral therapy (CBT) help address thoughts and behaviors. Nutritional guidance: dietitians provide education, meal support, and reassurance. Family involvement: engaging caregivers empowers them to support recovery in everyday life. Addressing Barriers and Stigma Many families face challenges in seeking help, whether due to stigma, lack of awareness, or limited access to specialists. To help, providers can: Normalize conversations about body image and mental health as part of overall well-being. Use culturally sensitive approaches that honor diverse experiences with food, body, and health. Connect families to community organizations, online resources, or telehealth when in-person specialty care is limited. Eating disorders in adolescents are serious, but with early recognition and timely support, recovery is possible. Providers are often the first to notice changes and can play a vital role in opening doors to crucial support. By blending professional expertise with empathy and collaboration, providers can guide adolescents and their families toward lasting recovery and a healthier future. References National Institute of Mental Health. (2023). Eating Disorders . Treasure, J., & Russell, G. (2011). The case for early intervention in anorexia nervosa: theoretical exploration of maintaining factors. The British journal of psychiatry : the journal of mental science, 199(1) , 5–7.
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