Eating disorders (EDs) pose a serious threat to physical and mental wellbeing. Anorexia (AN) is characterized by extreme diet restriction and fear of weight gain, bulimia (BN) by vicious binge-purge cycles, and binge eating disorder (BED) by frequent binges, or consuming very large quantities of food while feeling a loss of control over one’s action. Individuals experiencing significant distress and impairment from maladaptive thoughts and behaviors related to eating, food, or body image but who do not meet criteria for AN, BN, or BED may also be diagnosed with Other Specified Eating and Feeding Disorder (OSFED). Moreover, EDs do not always occur in isolation. The complications associated with eating disorders can be exacerbated or prolonged when combined with alcohol misuse and binge drinking. In fact, eating disorders are highly comorbid with substance use disorders, particularly alcohol use disorder.[1] This co-occurrence, however, varies across diagnostic subtypes. For example, research studies have found that individuals with BN may be up to three times more likely to report alcohol misuse problems than women without BN.[2] Among individuals with AN, those with binge-purge subtype endorse higher rates of alcohol abuse (22%) compared to restricting subtype (12%). Research has also identified biological factors that may partly account for the relationship between the two disorders. Recent genetic analyses have observed strong genetic overlap between bulimic behaviors (e.g., binging and purging via vomiting, laxative use, excessive exercise, or diet pills) and problematic alcohol use[3] and alcohol dependence.[4]^,[5] Brain imaging studies have shown similar patterns of activation in executive control and some reward regions of the brain in alcohol use disorder and BN/BED.[6]

Written by: Paige J. Trojanowski