Demi Lovato’s headline grabbing admission that her eating disorder led to her overdos
e in 2018 should be headline grabbing.
This interaction between substance use and eating disorders is, curiously, little recognized; sometimes even within the substance and eating disorder treatment
communities. It’s no surprise to many of us – those of us who know the science, those of us who’ve experienced it. Yet, even then, we sometimes fail to connect the dots.
It’s true that there are a lot of differences between eating disorders and substance use disorders, and there are a lot of differences in the way they’re treated. But there are a lot of similarities, too. Both are disorders of the limbic system and the reward pathway. The brain likes the release of dopamine and both substances and eating disorders (as well as other potentially compulsive behaviors like spending) provide.
After so many years, sometimes decades, of suppressing our guilt, anger, sadness, joy (!), fear through an eating disorder; recovery can be challenging in its own right. It’s so easy to slip between substances and eating disorders and other compulsive behaviors. All we know is that we’re not in our eating disorder anymore, often without realizing that we’ve replaced it with something else.
I’ve worked with so many folks to tell me “I stopped drinking 15 years ago!” without recognizing that this is when their disordered eating began. Or “I’ve been behavior free for 10 years!” only to discover that their drinking started to increase shortly after.
Other folks find that their substance use is an integral part of their eating disorder. Alcohol allows them to not care long enough to eat, maybe even binge. Adderall allows them to get through their nursing shift, get their kids off to school and clean the house; all without that pesky need to take time to eat. Getting into recovery from our eating disorder means getting into recovery from our substances. Forgive the bad pun – but that can be a hard pill to swallow.
Our brains desperately want to regulate; they want to feel “good.” Behaviors and substances help us do that. At least in the short term. In recovery, we’re battling against our brain’s limbic system; a powerful foe for sure. Pretty much all our instinct and survival are wrapped up in that tiny area. There is no thought, just the need to “do.” Eating disorders and substances can trick our limbic system into believing that they are necessary to keep us alive even though, often, the opposite is true.
We can’t control cravings and urges to use or engage in behaviors, but we can create a solid support system. We can set up accountability. We can choose to live in the solution. We don’t have to do it alone. We need our supporters to notice what we won’t or aren’t able to. Demi says
that she wishes she’d had people around her who would have noticed. Is it a guarantee we won’t slip? No. But we have a better chance if we’re armed with support, education, self-care and honesty.
Leah Young, LCPC, is the Clinical Manager of the Addiction Recovery Track at Eating Recovery Center and Insight Behavioral Health Centers. Leah has been with ERC Insight for nearly 4 years, introducing substance use treatment and education into the Mood, Anxiety and Trauma, Binge Eating Treatment and Recovery and Eating Disorder Programs at all levels of care.
Leah earned her Master’s from The Chicago School of Professional Psychology in 2007. Upon graduation, Leah was hired at Resurrection Behavioral Health as a clinician, running evening IOP groups for patients with substance use disorders. She was promoted to the position of Program Manager at the re-named Presence Behavioral Health which she ran for several years before coming to ERC Insight in order to reconnect with clinical work. She lives in Chicago with her exuberant 6 year old daughter, her hilarious husband and her two annoying cats all of who enjoy some good punk rock music. Maybe with the exception of the cats.