Addiction and eating disorder: help, treatment and support

Eating disorder behaviours and addiction often develop as ways of managing distress or an emotional need. Both tend to involve secrecy, shame, and a loss of control that’s hard to explain to anyone who hasn’t been through it. Binge eating, in particular, can share characteristics with addictive behaviour.

A meta-analysis published in the European Eating Disorders Review found that drug use rates are significantly higher in people with bulimia nervosa than in the general population. Earlier research in Psychiatric Clinics of North America found that women with substance use disorders report eating disorder behaviours far more often than the general population.

Outpatient treatment is often the right starting point. It may be suitable if you are medically stable, able to live safely at home, and looking for structured therapeutic or psychiatric support that fits into your daily life. Our outpatient service includes access to consultant psychiatrists, psychologists, and therapists across the UK and Europe.

Find out more about eating disorder help and addiction

Residential treatment may be the right approach if addiction is active, there’s a higher level of physical or mental health risk, or if outpatient support has not been enough. Research in the Journal of Affective Disorders found that residential treatment improved eating disorder symptoms more than day programmes, particularly for people with more severe presentations.

For some people, the structure of a residential setting is what makes the difference. At Castle Craig and Smarmore Castle, that structure includes daily therapy, peer support, medical oversight, and time away from the environment where substance use and disordered eating became established.

Good therapy helps people understand what drives their behaviour, not just the behaviour itself. That means working on emotional triggers and finding different ways to manage difficult feelings.

CBT is recognised as the leading approach for eating disorders, particularly because the core features of conditions like bulimia nervosa and binge eating disorder are cognitive in nature. NICE guidelines support CBT as the recommended treatment for bulimia nervosa in adults. Specific forms such as CBT-Enhanced (CBT-E) have been developed as a transdiagnostic approach across eating disorder presentations. In children and adolescents, family-based treatment (FBT) is the leading approach, and family therapy has also been adapted for bulimia nervosa.

At Castle Health, the therapy forms recommended for you will depend on your individual assessment.

When you contact us, you’ll speak with someone from our admissions team. They’ll listen to what’s going on, explain what Castle Health offers, and help you work out whether we’re a good fit.

After your assessment, we’ll talk through what seems most appropriate and why, and won’t push you towards anything you’re not ready for.

Continuing care and ongoing support are fundamental parts of our treatment. Before treatment ends, we work with you and your support network to plan what comes next. That may be aftercare, a step down to outpatient treatment, recovery coaching, or ongoing therapy. For people who have experienced both addiction and eating disorder behaviours, the period after initial treatment can be when both are most likely to resurface. Having a clear plan in place before you leave makes that easier to manage.

If you decide to speak with the person in your life about your concerns, try to focus on what you’ve noticed rather than what you think they should do. Try not to make it about food or how they look. Let them know you’re worried, and that you’re not there to push them into anything.

If there is immediate risk to their physical or mental health, contact emergency services or encourage them to do the same.

We offer family therapy, couples therapy, and family support as part of our treatment programmes. We also provide guidance on how to support someone close to you through the process of seeking and receiving help.

If someone in your life is affected by both addiction and eating disorder behaviours, contact our team. We can talk through what we offer and how families can be involved in each step of the process.

Castle Health can offer outpatient eating disorder treatment as a standalone service. Our residential programmes are usually most helpful when addiction is also present. If you’re unsure which applies to you, a confidential assessment is the best way to find out.

No. You don’t need a formal diagnosis to get in touch. Our team can speak with you about what you’re experiencing and help clarify what type of support may be appropriate.

Yes. At Castle Health, both can be assessed together, and your treatment plan will take account of how each condition affects the other. Research consistently identifies co-occurrence between eating disorders and substance use, and treating them together is fundamental to how we approach care.

You can contact Castle Health for guidance, particularly if you’re concerned that both addiction and eating disorder behaviours may be present. Our team can speak with you about what to do next. If the person is in immediate danger, please contact emergency services first.

Cover depends on your individual policy and provider. Our team can talk you through what your insurance may include. Get in touch and we’ll help you work through it.