Disordered eating and substance use in an epidemiological sample: I. Associations within individuals

Objective: This study examined the strength of associations between disordered eating and eating disorders and substance use and substance use disorders (SU/SUDs) in an epidemiological sample. Methods: 672 adolescent girls and 718 women completed structured interviews of lifetime eating disorders and substance use and misuse, as well as self-reported current disordered eating attitudes and behaviors. Results: Although effect sizes were small, eating attitudes and disorders were associated modestly with nicotine, alcohol, and drug use, and with nicotine dependence in adolescent girls. Alcohol use and misuse were related to eating attitudes and pathology in women. SU/SUDs were associated with restricting and bulimic behaviors and no prominent differences in associations were observed between substance classes. In contrast to findings in clinical populations, these community-based results were positive but generally weak, suggesting there is no strong, overarching relationship between eating and substance use problems. Discussion: These results have implications for the addiction model of eating disorders.