The National Center on Addiction and Substance Abuse at Columbia University has concluded that at least one half of women who suffer from an eating disorder also suffer from a substance use disorder (SUD). While eating disorders, and substance use disorders are linked to higher risk for mortality than all other psychological disorders, the two are present together result in a much more damaging outcome.
The rate of comorbidity varies among eating disorder classifications with the prevalence of SUD in individuals with Bulimia Nervosa or Anorexia Nervosa purging type much greater than individuals with Anorexia Nervosa, restricting type. Researchers have reported a higher use of stimulants, sedatives, and cocaine in individuals with Bulimia Nervosa, with marijuana and hallucinogen use in those with Anorexia Nervosa. It is speculated that the heighted impulsivity of those with Bulimia may reflect their more frequent use of these drugs along with the appetite suppressing nature of the drugs in individuals with Bulimia and those with Anorexia. It is also speculated that the escape offered by the drugs maybe appealing to those who suffer from anxiety associated with eating disorders.
Researchers at the University of Washington concluded that the onset of an SUD could be predicted in individuals with Anorexia Nervosa and Bulimia Nervosa if the individual had attempted suicide, or had been hospitalized. Furthermore, the severity of the bulimic symptoms could also be used to predict a future SUD.
For professionals working with eating disorder patients, a thorough knowledge of and specialized training in substance abuse is warranted, along with understanding the research regarding eating disorders and co-occurring substance use disorder. In a therapeutic setting, a thorough history needs to be completed in order to assess an individual’s comorbidity. It’s not acceptable for the clinician to omit an SUD diagnosis because the individual did not report substance use to that respective clinician – especially when the SUD is clearly documented in the individual’s history. If it is not documented, digging deep is a must for the clinician, given the concurrent nature of eating disorders and SUD. A thorough history can determine the degree of co morbidity in eating disorder patients and may also be used in determining treatment options that suit the patient’s unique coexisting disorders.
Behavioral therapies alone, or along with medications can be a highly effective for of treatment that can lead to more positive outcomes. Another treatment option for co-morbidities is Yoga therapy. Yoga therapy is the process of empowering individuals to progress toward improved health and well-being through the application of the philosophy and practice of Yoga. Yoga therapy incorporates a number of positive mind and body practices such as deep breathing, relaxation, deep meditation, and postural exercises. It adapts the practice of Yoga to an individual’s specific condition, and in the treatment of co-occurring eating disorders and substance abuse disorders, can be adapted to enforce a positive mental outlook, improved self-awareness and acceptance, and can relax and ground a patient.
Gamma-Amino Butyric acid (GABA) is an amino acid which acts as a neurotransmitter in the central nervous system. It inhibits nerve transmission in the brain, calming nervous activity. In recent studies, Yoga has been shown to increase the levels of GABA in the brain by more than 20 percent. This is important because people dealing with substance abuse usually exhibit low levels of GABA.
Mindful Yoga and meditation can affect the cerebral cortex, improving focus and awareness. The cerebral cortex is the center of the brain that is responsible for impulses, irrational thoughts and behaviors. Activating the cerebral cortex can diminish the impulsivity along with irrational thoughts and behaviors involved in eating disorders, substance abuse and related addictions.
The Concurrent Nature of Eating Disorders and Substance Use Disorders – Yoga as an Adjunct to Treatment Two (1) contact hours Tuesday June 20, 2017 11:45 am – 1:00 pm at Henry Ford Maplegrove, West Bloomfield, MI – Speaker BEVERLY PRICE, RD, MA, E-RYT 200, C-IAYT, CEDRD-S, IAEDP For more information or to register: Jessica Jacobs LMSW, MSW, CAADC (248)788-3011.
A special thank you to Bridgette Grabowski, NDTR, who researched the original content for this article.