Substance Abuse & Eating Disorder in Teens

Substance Abuse & Eating Disorder in Teens

It’s a parent’s worst nightmare – finding out their child or teen is illegally drinking and/or using drugs.

The statistics are alarming.  The National Institute on Drug Abuse reports a recent rise in marijuana use despite a preceding 10-year period of decline. In 2010, 1.2 percent of 8th-graders, 3.3 percent of 10th-graders, and 6.1 percent of 12th-graders reported daily marijuana use—defined as 20 or more occasions in the past 30 days.  Although the national average for alcohol abuse in teens has decreased, “In 2005, 4.4 million teenagers (aged 12 to 17) in the US admitted to taking prescription painkillers, and 2.3 million took a prescription stimulant such as Ritalin. 2.2 million abused over-the-counter drugs such as cough syrup. The average age for first-time users is now 13 to 14.” (

Often when parents find out their child is drinking and/or using drugs, they focus on putting a stop to those specific behaviors, as they should.  However, once your child is using drugs or alcohol to manage difficult feelings, did you know they are also more prone to life threatening eating disorders?

Half of individuals with eating disorders abuse alcohol or illicit drugs compared to 9% of the general population.  And up to 34% of alcohol or illicit drug users have eating disorders compared to 3% of the population.

If your child has an eating disorder, you must be extra careful to have her assessed for substance abuse problems, as well as the other way around.

Curtis Reed from Troubled Teen Search reports, “out of every ten teens dealing with substance abuse issues, three or four of them will also develop an eating disorder. That means struggling teens with eating disorders are five times more likely to abuse alcohol and drugs (ranging from caffeine and smoking to life-threatening street drugs). While other troubled teens abusing alcohol or illicit drugs are eleven times more likely to have an eating disorder.”

The Bermuda Triangle of Eating Disorders

In my therapy practice, I’ve coined a term I call the Bermuda Triangle of eating disorders.

What does that mean?

It is rare that a young person only has an eating disorder and no other harmful ways of self-soothing. They often have a group of unhealthy coping behaviors that switch off between each other over time and throughout life, i.e. alcohol and drug use, sex addiction, smoking, cutting, compulsive over work and/or compulsive exercise that they use along with, or sometimes in place of, an eating disorder.

Here is an example of story about one of my former clients.  He went to Alcoholic Anonymous for help with his drinking.  He told me that his sponsor totally quit using alcohol and drugs, which was great!  But the sponsor would opening binge, purge and compulsively diet, and didn’t see anything wrong that!

To me, that’s a prime example of The Bermuda Triangle: stopping one dangerous behavior, then switching to another because you never got to the root of the problem. In order to avoid The Bermuda Triangle, you need to look at all of these behaviors and know all of the unhealthy ways your child tends to deal with overwhelming when under stress.

This is so complicated.

A lot of adults and even therapists don’t think to look for all of the behaviors in the Bermuda Triangle, so how can we expect our children to be that savvy? Yet, if they don’t learn how to handle the stressors of life in healthy or life-affirming ways, they can set a precedent for using dangerous behaviors to cope throughout their lifetime.

Keep in mind the brain is not fully developed until age 25 when “childhood” is long over. So if your teen or young adult is using drugs and alcohol or hurting their bodies with eating disorder behaviors, they’re also affecting their developing brain and depriving it of the opportunity to learn and grow and develop healthy habits!

If your child doesn’t get to the root of the problem and figure out why he or she is self-soothing, then they may switch to drug use, or smoking pot, having more casual sex or over-exercising if they suddenly stop bingeing and purging, for example.

As a parent, what can you do to help?

First, if your child is seeing a therapist for eating disorder or substance abuse treatment, make sure that therapist knows to look out for the other harmful ways of self-soothing described above and knows how to successfully treat them.


Second, don’t be afraid to be assertive with doctors and other treatment providers about assessing for eating disorders, substance abuse, AND related problems.  Most of us grow up learning that doctors are absolute authorities who are not to be questioned.  Don’t let your fears of questioning authority figures keep you from asking providers perfectly reasonable questions about how and if they can help your child.  A good doctor, therapist, nutritionist, or psychiatrist will answer any and all questions you have about your child, and do so with patience and respect for YOU.  If they try to make you feel awkward or ashamed, it’s time to look elsewhere!

Remember, every single person, when they’re pushed too far and when they’re under stress, will have unhealthy ways of coping. They might gamble more. They might yell more. They might get depressed. They might use more drugs or alcohol. They may binge and purge, or starve themselves.  Just by being AWARE that these disorders can switch off or coexist puts you way ahead of most other parents in getting the best help for your child.

And remember, at The Body Image Counseling Center, we’re always here to help.