The Connection Between Eating Disorders and Substance Use Disorders

Abstract

Eating Disorders (ED) and Substance Use Disorders (SUD) commonly occur. In fact, approximately 50% of individuals with an ED report abusing alcohol or an illicit substance. Given the high rates of co-occurrence of ED and SUD, it is important to understand the connection between these disorders to guide prevention and treatment efforts. This chapter reviews shared etiological factors connecting ED and SUD. More specifically, neurobiological and candidate gene studies independently exploring SUD and ED suggest that similar genetic variants in both the dopamine and serotonin systems might influence ED-SUD comorbidity. Connections between ED and SUD are accounted for by shared characteristics related to reward sensitivity, impulsivity, executive function deficits, and emotion dysregulation. Additional shared risk factors include stress, environment, and trauma. These shared etiological factors highlight the importance of treating transdiagnostic mechanisms that contribute to both ED and SUD. Interventions that target the reward system, temperament, emotion regulation, and stressor-related symptoms are all essential to this work.