Diet pills, alcohol, caffeine, nicotine, amphetamines and cocaine abused by patients with eating disorders

Between 11 and 13 million people in the U.S. have eating disorders and at least one million will die from their disorder. It is not unusual for women and girls struggling with eating disorders to either abuse or become dependent on over-the-counter substances.

"It may surprise many people, including some healthcare providers, that over-the-counter products and supplements for dieting purposes are frequently abused by those with eating disorders," said Kevin Wandler, MD, of Remuda Ranch Programs for Eating and Anxiety Disorders. "A full 64 percent of eating disorder patients abuse diet pills. The health consequences of diet pill abuse are enormous and include high blood pressure, abnormal heart rhythms, tremors, thickening of the heart muscle, and kidney damage."

Other substances abused by individuals with eating disorders include:

• Alcohol - Typically individuals with anorexia don't consume alcohol, due to its high calorie content. However, for people with bulimia and a sub-group of those with anorexia who also binge and purge, alcohol is frequently consumed, then eliminated through vomiting.
• Caffeine - It's consumed in the form of black coffee or diet drinks to fill the stomach and it staves off hunger. Caffeine also serves as a diuretic, and people with eating disorders confuse temporary fluid loss with actual weight loss. In addition, those with bulimia in general use liquids because self-induced vomiting is easier when the stomach is full of fluid.
• Amphetamines and Cocaine - These substances are used because they suppress appetite and provide energy in the absence of adequate food intake.
• Nicotine - Nicotine is an appetite suppressant that can increase metabolism in females as much as 10 percent. It's not uncommon for girls with eating disorders to take up smoking to control appetite in an effort to lose unwanted pounds.
• Laxatives, Diuretics and Over-the-counter Diet Pills - Like so many over-the-counter medications, these drugs are intended to address a specific medical need during a limited time frame. Although laxatives and diuretics are not often considered drugs of abuse or dependence, individuals can become dependent on them. With prolonged use, users can develop tolerance and withdrawal. A recent study found that in a sample of 200 bulimics, 31 percent used diuretics.

"It can take the body months to recover from laxative and other over-the-counter substance abuse," adds Dr. Wandler. "It's important to get professional help before the abuse escalates."

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