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Archive for Did You Know?

Understanding Co-Occurring Disorders

Individuals struggling with an eating disorder are often only partially diagnosed and treated for their problem.  This is due largely to the likelihood of an eating disorder co-occurring with other psychological issues.  A co-occurring disorder, by definition is any two or more behavioral health disorders experienced by the same person at the same time.  If the eating disorder is treated without properly diagnosing every aspect of an individual’s mental health, their treatment can be significantly affected and can lead to relapse.

Disorders That Commonly Co-Occur With Eating Disorders

  1. Anxiety/Depression – The most common psychological problems that co-exist with eating disorders are anxiety and depression.  According to the Anxiety and Depression Association of America (ADAA), approximately two-thirds of individuals with an eating disorder, also suffered from anxiety or depression.
  2. Post-Traumatic Stress Disorder (PTSD) – Most cases of PTSD are the result of being exposed to a traumatic event that makes an individual feel helpless. Childhood sexual abuse is one of the bigger triggers for PTSD to co-occur with an eating disorder. As it pertains to eating disorders, some individuals turn to binge eating to help cope with their PTSD.
  3. Substance Abuse and Alcoholism – According to a study1 published in the American Journal of Psychiatry, about 12-15% of women with bulimia also have an alcohol abuse problem.  An additional 10% of women had a co-occurring drug abuse problem with their eating disorder.
  4. Cutting/Self-Harm – More common among individuals between the ages of 12 and 24, intentional self-harm is a co-occurring mental disorder that sometimes accompanies an eating disorder.  Individuals who start cutting and other forms of self-harm without intent to commit suicide are often times suffering from body image issues and low self-esteem.

Treating the Underlying Causes of Eating Disorders

When an individual suffers from an eating disorder, as well as one or more co-occurring psychological conditions, it is very important to treat each issue.  By addressing only one symptom or disorder, doctors fall short on getting to the root of an individual’s emotional and behavioral problems.  A patient that is only being treated for one of their psychological disorders is more likely to struggle after treatment.  This individual is prone to relapse and more likely to seek treatment again.

Not all individuals with an eating disorder suffer from other co-occurring disorders, but it is important to always be mindful and watch for the signs.  Patients that are given a full assessment of their psychological health are much more likely to get the treatment they need to overcome their disorders.



Schuckit, M., Tipp, J., Anthenelli, R. & Bucholz, K. (1996).  Anorexia
Nervosa and Bulimia Nervosa in Alcohol Dependent Men and Women and 
Their Relatives. The American Journal of Psychiatry, 152, 75-.

Staying on the same page

By Laura Collins

It is a common problem: parents not on the same page during eating disorder treatment.

Mom gives in too easily or dad forgets the “rules.” Maybe one spouse thinks they should back off and the other is ready to hold a hard line. Mom is super-vigilant and her partner believes in the power of trust.

What I have learned in watching countless couples struggle during eating disorder treatment:

•      It is better to be on the wrong page together than on different pages, so back your partner up. When you disagree, work it out in private. Those struggling feel unsure and even unsafe when the people taking care of them are not sending the same messages. If one direction isn’t working you can both change course together.

•      You may not (yet) be an expert on eating disorders, but you are the best authority on your own child. Learn all you can together about the disorder, and keep sight of what you both know of your loved one.

•      Your relationship to each other is the eating disorder’s worst enemy and it will try to divide you. Married, separated, or divorced: you can make your working relationship a brick wall against arguments and confusion.

•      The parent role is unique: it combines authority with protection. The best interest of the patient is also the best interest of the parents. Partners need to “be parental” even when they may feel over their head.

•      Caregiving can be exhausting and overwhelming, but remember that you are what stands between your loved one and great harm. If not you, who?

•      It is not about us. Myths about parents causing eating disorders are long gone. Parents have the opportunity to step up just as we do for any grave illness or accident, not because we caused it but because of our unique relationship and lifelong commitment.

•      Keep adult stuff among adults. Patients and siblings do not need to know or understand every decision and concern. Comfort and counsel one another.

•      Believe in one another. Each partner has strengths (and weaknesses) and qualities that brought you together. Find time to praise and use those strengths to support your loved one.

•      Eating disorders leave patients feeling anxious and uncertain. Fewer choices can help. If a question is open-ended or multiple choice it is often too challenging, at least early in treatment. Stick with clear, simple rules and few choices. That makes it easier to stay on the same page with one another, too.

•      Horizontal therapy works: head to bed. It doesn’t matter what you do there, but giving gravity a break really helps.



Laura Collins Lyster-Mensh is an award winning American activist and writer living in Virginia. A podcaster and international speaker, Lyster-Mensh’s books, essays, blogs, poems, and public speaking bring her infamy in some circles, praise in others, and an international readership.

Check out her blog Laura’s Soap Box

Follow her on Twitter @LauraCollinsLM