Skip to main content

Advertisement

Log in

Co-occurrence of eating disorders and alcohol use disorders in women: a meta analysis

  • Review article
  • Published:
Archives of Women's Mental Health Aims and scope Submit manuscript

Summary

This meta analysis involved 41 studies published between January of 1985 and May of 2006, which examined the co-occurrence of eating disorders (ED) and alcohol use disorders (AUD) in women. Studies were reviewed and a quantitative synthesis of their results was carried out via the calculation of standardised effect sizes. Direction and strength of the relationships between AUD and specific disordered eating patterns were examined. Heterogeneity of reported results was also assessed and examined. Only 4 out of 41 studies reported negative associations between ED and AUD. The magnitude of the associations between eating-disordered patterns and AUD ranged from small to medium size and were statistically significant for any ED, bulimia nervosa (BN)/bulimic behavior, purging, binge eating disorder (BED) and eating disorders not otherwise specified (EDNOS). No association was found between anorexia nervosa (AN) and AUD. The magnitude of the association between BN and AUD was the most divergent across studies and those between each of BED and dietary restriction and AUD were the most consistent across studies. Reported associations of different patterns of disordered eating and AUD were generally weakest and most divergent when participants were recruited from clinical settings and strongest and most homogeneous when participants were recruited from student populations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • InstitutionalAuthorNameAmerican Psychiatric Association (APA) (1987) Diagnostic and Statistical Manual of Mental Disorders EditionNumber3rd revised DSM-III-R. APA Washington, DC

    Google Scholar 

  • American Psychological Association Research agenda for psychosocial and behavioral factors in women’s health: Health behaviours (2005) Recommendations from the Advisory Committee of the Psychosocial and Behavioral Factors in Women’s Health: Creating an Agenda for the 21st Century Conference. Downloaded May 15, 2005 from http://www.apa.org/pi/wpo/behavior.html#alcohol

  • CM Bulik PF Sullivan FA Carter PR Joyce (1997) ArticleTitleLifetime co-morbidity of alcohol dependence in women with bulimia nervosa Addict Behav 22 437–446 Occurrence Handle9290854 Occurrence Handle10.1016/S0306-4603(96)00053-6 Occurrence Handle1:STN:280:DyaK2svjs1WrtQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • M Corcos S Nezelof M Speranza S Topa N Girardon O Guilbaud O Taïeb P Bizouard O Halfon JL Venisse F Perez-Diaz M Flament P Jeammet (2001) ArticleTitlePsychoactive substance consumption in eating disorders Eat Behav 2 IssueID1 27–38 Occurrence Handle15001048 Occurrence Handle10.1016/S1471-0153(00)00021-0 Occurrence Handle1:STN:280:DC%2BD2c7htFSmsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • JJ Deeks DG Altman MJ Bradburn (2001) Statistical methods for examining heterogeneity and combining results from several studies in meta-analysis M Eggar GD Smith DG Altman (Eds) Systematic reviews in health care: meta-analysis in context EditionNumber2 BMJ London 285–312

    Google Scholar 

  • JPT Higgins SG Thompson (2002) ArticleTitleQuantifying heterogeneity in a meta-analysis Statist Med 21 1539–1558 Occurrence Handle10.1002/sim.1186

    Article  Google Scholar 

  • C Holderness J Brooks-Gunn M Warren (1994) ArticleTitleCo-morbidity of eating disorders and substance abuse, review of the literature Int J Eat Disord 16 IssueID1 1–34 Occurrence Handle7920577 Occurrence Handle10.1002/1098-108X(199407)16:1<1::AID-EAT2260160102>3.0.CO;2-T Occurrence Handle1:STN:280:DyaK2M%2FgsVGiuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • TB Huedo-Medina J Sanchez-Meca F Marin-Martinez J Botella (2006) ArticleTitleAssessing heterogeneity in meta-analysis: Q statistic or I 2 index? Psychol Methods 11 IssueID2 193–206 Occurrence Handle16784338 Occurrence Handle10.1037/1082-989X.11.2.193

    Article  PubMed  Google Scholar 

  • MW Lipsey DB Wilson (2001) Practical meta-analysis Sage Thousand Oaks

    Google Scholar 

  • National Center on Addiction and Substance Use at Columbia University (2001) Food for thought: substance abuse and eating disorders Conference. Available via http://www.casacolumbia.org/absolutenm/templates/article.asp?articleid=296&zoneid=40

  • SH Stewart M Angelopoulos JM Baker FJ Boland (2000) ArticleTitleRelations between dietary restraint and patterns of alcohol use in young adult women Psychol Addict Behav 14 77–82 Occurrence Handle10822749 Occurrence Handle10.1037/0893-164X.14.1.77 Occurrence Handle1:STN:280:DC%2BD3c3ot1WmtQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • Streiner DL (2003) Meta-analysis: A 12-step program. Electronic Journal of Gambling Issues 1(9). www.camh.net/egambling/issue9v1/feature/. Retrieved April 3, 2007

  • MW Wiederman T Pryor (1996a) ArticleTitleSubstance use among women with eating disorders Int J Eat Disord 20 IssueID2 163–168 Occurrence Handle10.1002/(SICI)1098-108X(199609)20:2<163::AID-EAT6>3.0.CO;2-E Occurrence Handle1:STN:280:DyaK2s%2Fhs1CnsA%3D%3D

    Article  CAS  Google Scholar 

  • MW Wiederman T Pryor (1996b) ArticleTitleSubstance use and impulsive behaviors among adolescents with eating disorders Addict Behav 21 IssueID2 269–272 Occurrence Handle10.1016/0306-4603(95)00062-3 Occurrence Handle1:STN:280:DyaK283ptFOltw%3D%3D

    Article  CAS  Google Scholar 

  • WL Wolfe SA Maisto (2000) ArticleTitleThe relationship between eating disorders and substance use: moving beyond co-prevalence research Clin Psychol Rev 20 IssueID5 617–631 Occurrence Handle10860169 Occurrence Handle10.1016/S0272-7358(99)00009-4 Occurrence Handle1:STN:280:DC%2BD3M%2FitVSmsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

Articles included in the meta analysis:

  • DA Anderson MP Martens MD Cimini (2005) ArticleTitleDo female college students who purge report greater alcohol use and negative alcohol-related consequences? Int J Eat Disord 37 IssueID1 65–68 Occurrence Handle15690469 Occurrence Handle10.1002/eat.20046

    Article  PubMed  Google Scholar 

  • CM Bulik (1987) ArticleTitleDrug and alcohol abuse by bulimic women and their families Am J Psychiatry 144 IssueID12 1604–1606 Occurrence Handle3688289 Occurrence Handle1:STN:280:DyaL1c%2FnsVyrsw%3D%3D

    PubMed  CAS  Google Scholar 

  • C Cochrane R Malcolm T Brewerton (1998) ArticleTitleThe role of weight control as a motivation for cocaine abuse Addict Behav 23 IssueID2 201–207 Occurrence Handle9573424 Occurrence Handle10.1016/S0306-4603(97)00046-4 Occurrence Handle1:STN:280:DyaK1c3jsVCrsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • J Croll D Neumark-Sztainer M Story M Ireland (2002) ArticleTitlePrevalence and risk and protective factors related to disordered eating behaviors among adolescents: relationship to gender and ethnicity J Adolesc Health 31 IssueID2 166–175 Occurrence Handle12127387 Occurrence Handle10.1016/S1054-139X(02)00368-3

    Article  PubMed  Google Scholar 

  • BS Dansky TD Brewerton DG Kilpatrick (2000) ArticleTitleComorbidity of bulimia nervosa and alcohol use disorders: result from the National Women’s Study Int J Eat Disord 24 605–611

    Google Scholar 

  • TM Davis KR Bush DR Kivlahan DJ Dobie KA Bradley (2003) ArticleTitleScreening for substance abuse and psychiatric disorders among women patients in a VA Health Care System Psychiatr Serv 54 IssueID2 214–218 Occurrence Handle12556603 Occurrence Handle10.1176/appi.ps.54.2.214

    Article  PubMed  Google Scholar 

  • EC Dunn ME Larimer C Neighbors (2002) ArticleTitleAlcohol and drug-related negative consequences in college students with bulimia nervosa and binge eating disorder Int J Eat Disord 32 IssueID2 171–178 Occurrence Handle12210659 Occurrence Handle10.1002/eat.10075

    Article  PubMed  Google Scholar 

  • RE Frank MK Serdula D Adamo (1991) ArticleTitleWeight loss and bulimic eating behavior: changing patterns within a population of young adult women Southern Med J 84 457–460 Occurrence Handle10.1097/00007611-199104000-00011 Occurrence Handle1:STN:280:DyaK3M7psFOltQ%3D%3D Occurrence Handle2014429

    Article  CAS  PubMed  Google Scholar 

  • PE Garfinkel E Lin P Goering C Spegg DS Goldbloom S Kennedy AS Kaplan DB Woodside (1995) ArticleTitleBulimia nervosa in a Canadian community sample: prevalence and comparison of subgroups Am J Psychiatry 152 IssueID7 1052–1058 Occurrence Handle7793442 Occurrence Handle1:STN:280:DyaK2MzhtlOnsw%3D%3D

    PubMed  CAS  Google Scholar 

  • T Granillo G Jones-Rodriguez SC Carvajal (2005) ArticleTitlePrevalence of eating disorders in Latina dolescents: associations with substance use and other correlates J Adolesc Health 36 IssueID3 214–220 Occurrence Handle15737777 Occurrence Handle10.1016/j.jadohealth.2004.01.015

    Article  PubMed  Google Scholar 

  • ML Granner DA Abood DR Black (2001) ArticleTitleRacial differences in eating disorder attitudes, cigarette, and alcohol use Am J Health Behav 25 IssueID2 83–99 Occurrence Handle11297045 Occurrence Handle1:STN:280:DC%2BD3M3os1ensg%3D%3D

    PubMed  CAS  Google Scholar 

  • CM Grilo KN Levy DF Becker WS Edell TH McGlashan (1995) ArticleTitleEating disorders in female inpatients with versus without substance use disorders Addict Behav 20 IssueID2 255–260 Occurrence Handle7484320 Occurrence Handle10.1016/0306-4603(94)00065-4 Occurrence Handle1:STN:280:DyaK28%2FmvVSiuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • JI Hudson HG Pope D Yurgelon-Todd JM Jonas FR Frankenburg (1987) ArticleTitleA controlled study of lifetime prevalence of affective and other psychiatric disorders in bulimic outpatients Am J Psychiatry 144 1283–1287 Occurrence Handle3499087 Occurrence Handle1:STN:280:DyaL1c%2FitFCjsQ%3D%3D

    PubMed  CAS  Google Scholar 

  • B Jager R Liedtke HW Kunsebeck L Seide W Lempa (1991) ArticleTitleEverday addoctive behavior of bulimic women Psychother Psychomat 56 64–69 Occurrence Handle1:STN:280:DyaK3MzmvVSjsA%3D%3D Occurrence Handle10.1159/000133050

    Article  CAS  Google Scholar 

  • PE Keck HG Pope JL Hudson SL McElroy D Yurgelun-Todd EM Hundert (1990) ArticleTitleA controlled study of phenomenology and family history in outpatients with bulimia nervosa Comprehens Psychiatry 31 275–283 Occurrence Handle10.1016/0010-440X(90)90034-P

    Article  Google Scholar 

  • PK Keel KL Klump M McGue WG Iacono (2005) ArticleTitleShared transmission of eating disorders and anxiety disorders Int J Eat Disord 38 IssueID2 99–105 Occurrence Handle16134107 Occurrence Handle10.1002/eat.20168

    Article  PubMed  Google Scholar 

  • JD Killen CB Taylor MJ Telch TN Robinson DJ Maron KE Saylor (1987) ArticleTitleDepressive symptoms and substance use among adolescent binge eaters and purgers: a defined population study Am J Public Health 77 1539–1541 Occurrence Handle3674255 Occurrence Handle1:STN:280:DyaL1c%2FkslWlsQ%3D%3D

    PubMed  CAS  Google Scholar 

  • W Koepp S Schildbach C Schmager R Rohner (1993) ArticleTitleBorderline diagnosis and substance abuse in female patients with eating disorders Int J Eat Disord 14 IssueID1 107–110 Occurrence Handle8339092 Occurrence Handle10.1002/1098-108X(199307)14:1<107::AID-EAT2260140114>3.0.CO;2-Q Occurrence Handle1:STN:280:DyaK3szjvVCltA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • D Krahn C Kurth M Demitrack A Drewnowski (1992) ArticleTitleThe relationship of dieting severity and bulimic behaviors to alcohol and other drug use in young women J Subst Abuse 4 IssueID4 341–353 Occurrence Handle1294277 Occurrence Handle10.1016/0899-3289(92)90041-U Occurrence Handle1:STN:280:DyaK3s7pt1KlsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • DD Krahn (1991) ArticleTitleThe relationship of eating disorders and substance abuse J Subst Abuse 3 IssueID2 239–253 Occurrence Handle1821283 Occurrence Handle1:STN:280:DyaK38zjtVGltw%3D%3D Occurrence Handle10.1016/S0899-3289(05)80039-2

    Article  PubMed  CAS  Google Scholar 

  • DD Krahn CL Kurth E Gomberg A Drewnowski (2005) ArticleTitlePathological dieting and alcohol use in college women – a continuum of behaviors Eat Behav 6 IssueID1 43–52 Occurrence Handle15567110 Occurrence Handle10.1016/j.eatbeh.2004.08.004

    Article  PubMed  Google Scholar 

  • J Lock B Reisel H Steiner (2001) ArticleTitleAssociated health risks of adolescents with disordered eating: how different are they from their peers? Results from a high school survey Child Psychiatry Hum Dev 31 IssueID3 249–265 Occurrence Handle11196014 Occurrence Handle10.1023/A:1026433506298 Occurrence Handle1:STN:280:DC%2BD3M7hslGmsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • D Neumark-Sztainer PJ Hannan (2000) ArticleTitleWeight-related behaviors among adolescent girls and boys: results from a national survey Arch Pediatr Adolesc Med 154 IssueID6 569–577 Occurrence Handle10850503 Occurrence Handle1:STN:280:DC%2BD3czgs1KktA%3D%3D

    PubMed  CAS  Google Scholar 

  • D Neumark-Sztainer M Story LB Dixon DM Murray (1998) ArticleTitleAdolescents engaging in unhealthy weight control behaviors: are they at risk for other health-compromising behaviors? Am J Public Health 88 952–955 Occurrence Handle9618628 Occurrence Handle1:STN:280:DyaK1c3ot1ehtQ%3D%3D

    PubMed  CAS  Google Scholar 

  • E Penas-Lledo L Sancho G Waller (2002) ArticleTitleEating attitudes and the use of alcohol, tobacco, and exercise among male and female adolescents Eat Behav 3 IssueID2 101–111 Occurrence Handle15001007 Occurrence Handle10.1016/S1471-0153(01)00047-2

    Article  PubMed  Google Scholar 

  • N Piran T Gadalla (2006) ArticleTitleEating disorders and substance abuse in Canadian women: a national study Addictions 102 105–113 Occurrence Handle10.1111/j.1360-0443.2006.01633.x

    Article  Google Scholar 

  • N Piran S Robinson (2006a) ArticleTitleAssociations between disordered eating behaviours and licit and illicit substance use and abuse in a university sample Addict Behav 31 IssueID10 1761–1775 Occurrence Handle10.1016/j.addbeh.2005.12.021

    Article  Google Scholar 

  • N Piran S Robinson (2006b) ArticleTitleThe association between disordered eating and substance use and abuse in women: a community-based investigation Women Health 44 IssueID1 1–20 Occurrence Handle10.1300/J013v44n01_01

    Article  Google Scholar 

  • HE Ross F Ivis (1999) ArticleTitleBinge eating and substance use among male and female adolescents Int J Eat Disord 26 IssueID3 245–260 Occurrence Handle10441240 Occurrence Handle10.1002/(SICI)1098-108X(199911)26:3<245::AID-EAT2>3.0.CO;2-R Occurrence Handle1:STN:280:DyaK1MzntFOqsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • MA Schuckit JE Tipp RM Anthenelli KK Bucholz VM Hesselbrock JI Nurnberger SuffixJr (1996) ArticleTitleAnorexia nervosa and bulimia nervosa in alcohol-dependent men and women and their relatives Am J Psychiatry 153 IssueID1 74–82 Occurrence Handle8540597 Occurrence Handle1:STN:280:DyaK287ivF2lsw%3D%3D

    PubMed  CAS  Google Scholar 

  • R Sinha J Robinson K Merikangas GT Wilson J Rodin S O’Malley (1996) ArticleTitleEating pathology among women with alcoholism and/or anxiety disorders J Alcoholism Clin Experi Res 20 IssueID7 1184–1191 Occurrence Handle10.1111/j.1530-0277.1996.tb01109.x Occurrence Handle1:STN:280:DyaK2s%2FmtV2hsA%3D%3D

    Article  CAS  Google Scholar 

  • SL Stock E Goldberg S Corbett DK Katzman (2002) ArticleTitleSubstance use in female adolescents with eating disorders J Adolesc Health 31 IssueID2 176–182 Occurrence Handle12127388 Occurrence Handle10.1016/S1054-139X(02)00420-2

    Article  PubMed  Google Scholar 

  • GW Stuart MT Laraia JC Ballenger RB Lydiard (1990) ArticleTitleEarly family experiences of women with bulimia and depression Arch Psychiatr Nurs 4 IssueID1 43–52 Occurrence Handle2317098 Occurrence Handle10.1016/S0883-9417(05)80010-X Occurrence Handle1:STN:280:DyaK3c7pslejsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • K Suzuki A Takeda S Matsushita (1995) ArticleTitleCoprevalence of bulimia with alcohol abuse and smoking among Japanese male and female high school students Addiction 90 IssueID7 971–975 Occurrence Handle7663319 Occurrence Handle10.1111/j.1360-0443.1995.tb03506.x Occurrence Handle1:STN:280:DyaK2Mzpt1eltg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • CF Telch E Stice (1998) ArticleTitlePsychiatric comorbidity in women with binge eating disorder: prevalence rates from a non-treatment-seeking sample J Consult Clin Psychol 66 IssueID5 768–776 Occurrence Handle9803695 Occurrence Handle10.1037/0022-006X.66.5.768 Occurrence Handle1:STN:280:DyaK1M%2FitVGgtA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • MG Timmerman LA Wells S Chen (1990) ArticleTitleBulimia nervosa and associated alcohol abuse among secondary school students J Am Acad Child Adolesc Psychsiatry 29 118–122 Occurrence Handle1:STN:280:DyaK3c7gvF2ltQ%3D%3D Occurrence Handle10.1097/00004583-199001000-00018

    Article  CAS  Google Scholar 

  • BB Toner PE Garfinkel DM Garner (1986) ArticleTitleLong-term follow-up of anorexia nervosa Psychosomat Med 48 520–529 Occurrence Handle1:STN:280:DyaL2s%2FhslGisg%3D%3D

    CAS  Google Scholar 

  • KM Von Ranson WG Iacono M McGue (2002) ArticleTitleDisordered eating and substance use in an epidemiological sample: I. Associations within individuals Int J Eat Disord 31 IssueID4 389–403 Occurrence Handle11948644 Occurrence Handle10.1002/eat.10050

    Article  PubMed  Google Scholar 

  • TD Wade CM Bulik CA Prescott KS Kendler (2004) ArticleTitleSex influences on shared risk factors for bulimia nervosa and other psychiatric disorders Arch Gen Psychiatry 61 IssueID3 251–256 Occurrence Handle14993112 Occurrence Handle10.1001/archpsyc.61.3.251

    Article  PubMed  Google Scholar 

  • SL Welch CG Fairburn (1996) ArticleTitleImpulsivity or comorbidity in bulimia nervosa: a controlled study of deliberate self-harm and alcohol and drug misuse in a community sample Br J Psychiatry 169 451–458 Occurrence Handle8894196 Occurrence Handle1:STN:280:DyaK2s%2FkvFCltA%3D%3D Occurrence Handle10.1192/bjp.169.4.451

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gadalla, T., Piran, N. Co-occurrence of eating disorders and alcohol use disorders in women: a meta analysis. Arch Womens Ment Health 10, 133–140 (2007). https://doi.org/10.1007/s00737-007-0184-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00737-007-0184-x

Navigation