Thursday, March 22, 2012: 10:45 AM-12:15 PM
Crystal A (The Charleston Marriott)
This presentation will examine the demographics of eating disorders (ED) and substance use disorders (SUD), as well as their co-occurring demographics. Reviewing the brain reward system and research regarding the two, it discusses etiology and characteristics of individuals with ED & SUD and will present treatment methodologies within a recovery model.
- Definitions
- Demographics
- Findings of the National Center on Addiction and Substance Abuse
- DSM IV-TR diagnostic criteria
- The Disease Concept: ED’s as Addiction Spectrum Disorders
- Similarities and Differences
- The Brain Reward Pathway: Food and Substances of Abuse
- Research regarding Food as an Addiction
- 12 step facilitation for EDs
- Research: co-occurring ED and SA
- Treatment implications
Up to 50% of individuals with eating disorders also present with substance use disorders and up to 35% of individuals with substance use disorders also present with eating disorders, Bulimia Nervosa being most commonly linked to substance abuse. The findings of the National Center on Substance Abuse indicates both have shared risk factors (including occurrence in times of transition or stress; common brain chemistry, family history, low self esteem, depression, anxiety and impulsivity; and their shared characteristics (obsessive preoccupation, craving, compulsive behaviors, secretiveness and rituals; experience mood altering effects and social isolation, linked to other psychiatric disorders and medical complications; both are difficult to treat and potentially fatal; both have high relapse rates, and require intensive therapy). The DSM IV-TR diagnostic characteristics of Substance Dependence, Anorexia Nervosa and Bulimia Nervosa, will be presented as well as the diagnostic characteristics for the proposed Binge Eating Disorder (to be included in the DCM-V.) The disease concept used in addictions can be applied to eating disorders: both are primary, progressive and chronic diseases; both are family diseases; both have elements of both dependence and withdrawal symptoms; both have complex bio-psycho-social-spiritual etiologies; relapse is common to both; effects of both can be irreversible and both can be fatal, with significant mortality rates. Research has indicated that the brain reward system including the nucleus accumbens, the ventral tegmental area and the median forebrain bundle processes responses to both food and addictive substances in the same pathways. Research has indicated that these pathways mediate the positive emotional effects of natural rewards including sex, social interactions, exercise, gambling and sexual addiction. Overeating in obese individuals shares similarities with loss of control and compulsive drug taking behaviors with PET scans revealing similar processes in the Dopamine receptors. There are also similar genetic factors and developmental factors with both substance abuse and eating disorders. Due to the many similarities between eating and addictive disorders, the recovery and 12 step models used in substance abuse treatment can be used effectively with eating disorders.
Primary Presenter:
Kimberly Dennis, MD
Kim Dennis is a board-certified psychiatrist who specialized in treating addictions, eating disorders and co-occurring disorders. She is medical directorat Timberline Knolls and is a member of the AMA, Academy for Eating Disorders, the American Academy of Addiction Psychiatry and American Society for Addiction Medicine. She is published in the areas of gender differences in the development of psychopathology,co-occurring eating disorders and self-injury, and the use of medication with family-based therapy for adolescents with anorexia nervosa. She is on the edicotial board of Eating Disorders: The Journal of Treatment and Prevention.
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