The association between disordered eating and substance use and abuse in women: a community-based investigation

A behavioral analysis was conducted of various eating disorder behaviors and their relationship with the lifetime use of different substances in a community-based sample of young adult women, aged 18-25 years. Women with particular eating disorder behaviors were selected from the 517 women who completed the Women's Health Survey. Analyses compared the frequencies of lifetime use of a range of licit and illicit substances as well as the abuse of prescription medications between each of the eating disorder groups and the normal control group. Results showed that as eating disorder behaviors became more severe, or were clustered together, the number of substance classes used, increased. Severe bingeing was consistently associated with alcohol use. Dieting and purging, with or without bingeing, was associated with the use of stimulants/ amphetamines and the abuse of sleeping pills. The results of this study suggest that the co-occurrence between subclinical levels of eating disorders and the use and abuse of a wide range of substances should inform assessment and treatment planning for adult women.