Do you have any friends who use drugs in an effort to lose weight?

A relatively large body of research suggests that women who struggle with body image and eating issues are likely to abuse substances (Bahji et al., 2019; Robinson, Walter, Deane, & Larance, 2023). For example, in a recent retrospective chart review of 182 women in treatment for an eating disorder, MacNeil and colleagues (2025) found that 34.6 percent reported using substances, with alcohol and over-the-counter (OTC) medications being most common. Similarly, a meta-analysis of substance use disorders in individuals with eating disorders found that 21.9 percent struggled with both during their lifetime (Bahji et al., 2019).

Why do eating disorders and substance use co-occur so often, especially in women? One of the main reasons is that many women are highly dissatisfied with their appearance and will engage in........

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