A patient with an eating disorder may have a substance abuse problem, and vice versa. Both need to be addressed if progress is to be made in either.
Substance abuse may include: alcohol, tobacco, marijuana, cocaine, amphetamine, opioids
The prevalence of substance abuse varies with the type of eating disorder and may be highest in patietns with bulimia.
Barriers to problem resolution:
(1) secretiveness (unwilling to disclose eating disorder or substance use)
(2) high functioning
(3) substance misuse in family and friends (shared coping mechanism)
(4) belief that the substance use or eating disorder is not a problem
(5) fear of weight gain if substance is stopped or belief that the substance is helpful for weight control
The patient should also be screened for other addictive activities such as gambling or shopping.
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Specialty: Psychiatry, Toxicology, Nutrition
