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Medical News & Perspectives
February 28, 2001

What's the Connection? No Easy Answers for People With Eating Disorders and Drug Abuse

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JAMA. 2001;285(8):1006-1007. doi:10.1001/jama.285.8.1006-JMN0228-3-1

New York—For therapist Steven Levenkron, MS, "I know what I'm doing" is more than an angry retort uttered by many of the patients with eating disorders he treats. It's a glimpse into the distorted thinking that signals when the illness has sunk to its nadir.

The flippant phrase is also a favorite among heroin addicts, a connection noted by Levenkron and others to transcend mere coincidence. Somewhere between 12% and 18% of people with anorexia nervosa abuse drugs, including alcohol and tobacco. Among those grappling with bulimia nervosa, 30% to 70% struggle with substance abuse, according to the National Center on Addiction and Substance Abuse (CASA) at Columbia University, New York. That means of the 5 million Americans who have a diagnosable eating disorder, including compulsive binge eating, perhaps a million abuse or are addicted to drugs.