An eating disorder is a psychological condition where the person develops an unhealthy relationship to food. Sometimes, an eating disorder is linked to drug use.
There are three major eating disorders: anorexia, bulimia, and binge eating disorder.
With anorexia the person develops an aversion to eating and subsists on an extremely low calorie diet in an effort to stay slim. In severe cases of anorexia, the anorexic person might not eat anything at all for days at a time. They ignore their hunger cues and, after a while, might no longer feel those cues at all.
With bulimia, the person develops a cycle of binging followed by purging, usually in the form of vomiting. Sometimes bulimia is connected to compulsive eating disorder. Bulimics might also use laxatives to eliminate calories or over exercise to burn the calories they have consumed.
Binge Eating Disorder
With binge eating disorder, the person has cycles of binging but without the purging associated with bulimia. A person with this disorder may binge-eat on a daily basis, or have periods of normal eating interspersed with binging.
Non-Specific Eating Disorder
There is another class of eating disorder which is often called "non-specific." In general, non-specific eating disorders tend to combine some of the food restriction and aversions of anorexia, with the binging and/or purging elements of bulimia.
Eating Disorders and Drug Abuse
One of the most dangerous aspects of eating disorders is that they become so ingrained that people will do anything to maintain them, even when they know it is killing them. In that way, the psychology of eating disorders is similar to that of addiction. In fact, people with eating disorders might also abuse drugs (both legal and illegal) in an effort to control their bodies, and maintain their illness – the National Center on Addiction and Substance Abuse estimates that 50 percent of people with eating disorders also abuse drugs or alcohol.
Drugs That Support Eating Disorders
The truth is that any drug can support an eating disorder if it affects your ability to eat, or encourages purging. For example, someone who is sensitive to aspirin could take it to induce stomach pain, which would prevent her from eating. Someone who is addicted to staying slim might use a drug that suppresses the appetite. Another person might take drugs that stimulate the appetite, to encourage binging. That said, there are certain types of drugs that are abused more often than others in relation to eating disorders:
Stimulant drugs suppress the appetite, and they also energize people so they can keep going on few to no calories. A person with an eating disorder might start with a mild, over-the-counter stimulant like caffeine, nicotine, or diet pills. As the disease progresses and they need stronger stimulation, they could graduate to the stronger, illegal stimulants like cocaine and methamphetamine. Drugs like XTC (ecstasy) provide a sense of well-being and euphoria, in addition to increased energy and a reduced appetite. Some people might even combine stimulants, such as smoking several packs of cigarettes a day while using cocaine.
Opiates, Depressants, and Sedatives
Opiates, depressants, and sedative drugs dull the senses so that people don't feel their hunger, or much of anything else. A person might start out using alcohol, which is a depressant, opting to dull her senses with drink to avoid thinking about food. The alcohol could also provide emotional insulation, to keep her from feeling strong emotions that could lead to comfort eating. Alcohol has calories, however, and someone with anorexia might graduate to using something that doesn't contain as many calories – such as drugs like heroin and morphine, pain killers like Oxycontin, or an anesthetic-type drug like Ketamine.
In this context, prescription drugs refers to drugs that a doctor has prescribed to the individual, not prescription-level drugs purchased illegally.
Several legal prescriptions have side effects that can support an eating disorder. For example, some anti-depressants and anti-anxiety drugs suppress the appetite. Unfortunately, some people with eating disorders are prescribed these medications to help treat their conditions, and the drugs end up making their conditions worse.
Laxatives and Emetics
These types of drugs cause vomiting or increased bowel activity and are often used by people with purging as a component of their disease. People with binge eating disorders might also abuse laxatives because it clears the bowels, allowing them to eat more.
Treating an Eating Disorder
Treating eating disorders is very difficult. In fact, eating disorders have some of the highest relapse rates around. When drug addiction is part of the equation, it is even harder, because these are co-occurring diseases where one disease feeds into the other.
At this point, there are no cut-and-dried solutions for treating eating disorders. Counseling or therapy, and even support groups, are considered to be the most effective approach to treating eating disorders. Most therapists or counselors treating someone with an eating disorder will also work with other healthcare providers to address the patient's dietary needs to ensure she receives the nutrition she requires during recovery and in the long term. When drug addiction is a co-occurring problem, many mental health professionals opt to address the drug addiction first, or at least get their patients through a good detox program before tackling the eating disorder. Other professionals opt to treat both conditions together.