Eating disorders have one of the highest mortality rates of all psychological disorders (Neumarker 1997; Steinhausen 2002). Approximately 15 percent of women in substance abuse treatment have had an eating disorder diagnosis in their lifetimes (Hudson 1992). Three eating disorders are currently included in the DSM-IV-TR: anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified (APA 2000a). Compulsive eating, referred to as binge-eating disorder, is not included as a diagnosis in the DSM.
Currently, it is theorized that substance abuse disorders and compulsive overeating are competing disorders, in that compulsive eating (binge-eating) is not as likely to appear at the same time as substance abuse disorders. Consequently, disordered eating in the form of compulsive overeating is more likely to appear after a period of abstinence, thus enhancing the risk of relapse to drugs and alcohol to manage weight gain.
Bulimia nervosa, characterized by recurrent episodes of binge and purge eating behaviors, has the highest incidence rates in the general population for eating disorders (Hoek and van Hoeken 2003), and it is the most common eating disorder among women in substance abuse treatment (Corcos et al. 2001; Specker et al. 2000; APA 2000a).
Center for Substance Abuse Treatment. Substance Abuse Treatment: Addressing the Specific Needs of Women. Treatment Improvement Protocol (TIP) Series 51. HHS Publication No. (SMA) 09-4426. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2009.