Alcohol and Eating Disorders: Implications for Alcohol Treatment and Health Services Research

Sinha, Rajita; O’Malley, Stephanie S.

doi:10.1111/j.1530-0277.2000.tb02097.x

Cited by 60 publications

(20 citation statements)

References 60 publications

(47 reference statements)

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“…Biological models implicate common disturbances in neurotransmitter function in dopamine, serotonin, gamma aminobutyric acid, and endogenous opiate systems across both EDs and SUDs [7,38]. Evidence for this model includes the similarity in physical symptoms across these disorders and the links that have been shown between food deprivation and the increased “biologically reinforcing effects of substances” [7].…”

Section: Reviewmentioning

confidence: 99%

“…Research indicates that pharmacotherapy alone should not be the primary treatment for AN [76,95], however anti-depressants (particularly SSRIs) have been effectively used to treat both BN patients as well as patients with an alcohol use disorder with co-morbid major depression [38,76,95]. Some evidence has also been found to support the use of opioid antagonists in the treatment of both EDs and AUDs [38].…”

Section: Reviewmentioning

confidence: 99%

“…Some evidence has also been found to support the use of opioid antagonists in the treatment of both EDs and AUDs [38]. Pharmacotherapy may be indicated in combination with therapeutic interventions [8].…”

Section: Reviewmentioning

confidence: 99%

“…Sinha and O’Mally (2000) and Grilo et al (2002) nevertheless suggest that for the treatment of EDs and alcohol abuse, a CBT approach which targets both pathogenic eating behaviours as well as alcohol use is likely to be effective [38,76]. They identify particularly useful strategies such as self-monitoring, identification of high risk situations and coping skills to manage emotions or situations which may trigger loss of control.…”

Section: Reviewmentioning

confidence: 99%

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A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders

2013

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IntroductionResearch has shown that eating disorder (ED) patients who abuse substances demonstrate worse ED symptomatology and poorer outcomes than those with EDs alone, including increased general medical complications and psychopathology, longer recovery times, poorer functional outcomes and higher relapse rates. This article provides a broad overview of the prevalence, aetiology, assessment and management of co-morbid EDs and substance use disorders (SUDs).ReviewThe co-occurrence of EDs and SUDs is high. The functional relationship between EDs and SUDs vary within and across ED subtypes, depends on the class of substance, and needs to be carefully assessed for each patient. Substances such as caffeine, tobacco, insulin, thyroid medications, stimulants or over the counter medications (laxatives, diuretics) may be used to aid weight loss and/or provide energy, and alcohol or psychoactive substances could be used for emotional regulation or as part of a pattern of impulsive behaviour. A key message conveyed in the current literature is the importance of screening and assessment for co-morbid SUDs and EDs in patients presenting with either disorder. There is a paucity of treatment studies on the management of co-occurring EDs and SUDs. Overall, the literature indicates that the ED and SUD should be addressed simultaneously using a multi-disciplinary approach. The need for medical stabilization, hospitalization or inpatient treatment needs to be assessed based on general medical and psychiatric considerations. Common features across therapeutic interventions include psycho-education about the aetiological commonalities, risks and sequelae of concurrent ED behaviours and substance abuse, dietary education and planning, cognitive challenging of eating disordered attitudes and beliefs, building of skills and coping mechanisms, addressing obstacles to improvement and the prevention of relapse. Emphasis should be placed on building a collaborative therapeutic relationship and avoiding power struggles. Cognitive behavioural therapy has been frequently used in the treatment of co-morbid EDs and SUDs, however there are no randomized controlled trials. More recently evidence has been found for the efficacy of dialectical behavioural therapy in reducing both ED and substance use behaviours.ConclusionFuture research would benefit from a meta-analysis of the current research in order to better understand the relationships between these two commonly co-occurring disorders.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

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A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders

2013

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“…Indeed, ethanol is unique among the drugs of abuse in that, like food, it holds caloric value- thereby providing a potential source of nutrients- and has an exclusive oral route of administration. Moreover, a multitude of clinical reports have described a relatively high rate of co-morbidity between alcohol abuse and eating disorders (Higuchi et al, 1993; Holderness et al, 1994; Dansky et al, 2000; Sinha and O'Malley, 2000; Anderson et al, 2005), which should come as no surprise considering aberrant consummatory behavior and a loss of control are hallmarks of both conditions. What is more, it has previously been documented that comorbid patients often show improvements in both conditions when receiving treatment for one disorder (Dawe and Staiger, 1998; Daniels et al, 1999; O'Malley et al, 2007).…”

Section: Targeting the Melanocortin Receptors To Treat Alcohol Abuse mentioning

confidence: 99%

Targeting central melanocortin receptors: a promising novel approach for treating alcohol abuse disorders

Olney¹,

Navarro²,

Thiele³

2014

Front. Neurosci.

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The melanocortin (MC) peptides are produced centrally by propiomelanocortin (POMC) neurons within the arcuate nucleus of the hypothalamus and act through five seven-transmembrane G-protein coupled melanocortin receptor (MCR) subtypes. The MC3R and MC4R subtypes, the most abundant central MCRs, are widely expressed in brain regions known to modulate neurobiological responses to ethanol, including regions of the hypothalamus and extended amygdala. Agouti-related protein (AgRP), also produced in the arcuate nucleus, is secreted in terminals expressing MCRs and functions as an endogenous MCR antagonist. This review highlights recent genetic and pharmacological findings that have implicated roles for the MC and AgRP systems in modulating ethanol consumption. Ethanol consumption is associated with significant alterations in the expression levels of various MC peptides/protein, which suggests that ethanol-induced perturbations of MC/AgRP signaling may modulate excessive ethanol intake. Consistently, MCR agonists decrease, and AgRP increases, ethanol consumption in mice. MCR agonists fail to blunt ethanol intake in mutant mice lacking the MC4R, suggesting that the protective effects of MCR agonists are modulated by the MC4R. Interestingly, recent evidence reveals that MCR agonists are more effective at blunting binge-like ethanol intake in mutant mice lacking the MC3R, suggesting that the MC3R has opposing effects on the MC4R. Finally, mutant mice lacking AgRP exhibit blunted voluntary and binge-like ethanol drinking, consistent with pharmacological studies. Collectively, these preclinical observations provide compelling evidence that compounds that target the MC system may provide therapeutic value for treating alcohol abuse disorders and that the utilization of currently available MC-targeting compounds- such as those being used to treat eating disorders- may be used as effective treatments to this end.

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The prevalence and correlates of eating disorders among emergency department patients aged 14–20 years

Dooley-Hash

Banker²,

Walton

et al. 2012

Intl J Eating Disorders

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Alcohol and Eating Disorders: Implications for Alcohol Treatment and Health Services Research

Cited by 60 publications

References 60 publications

A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders

A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders

Targeting central melanocortin receptors: a promising novel approach for treating alcohol abuse disorders

The prevalence and correlates of eating disorders among emergency department patients aged 14–20 years

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