A recently published study of more than 7500 subjects who had identified themselves as having an eating disorder (ED) has examined the statistical likelihood to have co-occurring anxiety disorders and substance use disorders (SUD). Including both prescription and nonprescription drugs, historical research has long indicated a high concurrence. With up to 50 percent of individuals diagnosed with ED also experiencing SUD issues, and more than a third of those with SUD meeting criteria for ED, this study has presented long reaching impact. Through this research, health care providers may be able to build more effective methods of treating eating disorders and their affiliated comorbidities, having now established the link.
By studying individuals with both ED and SUD, researchers aim to determine ways to prevent severe health consequences and develop treatment to effectively answers these individuals’ needs. Findings from the new study (Rodan, et. al) show high incidence of self-medication among those experiencing anorexia nervosa (AN), bulimia nervosa (BN), or binge-eating disorder (BED) often motivated by anxieties. The behavior may often stem from the patient’s perceived benefit of the substance being abused, as well as from a desire to seek non-medical relief due to the social stigmas of either ED or SUD.
Key Points
- In the 2025 study, 40 percent of all subjects reported anorexia nervosa (AN), 19 percent bulimia nervosa (BN), and 11 percent binge-eating disorder (BED).
- Of the total study group, subjects also reported having depression (65 percent), anxiety (55 percent), SUD (15 percent) and alcohol use disorder (9 percent).
- Prescription medications being used by those with ED include: selective serotonin reuptake inhibitors (SSRIs) for anxiety and depression; lisdexamfetamine (Vyvanse) for BED; and GLP-1 receptor agonists such as Ozempic (sometimes without prescription or a doctor’s supervision). Study subjects reported mixed to moderately effective results with each of these medicines.
- Subjects reported the frequent use of non-prescription cannabis and psychedelic substances to manage feelings of anxiety, dysphoria, and obsessive thoughts about food. Some individuals with AN have also historically presented as high risk for abuse of Schedule II drugs in cluding cocaine or amphetamines to facilitate binge-purge cycles.
Looking Ahead
Despite both longstanding and new research, most health care structures are currently under-informed and ill-equipped to provide adequate treatment for a co-occurring eating disorder and substance use disorder. Few clinicians have firsthand experience with both conditions. As a result, programs designed to treat one disorder may not properly identify the other or overlook the signs of comorbidities altogether. Such scenarios increase the likelihood of negative outcomes, including mortality; the National Eating Disorders Association (NEDA) reports premature deaths occur often among those who have both ED and SUD due to suicide, cardiovascular disease, or long-term effects of sustained malnutrition.
While educating providers on the relationship between ED and SUD is a top field focus, emerging medical treatments are being backed by pharmaceutical companies and a number of colleges. Low-dose Schedule I psychedelic medications taken under careful supervision to “dismantle default brain patterns, [and] enable increased brain flexibility,” in controlled environments show potential, say the organizations. Advocates say the treatment can encourage patients to form new neural pathways and psychological resilience to interrupt existing harmful patterns.
Ongoing trials and emerging medical treatments may offer new therapies well into the future, but legalized care models are getting realistic about the population with these co-occurring disorders. Integrating the needs of the dually diagnosed population and knowledge infrastructure improvements are expected to continue to unite the behavioral health community.
Sources:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2836693