What Does Effective Treatment for Co-Occurring Eating Disorders and Substance Addiction Look Like?
There is a traditional maxim here on Hawaii’s Big Island that goes, “‘IMI OLA.” IMI OLA means that our goal in life is to make it the best life possible. It means to seek to live life to its fullest potential. This is not possible when we are struggling with co-occurring eating disorders and substance addiction. However, the good news is there is effective help out there, and with that help, there is no reason why IMI OLA cannot be fulfilled every day.
The Current Prevalence of Substance Addiction
Substance addiction remains a very prevalent issue in the United States and around the world. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), “In 2022, 48.7 million people aged 12 or older (or 17.3%) had a substance use disorder (SUD) in the past year, including 29.5 million who had an alcohol use disorder (AUD), 27.2 million who had a drug use disorder (DUD), and 8.0 million people who had both an AUD and a DUD.”
These are not insignificant numbers. They become even more troubling when one considers that many of these people represented will not receive the help that they need. According to the U.S. Department of Health and Human Services (HSS) and SAMHSA, “7 in 10 (72.2 percent or 20.9 million) adults who ever had a substance use problem considered themselves to be recovering or in recovery.” Similar statistics can be found within the realm of eating disorders and disordered eating recovery.
The Current Prevalence of Eating Disorders and Disordered Eating
Eating disorders and disordered eating do not discriminate when it comes to who can be affected. According to HSS, “More than 28 million Americans will have an eating disorder in their lifetime. Individuals of all ages, race/ethnicities, genders, sexual orientations, body shapes, weights, socioeconomic statuses, and levels of physical activity can develop an eating disorder.” Also, “During the COVID-19 pandemic, eating disorder-related hospital admissions among adolescents and young adults have increased has contributed to higher stress and anxiety, two risk factors for eating disorders.”
Unfortunately, many people will also never receive the help they need for their eating disorder. It is a deadly disease. According to the peer-reviewed journal Current Opinion in Psychiatry, “Estimates are that yearly over 3.3 million healthy life years worldwide are lost because of eating disorders. In contrast to other mental disorders, in anorexia nervosa and bulimia nervosa years lived with disability (YLDs) have increased. Despite treatment advances, mortality rates of anorexia nervosa and bulimia nervosa remain very high: those who have received inpatient treatment for anorexia nervosa still have a more than five times increased mortality risk.” These mortality risks are significantly increased for those who have both an eating disorder and substance addiction.
Better Understanding Co-Occurring Eating Disorders and Substance Addiction
Co-occurring eating disorders and substance addiction are more common than many people think. In fact, these two issues are some of the most common to occur together.
According to an analysis conducted by the U.S. Department of Justice (DOJ), “[They] found that up to 50 percent of individuals with an eating disorder abuse alcohol or illicit drugs, compared to approximately 9 percent in the general population. Up to 35 percent of alcohol or illicit drug abusers have an eating disorder, compared to up to 3 percent in the general population. Many individuals who engage in unhealthy weight-control behaviors or have full-blown eating disorders use or abuse substances such as caffeine, tobacco, alcohol, cocaine, heroin, and over-the-counter medications such as appetite suppressants, diuretics, laxatives, and emetics.”
It is because of this common nature that it is important that there be treatment plans in place that address both issues in tandem. Only when all issues are addressed can one begin to heal at the cellular level.
The Importance of Treating All Issues of Addiction and Mental Health at the Same Time
It is critical that once an individual is dually diagnosed, they begin a treatment plan that focuses on healing both issues. If one disorder is not treated adequately, there is a much higher risk of relapse, and it may surprise people as to how common relapse currently is in the U.S.
According to the peer-reviewed journal Current Psychiatry Reports, “It has long been known that addictive disorders are chronic and relapsing in nature. Recent estimates from clinical treatment studies suggest that more than two-thirds of individuals relapse within weeks to months of initiating treatment.” Also, “For 1-year outcomes across alcohol, nicotine, weight, and illicit drug abuse, studies show that more than 85% of individuals relapse and return to drug use within 1 year of treatment.” Of course, relapse is not the only issue that arises out of only treating one of multiple issues.
The primary issue that comes from only treating part of the problem is that healing can only happen part way. No one is looking for partial recovery. Rather, people should ultimately be looking to heal at the cellular level.
What Does Healing at the Cellular Level Look Like?
Healing at the cellular level should always look individualized and comprehensive. This means that treatment must take an individual’s needs into account (for example, if they have a dual diagnosis). It also means that healing should pull from all avenues of recovery.
Too many treatment facilities and recovery centers focus on overarching plans that ultimately will not suit every one of their clients. That is why we take the time at Exclusive Hawaii Rehab to administer a thorough and comprehensive intake and assessment. Then, we can best build the recovery plan that is going to address all of one’s issues, especially the underlying ones.
To heal at the cellular level, one must always get to the underlying root/core causes of one’s issues. This can be especially true for individuals with eating disorders, substance addiction, or both. It is not the behaviors or actions that are the ultimate problem; it is the cognitions (thoughts) and emotions (feelings) that underly them. Comprehensive treatment plans are going to address all of these underlying issues.
What Does Comprehensive Treatment for Eating Disorders and Substance Addiction Look Like?
The key to effective treatment plans for both eating disorders and substance addiction is that they pull from all areas of recovery. This includes the nutritional perspective, the psychotherapeutic perspective, and the holistic model.
Comprehensive treatment for eating disorders and substance addiction should also involve therapies that go beyond the realm of “the norm.” Recovery must also be engaging and enjoyable. This is where experiential therapies like nature immersion, art, and surf therapy come in. However, it is generally best to keep them as supplemental options to a more evidence-based recovery plan that utilizes psychotherapy.
Utilizing Psychotherapy for Co-Occurring Eating Disorders and Substance Addiction
Psychotherapy (“behavioral” therapy) has been shown to be effective in treating issues of addiction and mental health. According to the National Institute on Drug Abuse (NIDA), “Behavioral therapies help people in drug addiction treatment modify their attitudes and behaviors related to drug use. As a result, patients are able to handle stressful situations and various triggers that might cause another relapse. Behavioral therapies can also enhance the effectiveness of medications and help people remain in treatment longer.”
“Traditional” psychotherapies like cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) are exceptional at getting to the underlying issues of eating disorders and addiction. Once these issues are detected, they can then be worked on to address damaging and detrimental behaviors such as those associated with not eating, overeating, binging, purging, using substances, and drinking alcohol.
Also, once these changes start to happen, it is important that they be supplemented with other types of therapy. Regarding co-occurring eating disorders and addiction, nutritional therapy is of vital importance.
Utilizing Nutritional Therapy for Co-occurring Eating Disorders and Substance Addiction
Here at Exclusive Hawaii Rehab, we have a saying that we both believe in and practice every day – “Food is medicine.” As the father of Western medicine, Hippocrates, once said, “Let food be thy medicine and medicine be thy food.” Of course, nutrition is not just about the foods we eat, and neither is nutritional therapy.
Nutritional therapy is also about the foods we do not eat. According to the Journal for Nurse Practitioners, “Nutritional Therapy uses food to prevent and reverse diseases that plague most western societies: diabetes, obesity, heart disease, arthritis, and depression. For food to be therapeutic, it must be nutrient-dense, measured in part by the nutrients and anti-nutrients, contained in consumed foods. Nutrients are plant and animal sources providing macronutrients (protein, carbohydrates, fat), micronutrients (vitamins, minerals, phytochemicals, antioxidants, probiotics), and fiber,” and “Anti-Nutrients are food products that have no biological necessity.”
At Exclusive Hawaii Rehab, we have licensed dieticians and nutritionists who ensure that all of our client’s nutritional needs are met. They also ensure that individuals have the right tools and skillsets to go out into the world and practice healthy nutrition habits.
Of course, we also recognize the importance of food being delicious, satisfying, and nutritious. This is why all of our meals are individually tailor-made for each client and prepared by world-class chefs.
Utilizing Surf Therapy for Co-Occurring Eating Disorders and Substance Addiction
Here at Exclusive Hawaii Rehab, we believe in recovery that also takes place outside of a therapist’s office. We feel that one of the best places for this to happen is riding the surf at one of our amazing surf breaks. Surf therapy is picking up more steam, as its benefits become more and more apparent.
It is important to understand that surf therapy is about much more than surfing. According to the peer-reviewed journal Frontiers in Psychology, “A growing body of evidence worldwide has validated the use of surfing as a therapeutic mediator to achieve positive change such as increased well-being. Surf therapy is defined by the International Surf Therapy Organisation as an intervention that combines surf instruction, surfing, and structured individual and/or group activities to promote physical, psychosocial, and psychological well-being. In addition to physical exercise, surf therapy interventions typically include individual mentoring, social skills development, psychoeducation, and group discussions focused on increasing resilience and personal growth.”
Surf therapy can also be an exceptional way to get the benefits of nature immersion. According to the International Journal of Environmental Research and Public Health, “Besides improvements to physical and psychological well-being, exposure to natural environments has been shown to bring about positive impacts on cognitive functioning.” Also, “While cognitive restoration and physiological well-being are the prominent and renowned benefits of nature exposure, there is one important construct that is often overlooked in environmental psychology research studies – that is, the human-nature relationship; also known as connectedness to nature (CN).” Another exceptional way to get this “connectedness to nature” is via horticulture therapy.
Utilizing Horticulture Therapy for Co-Occurring Eating Disorders and Substance Addiction
Having a co-occurring eating disorder and substance addiction inhibits individuals from having a healthy relationship with their food. This includes where their food comes from. Horticulture therapy can help with this sense of disconnection.
Here at Exclusive Hawaii Rehab, our clients have an opportunity to engage with their food in a very intimate way. They get to engage with it and see the fruits of their labor. On our luxury 30-acre property, we have rows of citrus trees, coconut trees, guava bushes, pineapple patches, and vegetable boxes ready and waiting to be cultivated.
Individuals also receive many unique benefits from horticulture therapy. According to the International Journal of Environmental Research and Public Health, “First, horticulture could have emotional benefits, such as reducing stress, reducing psychiatric symptoms, stabilizing mood, and increasing the sense of tranquility, spirituality, and enjoyment. Second, it could help people to reduce fatigue and restore attention and cognitive ability. Third, it could increase self-efficacy, self-esteem, and quality of life.”
Horticulture therapy also helps to give individuals a sense of purpose and accomplishment. The same is true with the practice of yoga.
Utilizing Yoga for Co-Occurring Eating Disorders and Substance Addiction
The renowned yogi and spiritual teacher B.K.S. Iyengar said, “Yoga allows you to rediscover a sense of wholeness in your life, where you do not feel like you are constantly trying to fit broken pieces together.” This is critical for those recovering from co-occurring eating disorders and substance addiction.
Yoga has been practiced for thousands of years. Originally it was strictly a religious and/or spiritual practice, but it has since moved into other areas of life. This includes the arena of recovery.
Yoga can be particularly helpful for co-occurring issues. According to the International Journal of Yoga (IJOY), “Yoga and meditation practices exert positive influence on addictive behaviors… Eating disorders are a specific type of addiction and yoga appears to be beneficial in improving body image disturbances and useful in the recovery from eating disorders. One study found that female yoga practitioners attribute their positive feelings and sense of well-being to yoga practice and report less self-objectification, greater satisfaction with physical appearance, and fewer disordered eating attitudes compared to non-yoga practitioners.”
Yoga is also an exceptional practice because it can virtually go anywhere the practitioner does. Once a yoga practice is established in treatment, it becomes available whenever an individual wants to engage in it. It can become essential for long-term recovery.
The Importance of Whole Mind-Body-Soul Treatment at Exclusive Hawaii Rehab
Here at Exclusive Hawaii Rehab, we also understand the importance of whole mind-body-soul treatment. We know that when we treat the “whole” all of the partial issues will soon fall into place.
There is another traditional saying that we have on Hawaii’s Big Island that goes, “KA LĀ HIKI OLA.” This means that with every day comes new hope and a new promise. That is also a promise we keep at Exclusive Hawaii Rehab – with faith and effort, there is always hope and recovery on the horizon. The time is now. We can help.
Co-occurring eating disorders and substance addiction are actually much more common than many people may think. Due to this reality, it is important that individuals with co-occurring eating disorders and substance addiction get help for both issues at the same time. Disregarding one or the other can lead to stilted recovery and a potential relapse. If you feel like you or a loved one are struggling with substance addiction, an eating disorder, or co-occurring issues of both, we can help get you on the road to recovery. For more information about how to heal at the cellular level from an eating disorder and substance addiction at the same time, please reach out to Exclusive Hawaii Rehab today at (808) 775-0200.