Understanding the Connection: Eating Disorders & Alcohol Use
The connection between alcohol use and eating disorders is more common—and more complex—than many people realize.
Research shows that up to half of those with an eating disorder have also struggled with substance use. And for people with a history of substance use challenges, the likelihood of also experiencing an eating disorder is approximately 11 times higher than in the general population.
While every story is different, eating disorders and substance use disorders can share common threads, such as emotional pain, histories of trauma, or traits like impulsivity and perfectionism. Disordered eating and substance use behaviors may look different on the outside, but both can serve as ways to cope with overwhelming thoughts or feelings.
That’s why integrated support is so important. At The Emily Program, we recognize the toll of this overlap and the added burden it can place on people seeking help. Too often, treatment for eating disorders and substance use happens in silos, forcing individuals to navigate one while putting the other on hold.
To help close that gap, our Cleveland outpatient site is piloting a new track of care designed to support both concerns—together, in one integrated and trauma-informed space. The initiative is led by therapist Amy Allison, LPC, CRC, CDCA, RYT 500, who has a decade of experience in the mental health field. “I’ve always been passionate about helping people,” she says. “And over the years, I found myself gravitating toward helping people with addictions and eating disorders.”
To understand why this track matters, it helps to look more closely at how these struggles can overlap.
Why Eating Disorders and Alcohol Use Often Go Hand in Hand
Eating disorders and substance use disorders don’t always emerge at the same time—or for the same reasons. But over time, they can become closely connected in ways that aren’t always obvious at first.
For some, alcohol may be used to quiet the anxiety that follows eating. For others, eating behaviors may intensify after drinking—sometimes as a way to cope with shame, sometimes in response to the loss of inhibition. In either direction, these patterns can reinforce each other, creating a cycle that’s difficult to disrupt.
Importantly, this cycle isn’t about a lack of willpower. It’s often about survival—about managing pain, trauma, overwhelm, or emotion in the only ways that may have felt accessible at the time.
While every person’s experience is different, certain factors can increase the likelihood of both eating disorders and problematic alcohol use. These include:
- Trauma or post-traumatic stress
- Co-occurring anxiety or mood disorders
- Difficulty regulating emotions
- Perfectionistic or impulsive traits
- Low self-worth or body image distress
- A family or genetic history of either condition
These vulnerabilities don’t guarantee someone will develop either struggle—but they can create the conditions where behaviors that initially offered relief become increasingly difficult to let go of.
“I truly wish people understood that these are both diseases,” says Amy. “Our clients did not ask to have eating disorders or substance use disorders. Healing takes time and support, and part of that starts with not being shamed for needing support or help, or for having a disease.”
Shame is a powerful barrier to seeking help. Many people feel like they have to choose which condition to address first, or worry that their full story is too complicated to be treated in one place. That’s one reason Amy and the Cleveland team felt so strongly about creating a space where both concerns could be addressed in tandem.
Supporting Clients with Both Eating Disorders and Alcohol Use Concerns
People navigating both an eating disorder (ED) and a substance use disorder (SUD) are often told—directly or indirectly—that they need to choose which to treat first. This separation of care can leave people feeling fragmented, unseen, or caught between systems that don’t fully understand the complexity of their experience.
The track now piloting in Cleveland was created to close that gap. It’s led by local clinicians and supported by organizational leadership, and offers a more integrated approach to care.
“I’m grateful for the support of our senior leadership in allowing us, in Cleveland, to pilot this track,” Amy says. “It’s something our team has wanted to offer for a long time.”
She explains the track’s purpose this way: “Our ED-SUDs track aims to help clients who are dealing with comorbid eating disorders and substance use disorders. The goal is to eliminate the experience of being bounced back and forth from eating disorder treatment and substance use disorder treatment.”
Rather than dividing treatment across providers, this track brings both concerns into one therapeutic setting. It’s not a standalone program, but a specialized offering embedded within our existing levels of care—designed to provide more coordinated, comprehensive support.
“This track within The Emily Program gives clients space to navigate their eating disorders and substance use disorders simultaneously,” Amy adds. “Much of the research out there indicates that treating both together is crucial for long-term recovery. The goal is to separate the disease from the client, allowing clients to live their life worth living.”
By naming both disorders, honoring the full context of someone’s experience, and treating both in one setting, the track reinforces a core belief of The Emily Program: that people are more than their diagnoses—and that healing becomes more possible when we treat the whole person.
You’re Not Alone: When to Reach Out
It’s common to wonder if your experience is “serious enough” for treatment—especially when you’re navigating more than one concern. Maybe drinking only feels problematic sometimes. Maybe the eating disorder is harder to talk about, or feels easier to hide. Maybe you’re worried that your story is too complex to be understood.
But healing doesn’t require certainty. It just requires a willingness to take one step.
If you’ve noticed alcohol use becoming tangled up with how you eat, cope, or feel about your body—you’re not alone. These patterns can take many forms, including:
- Using alcohol to quiet food-related anxiety or guilt
- Restricting food intake to “make room” for drinking
- Binge drinking followed by binge eating or purging behaviors
- Feeling out of control around both substances and food
There’s no single “right” version of what it looks like to struggle. If any of this resonates with you, you deserve care that understands the full picture.
“If you are unsure if treatment is for you, I encourage you to give it a try,” says Amy. “We never truly know if something will or won’t help until we try it. If you’ve been struggling or having a hard time, now is a good time to see if treatment is for you. You are not alone, and in our programs and tracks you’ll be supported by wonderful staff and peers that will do their best to help you.”
If you’re feeling overwhelmed, uncertain, or afraid to ask for help—that’s okay. You don’t have to have it all figured out. You just have to start somewhere.
We’re here when you’re ready.
Want to learn more about the launch of our new ED-SUDs track in Cleveland? Read the full announcement here.
If you or someone you love is experiencing challenges with food, body image, and alcohol use, we’re here to help. Call us at 1-888-272-0836 or fill out our online form to take the first step toward healing.
Founded in 1993, The Emily Program is nationally recognized for our compassionate and personalized approach to eating disorder awareness, treatment, and lifetime recovery. We understand the tangled complexities of eating disorders, often from personal experiences. We know that you’re not defined by your eating disorder, and our team of experts—including therapists, dietitians, and medical staff—focuses on treating the whole person. We provide an integrative approach for people of all ages and genders who struggle with eating disorders and related mental health and body image issues. The Emily Program care teams bring decades of experience managing the unique medical and psychiatric complications of eating disorders. With convenient locations in GA, MN, NC, OH, PA, and WA or within a virtual environment, The Emily Program is here to help you no matter where you live. For more information, please visit emilyprogram.com.