Eating Disorders and Substance Abuse Disorders - Research Paper Example

? Eating Disorders and Substance Abuse Disorders Eating Disorders and Substance Abuse Disorders Eating disorders (EDs) and substance use disorders (SUDs) appear together frequently. EDs have psychological consequences such as problems with family and friends and low perceived happiness. Comorbidity of EDs and SUDs makes assessment, treatment, and recovery complicated than for either disorder(Courbasson, 2008). EDs are characterized by inconsistent eating patterns and negative attitudes towards food and body shape. This leads to loss of control, compulsive behavior and continuous use despite negative consequences. SUDs also have psychological effects such as poor brain function and behavior, and addiction. Research indicates that about 50 percent of people with ED abuse drugs such as alcohol (Courbasson, 2008). Integrated treatment of both disorders has been suggested by researchers, but few interventions provide combined treatment and the current research does not lay out the best procedure for simultaneous treatment. EDs can begin between 8 and 21 years although they can start later or earlier and the exact mechanisms that cause them remain unknown, but SUDs can occur at any stage of addiction (Courbasson, 2008). EDs such as anorexia nervosa, bulimia nervosa and binge eating affect over five million Americans (Harrop and Marlatt, 2010). Millions of others display some symptoms if not the full-blown disorder. EDs have devastating physical and mental health of which is the increased potential for substance abuse. Between 30 and 50 percent of people with bulimia abuse or are addicted to alcohol. Between 12 and 18 percent of individuals with anorexia abuse or depend on alcohol or other drugs. Approximately 35 percent of individuals abusing alcohol or drugs have an eating disorder compared to 3 percent of the general population without SUDs (Piran, Robinson and Cormier, 2007). Eating disorders mostly affect girls and women, but the problem is increasing among men. However, there is a small variation on the occurrence of EDs among men and women with SUDs. Substances frequently abused by people with EDs include caffeine, tobacco, alcohol, heroin, cocaine, laxatives, and appetite suppressants. Anorexia Nervosa (AN) is characterized by an insatiable desire to become slim, and the patient fails to maintain the minimum weight acceptable for age and height (Piran and Robinson, 2006). Anorexia mostly occurs in adolescent girls who develop a distorted perception of the body image, denial of illness, and fear of becoming overweight. The most common ages of anorexia are mid teens, but about 5 percent of the patients develop the disorder in their early 20s. The disorder occurs in 0.5 to one percent of the general population and 20 times more often in females than in males (Piran and Robinson, 2006). Although people with Anorexia lack appetite, they develop appetite and experience hunger, but they avoid consuming food. There are two types of AN namely restrictive and binge eating/ purging. Individuals suffering from restrictive anorexia have a low weight due to restricted food consumption and over exercising. Individuals experiencing binge eating and purging maintain a low body weight by restricting their food intake. However, they have binge eating, which is the inability to control food consumption until they experience discomfort or pain. Purging is the use of laxatives and other drugs to induce vomiting (Piran and Robinson, 2006). Bulimia Nervosa consists of recurring incidents of binge eating and vomiting, excessive exercising, laxative use, and fasting (Piran and Robinson, 2006). Individuals with BN are unable to voluntarily stop eating and feel out of control of their eating habits. Patients with BN maintain a normal body weight, which makes it hard to detect the disorder. About one-third of patients with BN have a history of anorexia nervosa. Bulimia Nervosa occurs in late adolescence or early adulthood (Piran and Robinson, 2006). BN occurs mostly among women than men, with an average development age of 18 years. Individuals with BN have medical consequences such as fluid and electrolyte imbalance, irregular menstrual periods, and reproductive system problems (Piran and Robinson, 2006). People with purging BN have erosion of teeth enamel, esophageal tear, and gastric rapture. Eating disorders that are below the diagnostic criteria of AN and BN are classified as other types of eating disorders. Binge eating disorder involves over consumption of food at once. Individuals with BED are not concerned with body weight and are usually obese (Harrop and Marlatt, 2010). This leads to anxiety due to overconsumption of food and excessive weight. Obesity is a growing problem in several countries with 64 percent of American adults being overweight or obese. Obese individuals develop addictive symptoms such as compulsive behavior and low brain chemistry. Individuals with BED develop medical problems such as diabetes, stroke, heart disease, high blood pressure, cancers, and gynecological problems (Harrop and Marlatt, 2010). Compulsive overeating also exists and is not accompanied by purging or binge. Individuals with compulsive overeating consume a lot of food as a mechanism of coping with emotions by disregarding hunger or fullness. Individuals with eating disorders may rely on coffee or caffeinated beverages to boost energy and alleviate hunger. For instance, an eight-ounce brewed coffee contains 135 milligrams of caffeine, an eight-ounce diet Mountain Dew contains 37 milligrams of caffeine, and an eight-ounce Diet coke contains more caffeine than regular coke. Regular consumption of caffeine leads to tolerance and withdrawal symptoms. These effects are common among low-weight women and men who consume large amounts of dietary caffeinated beverages. Research studies have indicated that girls and young women consuming large amounts of caffeinated drinks are trying to lose weight (Woodside and Staab, 2006). About 15.7 percent of young women and girls take diet pills to help them lose weight. These individuals often result to drinking coffee frequently to hasten the weight loss process. Excessive consumption of caffeine may lead to addiction and individuals experiencing EDs may consume large amounts of caffeinated drinks and pills to control their weight (Woodside and Staab, 2006). Dieting and eating disorders are strongly related to smoking. Women and girls who want to lose weight are attracted to smoking. Smokers have suppressed appetite and smoking is an alternative oral activity that reduces eating activities. Smoking usually attracts individuals with eating disorders who are obsessed with food. However, weight loss among girls and young women indulged in smoking is not very significant. Teens engaged in smoking may have an increase in body mass index for up to two years after initiation. Individuals who smoke and those who do not smoke have a very small variation in body weight. Adolescent girls with EDs and indulge in smoking have the highest levels of eating disordered attitudes and thoughts (Woodside and Staab, 2006). Smoking is common among bulimics and is prevalent among people with bulimia. Non-disordered weight-control behaviors increase the risk of smoking due to the perceived benefits of smoking. Individuals who suppress their appetite through smoking have potential for nicotine addiction making them vulnerable to tobacco abuse. High rates of alcohol misuse and abuse are evident among adolescents and adults with eating disorders (Klump et al, 2009). The relationship between EDs and alcohol abuse exists from cases of chronic dieting to extreme eating disorders. The prevalence of alcohol consumption among individuals with EDs is high than among people without eating disorders. Conversely, individuals who abuse alcohol have disordered eating behavior more often than among those who do not use alcohol. Individuals with BN have the highest probability of alcohol abuse compared to individuals with other types of ED. This increases the rate of suicide attempts, anxiety, and personality disorders among women with BN. Adolescent girls concerned about their weight have a high probability of early alcohol use. Individuals with a history of alcohol use control their weight through purging. Alcohol addicts accumulate body fat and are likely to participate in unhealthy dieting activities such as consuming diet pills, fasting, and using laxatives (Klump et al, 2009). Individuals with EDs often resort to prescription and over-the-counter drugs that reduce water retention and induce purging. These individuals purchase diet pills, powders, and liquids without a doctor’s prescription in order to reduce weight gain. Diuretics are available in OTC and prescriptions increase urination as a way of reducing water retention (Klump et al, 2009). Overconsumption of diuretics leads to nausea, vomiting, and gastrointestinal distress. Emetic agents are also common among individuals with EDs in order to induce vomiting and regulate body weight. Bulimics have a tendency of self-administering laxatives to reduce bloating after bingeing. Chronic abuse of laxatives can be fatal, and continuous consumption leads to diarrhea, weakness, nausea, dehydration, and abdominal pain. Repeated laxative use leads to tolerance and withdrawal symptoms occur after discontinuation. Most OTC diet pills contain PPA that helps suppress appetite and acts as a nasal and bronchial decongestant (Klump et al, 2009). Bulimia Nervosa is strongly linked to illicit drug use. Bulimics have a high likelihood of abusing a variety of drugs other than anorexics (Gadalla and Piran, 2007). Women with BN have a higher probability of using marijuana, cocaine, tranquilizers, and barbiturates compared to the general population. The highest number of illicit drug users is among individuals with binge and purge. Some bulimics use heroin to help them vomit after a heavy food consumption. Individuals with EDs may abuse cocaine and other stimulants to suppress their appetite and increasing metabolism as a way of reducing weight. Anorexics are attracted to cocaine since it helps suppress appetite that reduces the craving for food and gives them control over their eating habits (Gadalla and Piran, 2007). Cocaine users with eating disorders are more likely to use laxatives for weight loss than cocaine users without diagnosed eating disorders. Individuals with EDs have a high probability of developing addictions due to continued use of appetite suppression drugs (Gadalla and Piran, 2007). EDs and SUDs are long term and difficult to treat disorders that require intensive therapy. These disorders have a preoccupation with s substance, food or drugs, and a compulsive behavior characterized by loss of control. Individuals with SUDs and EDs are caught up inside cycles of overeating, bulimia, and intoxication. Treatment involves an intervention for addiction, disordered eating, and a combination of individualized and family or group therapy. Patients undergo a medical and psychiatric evaluation to determine the extent of the addiction (Gadalla and Piran, 2007). The disorders affect the nutritional health of the patient and nutritional rehabilitation and maintenance is necessary. Patients with AN or BN may have dehydration, starvation, and electrolyte imbalance. These conditions have serious health complications and hospitalization of patients in required as the first treatment. Hospitalization stabilizes the patient medically, and other forms of treatment for EDs and SUDs can be incorporated. Psychotherapy such as cognitive-behavior therapy attempts to correct distorted thinking patterns that lead to eating disorders. Therapists can combine other forms of therapy that address both disorders. Substance use disorders and eating disorders are strongly related. People with eating disorders have an urge of controlling their weight and may indulge in drug use as a remedy. Eating disorders range from overeating to low consumption. Individuals with EDs can become obese or maintain a low body weight below the standards of their age and height. People with EDs indulge in substance abuse in order to reduce their appetite, purge, increase metabolism, or reduce water retention. Substances such as nicotine, alcohol, and caffeine reduce appetite leading to low consumption of food. Drugs such as heroin, diuretics, and laxatives reduce water retention, induce vomiting and increase metabolism. These substances may lead to addiction or extreme medical implications such as dehydration. Treatment requires medical stabilization and therapeutic interventions that address the disorders. References Courbasson, R. W. (2008). Emotional Eating among Individuals with Concurrent Eating and Substance Use Disorders. International Journal of Mental Health Addiction, 6: 378-388. Gadalla, T., and Piran, N. (2007). Co-occurrence of eating disorders and alcohol use disorders in women: A Meta analysis. Archives of Women’s Mental Health, 10, 133–140. Harrop, E. N., and Marlatt, G. A. (2010). The comorbidity of substance use disorders and eating disorders in women: Prevalence, etiology, and treatment. Addictive Behaviors, 35, 392–398. Klump, K. L., Bulik, C. M., Kaye, W. H., Treasure, J., and Tyson, E. (2009). Academy for Eating Disorders position paper: Eating disorders are serious mental illnesses. International Journal of Eating Disorders, 42(2), 97–103. Piran, N., and Robinson, S. R. (2006). The association between disordered eating and substance use and abuse in women: A community-based investigation. Women and Health, 44(1), 1–20. Piran, N., Robinson, S. R., and Cormier, H. C. (2007). Disordered eating behaviors and substance use in women: A comparison of perceived adverse consequences. Eating Disorders, 15, 391–403. Woodside, B. D., and Staab, R. (2006). Management of psychiatric comorbidity in anorexia nervosa and bulimia nervosa. CNS Drugs, 20(8), 655?663. Read More