By BodyMatters therapist Sarah McMahon
When people present to our clinic with eating issues, often find that there is actually a lot more going on. As a standard peocedure, part of our intake & initial assessment involves sceening for some of the most common “comorbid” conditions, includimg depression, anxiety, bipolar and so forth. Another very common issue that we see is alcohol abuse. For all of these conditions, sometimes it pre-dates the eating disorder, other times it comes with the eating disorder symptoms & resolves as recovery takes place.
Alcohol abuse and eating disorders
The co-occurrence between alcohol usage and eating disorders is quite clearly documented in research, suggesting a relationship of up to 40%. I am also constantly hearing anecdotal information about people recovering from eating disorders and going on to develop serious issues with alcohol abuse . The co-occurence makes sense when considering the number of shared risk factors between eating disorders & alcohol. In particular:
- Most likely occurrence during times of transition or stress
- Often there is a shared family history- with possible inherited & environmental vulnerabilities
- Individual vulnerabilities that include low self esteem, depression, anxiety, impulsivity
- Susceptibility to messages from advertising and entertainment media
There are also a number of shared characteristics of both problems:
- Obsessive preoccupation, craving, compulsive behaviour, secretiveness, rituals
- Experience mood altering effects, social isolation
- Linked to other psychiatric disorders, suicide
- Difficult to treat, life threatening
- Chronic diseases with high relapse rates
- Require intensive therapy
You might be interested in reading more about the relationship between the two here. The thing that strikes me most is the role both play in anesthetizing emotions- very effectively.
Signs there may be a problem with alcohol
You may have chosen to read this article because of it’s title, and so it would be worth considering whether alcohol is a problem for you. If you can say “yes” to more than one of these points, you may have a problem with alcohol:
- Using alcohol to cope with stress, anxiety, anger or sleeplessness
- Regularly drinking more than 6 drinks on one ocassion
- Attempting to reduce alcoholic consumption with limited success
- Compromising on values or commitments due to aochol
- Experiencing “drinkers remorse” following a period of drinking
- Simply not being able to remember what has occured following a period of drinking
- Injuring yourself or another person due to alcohol
- Fights & conflict as a result of drinking
- Difficulty stopping drinking once it has commenced
- A friend, relative or doctor has expressed concern about your drinking
Warning: Alcohol is not good for you!
One of the few incentives for many people with eating disorders to reduce drinking is the fear of weight gain. Alcohol actually has many “bad effect”s. I have once heard a person likening drinking alcohol to drinking poison! While that may be a bit extreme, the following diagram illustrates of some of the effects on the body is as follows:
Basic suggestions for cutting down
If it does look like you have a problem with alcohol, it might be worth considering “cut down” or even “cut out” your drinking. If you do want to cut down your drinking, a few simple things you can do include:
- Say “no thanks”. Tell people you are cutting down or cutting out & enlist thier support. You might find it difficult to start with, however it will get easier so say ‘no’ with practice and experience
- Try low alcohol alternatives
- Take less alcohol with you when you go out
- Count your drinks. For stubbies, put the caps in your pocket to keep track; for cans, save the ring pulls. For wine, ensure you finish the glass before someone tops it up.
- Slow down your drinking by drinking mindfully (sip a glass over a period of 30 minutes) or by alternating with non alcoholic alternatives
- Drink water with meals & save alcohol for before/ after a meal
- Use small glasses for beer & wine
- When you feel you have reached your limit, simply drink something else. Again you might find it easier than you expected- you might not have needed that extra drink after all
What to do if these suggestions don’t work?
If you have tried some of the suggestions, however have been unable to cut down, you may need some extra help. You could try to cut it out for a period of time & see how that goes. However I would recommend considering professional intervention with a counsellor who specialises in working with alcohol abuse, particularly if it seems this is a bigger problem than the eating disorder.
At BodyMatters we also do see many clients who have a co-morbid or co occuring issue with alcohol, however are not specialists in working with alcohol addiction. Contact the Australian drug clearing house for information regarding treatment options.