by Jasmine Atwal
Trigger Warning: Mentions of Suicide and Childhood Trauma/Abuse
Singer and Actress, Demi Lovato at Award Function, Gazette, 2020. Retrieved from Justin Bieber and Jennifer Lopez among E! People’s Choice Awards winners | Basingstoke Gazette
“I’m tired of running myself into the ground with workouts and extreme dieting. I thought the past few years was recovery from an eating disorder when it actually was just completely falling into it,” -Demi Lovato
Demi Lovato. Russel Brand. Elton John. Amanda Bynes.
Aside from being talented artists, these individuals share one more common link- they have all experienced eating disorders and substance abuse.
In 2018, Lovato was hospitalized due to an overdose and has since shared her heart-wrenching experience with alcohol abuse and eating disorders in the 2021 docuseries, Demi Lovato: Dancing with the Devil.In 2018, after mixing multiple substances, Lovato experienced multiple strokes, a heart attack, brain damage, and legal blindness. Regarding her previous experience with eating disorders, Lovato recounted:
- “I was compulsively overeating when I was 8 years old.”
- “For the past 10 years I’ve had a really unhealthy relationship with food.”
- “I was performing concerts on an empty stomach.”
Lovato’s story is one among many that highlights the life-threatening impact that eating disorders and alcohol abuse can have on an individual.
Eating disorders refer to illnesses in which individuals experience significant disturbances to their eating behaviours and accompanying emotions and thoughts. Often, these individuals are preoccupied with thoughts about food and body weight. There are many types of eating disorders including:
- Anorexia nervosa– The individual may have an unusually low body weight and a fear of gaining weight. These individuals will try to control their weight by limiting calories, exercising excessively, or using laxatives.
- Bulimia nervosa– These individuals will eat a lot of food and then try to get rid of the calories through unhealthy ways such as vomiting, using laxatives, or exercising too much.
- Binge eating– These individuals will likely eat too much and feel that they cannot control their eating. They will continue to eat even if they are full and often feel guilty afterwards.
The Signs of an Eating Disorder, Rehab Medical, 2020. Retrieved from Eating Disorders: Symptoms, Signs, Types and Causes- Rehab Medical (rehab-medical.com)
In Canada, eating disorders impact approximately 1 million individuals and these behaviours are often accompanied by other harmful behaviours, such as abusing alcohol. Abusing a substance refers to using too much, too often, or being unable to control use even though it might be harming other parts of your life. Approximately, 50% of individuals with an eating disorder also abuse alcohol.
Clearly, there is a large percentage of people who are experiencing symptoms related to two separate illnesses at the same time. Thus, these individuals require treatments that are able to target both mental illnesses. Treatments are only effective if the roots of the illness are identified and targeted, thus, it becomes extremely important to understand the specific risk factors (i.e., things that increase the likelihood of engaging in a behaviour) that contribute to the development of both disorders. It must be emphasised that the presence of these factors does not necessarily mean that you will definitely develop both/either disorder, it simply means that there may be an increased risk. Also, the factors that will be discussed can also lead to the development of other illnesses, but due to a limited number of studies that focus only on eating disorders and alcohol abuse, it is difficult to determine risk factors that are only related to these two disorders.
Also, alcohol abuse and eating disorders can be risk factors for the development of each other. For example, some individuals with anorexia may use alcohol to suppress their appetite- they drink to avoid eating. Some individuals may use alcohol to relieve themselves of feelings of guilt and shame when they do not eat or eat too much. Thus, while we will discuss what factors contribute to the development of both disorders, each one can contribute to the other as well.
Childhood Trauma
It has been well-established that our childhood influences our adult lives by shaping our personalities, opinions, and memories. Childhood trauma refers to an emotionally painful, scary, violent, or threatening experience that occurs in one’s childhood and has a lasting impact on their mental or physical health. This can include neglect, sexual and physical abuse.
Childhood trauma has been found to be a risk factor for eating disorders and alcohol abuse. For example, a study by Corstorphone et al. (2007) found that individuals who had experienced any form of abuse in their childhood were more likely to develop any type of eating disorder in their adult lives. Further, childhood sexual abuse was the most significantly linked to the development of bulimia and binge-eating, alcohol abuse, and self-harming behaviours. Similarly, a study by Guillaume et al. (2016) found that any form of mistreatment in one’s childhood could predict future development of an eating disorder and accompanying alcohol abuse.
In fact, childhood trauma is fairly common in individuals who are experiencing eating disorders and alcohol abuse. Multiple studies have found that 37% to 100% of individuals with eating disorders have experienced some form of abuse or neglect within their childhoods. While the reasons are likely complex, it is suggested that individuals with traumatic experiences in their childhood may lack proper coping skills and resort to harmful behaviours (such as eating and drinking a lot) as a way to deal with their trauma and emotions. Alongside childhood trauma, one’s personality also influences the development of these illnesses.
Childhood Trauma and Development of Eating Disorder, ESI, 2019. Retrieved from Childhood Feeding Neglect and Trauma in Developing Eating Disorders
Personality
Our personality influences many aspects of our lives. Impulsivity (i.e., acting quickly without thinking), how we respond to our emotions, among other factors can increase or decrease the likelihood of committing certain behaviours and in turn what disorders are developed.
A study by Lozano-Madrid et al. (2020) focused on personality traits in female participants with diagnosed eating disorders who displayed symptoms of alcohol or drug abuse. The researchers found that impulsive individuals with executive control problems and emotional dysregulation were at a higher risk of abusing alcohol. Executive control problems refer to one’s ability to make decisions and create/work through goals while emotional dysregulation is one’s inability to control their emotional responses. Essentially, the study found that the symptoms of alcohol abuse in individuals with eating disorders were more likely to transform into a disorder in the presence of the previously mentioned risk factors.
Similarly, a study conducted by Micheeva and Tragesser (2016) focused on multiple personality factors including negative urgency and emotionality. Negative urgency refers to a type of impulsivity in which one reacts rashly when they are in distress, such as using alcohol to cope with a problem in their lives. The researchers found that negative urgency heavily contributed to the development of eating disorders and alcohol abuse. These individuals may turn to food or alcohol as a means to cope with the problems they are currently or have in the past,- experienced and, overtime, these behaviours increase in riskiness and translate to disorders.
Concluding Remarks
While the studies mentioned above provide important information, there are some things that we must remember. Firstly, the above list is not exhaustive as there were many factors that were not discussed in this post including genetics. Also, we must remember that the simple presence of these factors in your life do not automatically guarantee the development of eating disorders and alcohol abuse- it simply increases the risk.
Fortunately, there are many treatments that are available for individuals with eating disorders and alcohol abuse, that target specific risk factors (such as those mentioned above). For example, cognitive-behaviour therapy (CBT) targets negative thoughts and behaviours and has been found to be effective in reducing anorexia and binge-eating. Interpersonal psychotherapy which targets interpersonal problems (i.e., family or relationship issues) in the individual’s life that may be contributing to their poor eating/drinking habits. These treatments may seem vague, but each one can be specialized to target the factors that are causing the individual’s problems. In Canada, organizations such as National Eating Disorder Information Centre (NEDIC) and Ontario Community Outreach Program for Eating Disorders can help you gain access to such treatments.
If you or a loved one require support, please refer to the following website which provides information about Canadian organizations that provide resources and support to individuals with eating disorders and other accompanying problems. https://www.eatingdisorderhope.com/treatment-for-eating-disorders/international/canada/canadas-eating-disorder-organizations-charities
References
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Guillaume, S., Jaussent, I., Maimoun, L., Ryst, A., Seneque, M., Villain, L., Hamroun, D., Lefebvre, P., Renard, E., & Courtet, P. (2016). Associations between adverse childhood experiences and clinical characteristics of eating disorders. Scientific Reports, 6(1), 35761-35761. https://doi.org/10.1038/srep35761
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