Research indicates that addiction to drugs or alcohol and eating disorders often co-exist. A study in the US found that 30 – 50% of individuals with bulimia and 12 – 18% of those with anorexia are dependent on alcohol, illegal drugs or prescription drugs, compared to 9% of the general population.
It also found that 35% of alcohol and drug users have eating disorders, compared to three percent of the general population. Eating disorders and substance abuse are both long-term illnesses which require intensive therapy to treat. Both involve an obsessive craving and a preoccupation with a substance (food or drugs), both have mood-altering effects, both are compulsive, often secretive and the sufferer will be in denial that there is a problem and continue with the compulsive behaviour despite the negative consequences on their health and in their lives.
It is important that where there is a co-existing eating disorder in a person who is chemically dependent, that the sufferer is treated within a personalised programme of individual therapy, group therapy and family therapy for both conditions. If not there is an increased risk of relapse after treatment.
Treatment for eating disorders with addiction at Castle Craig
At Castle Craig we can treat people with alcoholism and drug addiction who have the additional complication of an eating disorder. Anyone with an eating disorder and chemical dependence will be assessed by a Consultant Psychiatrist as to their suitability for admission. Most of our eating disorder patients are of only mild-severity and suffer from Bulimia Nervosa or Binge Eating Disorder. It is not possible to admit patients with an extremely low BMI as we cannot offer the very specific specialist monitoring, attention and care that they need.
Patients are assessed according to the following diagnostic tests:
- The Eating Attitudes Test (E.A.T.). This is used for a measure of the features of Anorexia Nervosa. It has a total score and three sub-scores: Bulimia, Oral Control & Dieting.
- The Bulimic Investigatory Test, Edinburgh (BITE). This is an aid to diagnosing Bulimia Nervosa. There are two scales: the Symptom scale which measures attitudes to food and weight, and the Severity scale which is a concrete measure of bulimic behaviours.
- SCOFF Questionnaire addresses the core features of anorexia nervosa and bulimia nervosa.
- The Body Shape Questionnaire (BSQ). This is a self-rating scale.
- Eating Restraint Questionnaire (ERQ). This is used to assess the level of restraint exerted over eating.
Counselling and Therapy
Treatment at Castle Craig runs in conjunction with the 12 step treatment programme for addictive behaviour. Eating disorders are viewed as illnesses where a compulsive/obsessive relationship with food has developed leading to a negative body image and low self-esteem which in turn will perpetuate addictive behaviour. At Castle Craig those who have an associated eating disorder will be assessed. The environment here is safe and patients are supported by trained and knowledgeable staff, enabling the patient to begin the recovery process. Throughout treatment patients’ eating behaviour is closely monitored and weights checked.
“Cognitive behavioural therapy, in the context of specific eating disorders treatment, offers the best evidence-based treatment so far.” – Glynis Read, PhD. Former Eating Disorders Specialist, Castle Craig.
Our eating disorder therapy is based on cognitive behavioural therapy (CBT) and takes place both individually and during group therapy. Patients begin by working through the 12 steps of Obsessive Eaters Anonymous (OEA). They also attend OEA meetings during treatment.
Group therapy provides the basis of treatment. Groups are psycho-educational and as well as providing information, the group assists people to address associated low self-esteem. Individual therapy is tailored to the patient’s needs and supplements the group work. With successful treatment there is a growth in self-acceptance and a gradual lessening of obsessive compulsive behaviours.
Diet and Food Preparation
Our chefs provide healthy and nutritious meals and snacks for patients. The consumption of sugars and unrefined flour is discouraged as these may set up craving. The principles of normal eating are adhered to and patients have three meals and three snacks daily. Depending on the stage of recovery meals may be plated and staff members may eat with patients in a caring and friendly environment.
Our medical supervision includes prescription of food supplements, electrolyte monitoring, weight monitoring, electrocardiogram testing where necessary.