Study Links Substance Use to Co-Occurring Eating Disorders

A recent study of 1,533 women in drug treatment centers in Nevada found that weight and body image concerns are far more common than many treatment programs currently address. Psychologist Cortney Warren and her colleagues point to a pattern of co-occurring disorders that mental health and addiction providers increasingly need to screen for together rather than separately.

Co-Occurring Eating Disorders in Women’s Drug Treatment

Researchers found that 12.3% of the women had a lifetime eating disorder diagnosis, while another 21% reported symptoms of eating pathology without formal diagnoses. About 44% strongly agreed they started taking substances specifically to lose weight, and 57% reported concern about gaining weight during recovery. 

Women who reported using substances for weight loss also showed significantly higher levels of body dissatisfaction, binge eating behavior and general eating pathology than women who didn’t report that motivation.

This pattern extends beyond Nevada. In a nationally representative sample of 12,000 young adults, losing weight was one of the most common reasons women reported for nonmedical stimulant use. A separate study of 131 college students who used substances found that 15.3% of women reported using drugs for weight control, most often stimulants known for suppressing appetite, including cocaine and methamphetamine.

Dual Diagnosis and Co-Occurring Disorders

Co-occurring disorders describe two or more conditions, such as unhealthy diets, mental health conditions, and substance use, that occur together and interact with one another. When body image concerns and disordered eating go unaddressed during substance use treatment, they undercut recovery, since a person may be managing weight-related distress that treatment never directly names or treats. 

Integrated, dual diagnosis care, including stronger and healthier diets, that screens for both conditions from the start gives providers a more complete picture of what is driving a person’s substance use.

Treatment Approaches for Eating and Substance Use Disorders

A 2026 advisory from the SAMHSA described the need for evidence-based care that addresses body image concerns and eating disorder symptoms alongside substance use, rather than treating them as separate and sequential problems. The advisory emphasized assessing how weight and eating concerns relate to a person’s recovery, treating overlapping symptoms at the same time, and providing that care in a supportive, nonjudgmental setting with staff trained in both areas.

One example of this integrated approach is Healthy Steps to Freedom, a 10- to 12-week supplemental program that runs alongside standard drug treatment and covers nutrition, physical activity, body image, and eating behavior. In a study of 607 adult women in drug treatment, healthier eating and activities that led to a significant decrease in negative body images and disordered eating symptoms.

Find Help Today

For women whose substance use is tied to weight or body image concerns, a treatment center that screens for co-occurring disorders at intake, rather than only after a crisis, offers a more complete path to recovery. Consider prospective treatment centers that include screenings for eating disorders and body image concerns during intake.

Our searchable directory lists treatment centers that offer dual diagnosis care for co-occurring eating disorders, mental health conditions and substance use disorders. Women and men don’t have to choose between treating one condition and treating the other. You can also dial 800-908-4823 (Sponsored) to speak with a specialist today.

Author

Quentin Blount

Content Manager

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Quentin brings nearly a decade of experience as a writer, editor, and digital publisher to his role as Content Manager for Rehab.com. He aims to help people better understand their treatment options by creating engaging and informative content that is user-friendly, factually accurate, and optimized for search engine visibility. In his free time, Quentin enjoys the company of his friends, family, and his dog, Coop.

Editor

Peter Lee, PhD

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Peter W.Y. Lee is a writer and historian of American history during the Cold War. His primary focus is the relationship between youth and popular culture and its impact on U.S. society during the twentieth century. He has published widely on how the public has used popular culture as a mechanism to address political and social shifts throughout time