From the Research
Eating disorders and alcohol use disorders should be treated concurrently with an integrated care approach, prioritizing comprehensive assessment and multidisciplinary treatment to address the complex needs of patients with this dual diagnosis. This approach is supported by recent studies, such as the 2023 scoping review protocol 1, which highlights the importance of integrated treatment for comorbid eating disorders and substance use disorders.
The treatment plan should involve a multidisciplinary team, including psychiatrists, psychologists, nutritionists, and addiction specialists. For alcohol use disorder, medications like naltrexone (50mg daily), acamprosate (666mg three times daily), or disulfiram (250mg daily) may be prescribed alongside psychotherapy, as suggested by the 2019 review on treatment of substance use disorders with co-occurring severe mental health disorders 2.
For eating disorders, selective serotonin reuptake inhibitors such as fluoxetine (20-60mg daily) are often beneficial, particularly for bulimia nervosa, as indicated by the 2012 review on current and emerging directions in the treatment of eating disorders 3. Cognitive-behavioral therapy is effective for both conditions and should be incorporated into treatment plans, typically lasting 12-20 weeks.
Key components of treatment include:
- Nutritional rehabilitation and meal planning for eating disorder recovery
- Regular monitoring of physical health due to the medical complications associated with both disorders
- Consideration of higher levels of care, including partial hospitalization or residential treatment, if outpatient management is insufficient
- Addressing the relationship between eating disorders and alcohol use disorders, which often involves using substances to suppress appetite, manage negative emotions, or reduce inhibitions around binge eating, as discussed in the 2020 study on correlates of co-occurring eating disorders and substance use disorders 4.
Overall, an integrated care approach that prioritizes comprehensive assessment, multidisciplinary treatment, and concurrent management of both eating disorders and alcohol use disorders is essential for improving outcomes and reducing morbidity and mortality in patients with this dual diagnosis.