The incredibly risky combination of alcohol abuse and an eating disorder can lead to an onslaught of physical and emotional consequence: Possibility of severe organ damage, coma, and death top the list—not to mention relationship impairment, diminished functioning at school or work, and risk of anxiety and mood disorders, explain Ephrat Lipton, a licensed clinical social worker and therapist.
Unfortunately, though, sometimes they go hand in hand. Sita Wilson Stukes, 26, program coordinator for the Eating Disorders Information Network (EDIN), shares her story—and what you can do to help yourself or a loved one who may be in trouble.
“I was adopted from India into a white family, and I was always conscious of looking different,” Stukes begins. “When I look back at pictures, I was a knock-kneed skinny little kid, but I remember feeling fat. I couldn’t pinpoint an occasion or a trigger, but I just always had that feeling.”
By 16, she started “purposely restricting” food while attending an all-girls high school. “It was a ripe breeding ground for eating disorders—we had uniforms with skirts and I was very conscious of what I looked like.”
She discovered alcohol her senior year at a New Year’s Eve party. “The first time I drank, I drank a ½ handle [a handle=1.75 liters] of vodka and blacked out. In what I’ve learned from the addiction world—if that’s what your brain is exposed to at the beginning, it’s a pattern that continues.” Soon, she drank routinely on the weekend with friends.
For her senior trip, she went to Club Med in the Dominican Republic, where the legal drinking age is 18. “I was two months shy of 18 and I managed to get a bracelet. We had free-flowing access to alcohol,” she explains, before dropping a bomb. “I was raped—and my friends told me I couldn’t tell anyone because we were drinking.”
After that, she says, “My body went into complete shock. My way of protecting and soothing myself was to binge [eat]. And then, I figured out how to purge.”
Stukes had her own bedroom and bathroom, so her parents remained unaware. “I’d bring food into the house and hide it. We lived in an apartment so anything that I binged on, I could throw away [the wrappers] in the garbage cans in the communal hallway.”
Stukes suffered another sexual assault while drinking the night of her high school graduation, which led to a bout of “incredible guilt and shame.” She spent the summer abstaining from drugs, alcohol, and her eating disorder.
But then she went to college. “The only way I was exposed to drinking was fast and in large quantities. I don’t think my dad has ever had alcohol in his life and my mom is a lightweight—she acts drunk after a glass of wine. The only context of drinking was binge drinking, so to me, it wasn’t abnormal.
“I had social anxiety and given my sexual traumas, I was anxious and uncomfortable around boys. At the same time, I equated any sort of interaction with a guy with intoxication. So, [my friends and I] would take shots.” Stukes did not binge, purge, or restrict calories—and she gained 30 pounds.
When she returned home, her weight gain was noticed—mainly by her mother. “She never did anything intentionally to hurt me, and she struggled with disordered eating behavior herself… but if your own mother thinks you are fat—that must mean the world thinks it times 1,000.” Stukes began once again actively restricting calories.
She joined a sorority sophomore year, and her drinking and drug experimentation escalated. “Mentally, I think my emotional and mental states were very fragile. You’re tired, you’re not thinking clearly, you’re irritable and moody. When you’re actively engaged in your eating disorder, that happens anyway—but you throw in drugs and alcohol and it’s magnified. I remember never feeling good.” On Easter Sunday, Stukes awoke hung over and bruised. She had fallen down a flight of stairs and sprained her spine. She had no recollection.
Her senior year, she fell into a depression after breaking up with an emotionally abusive boyfriend. “I started back with the bulimia. I was drinking daily and living on a small amount of calories. I wouldn’t eat so I could get drunk faster, and I would purposely get sick to get rid of the alcohol that was in my stomach.”
“The alcohol made it feel better—it made it not so miserable when I was doing these things. The self-loathing was constant, but using drugs and alcohol made it easier to sit with myself, to sit with my feelings.”
During a Thanksgiving trip home, she broke down to her parents that she was extremely stressed—but did not disclose the eating disorder or the extent of the substance abuse. She agreed to a medical withdrawal from school and counseling and brokered a plan to return to her college apartment to finish out her lease. Her parents thought it would be good idea to be around her friends.
A car accident soon followed after an emotional encounter with her boyfriend. “It was a miracle that I was sober—but I was crying and upset. I turned to get on the highway and I didn’t see a car coming in the other direction. I totaled my car.” Stukes sustained a knee injury and underwent surgery.
“That’s when I was introduced to pain pills—that’s really when I was the lowest.” Stukes avoided leaving her apartment and alienated most of her friends. “When I did leave, it was to get drugs or alcohol. I could not leave my apartment sober. “
Stukes’s roommate was also depressed, had withdrawn from classes, and was flying home. It was at this point that Stukes’s therapist confronted her, concerned about her being completely alone in her apartment.
“She said, ‘It’s 4:30—have you eaten anything today?’ She told me I shouldn’t drive—I could have a seizure or pass out. I thought she was being dramatic. I can’t remember if I told her about the bulimia and I didn’t tell her with any sort of accuracy the amount [of drugs or alcohol] I was doing.”
That was also a turning point. “She asked me if I would be willing to seek treatment for my severe depression. And I was so miserable and desperate I just said yes.”
After struggling through tough years of treatment, Stukes is now in recovery from drugs, alcohol, and her eating disorder. Her work with EDIN includes educational outreach on eating disorder prevention, where she helps others who are dealing with similar struggles. “I’m not embarrassed about what I’ve gone through, because I can use it as a tool,” she explains.
Part of her work is helping educate people on what eating disorders look like, so that they can help their loved ones. If you suspect a friend or family member has an issue with restricting calories, binging and purging, or abusing drugs or alcohol—she recommends “educating yourself before you take any action” by checking out websites like EDIN or talking to a professional.
Once you’re armed with information, she advises avoiding a combative approach. “Come from a place of concern and not a place of judgment.”
Lynn Blanchard, a certified addiction counselor and clinical director of the California-based treatment center New Directions for Women, agrees. “I would not directly say, ‘Hey, I’ve noticed you throwing up or drinking too much,’ but instead say, ‘I noticed a couple of things and it looks like you’re struggling a bit. What can I do to help?’”
If a friend does open up to you, Blanchard recommends brainstorming about what that help would look like. For example, say, “Do you want me to come with you to an AA meeting? Do you need help finding a therapist?”
If the behavior is related to food, Lipton suggests an approach that “normalizes” the behavior somewhat. “[Try saying], ‘We’re all over-focused these days on our appearance, health and weight—why don’t we check out a meeting and see what they have to say? Maybe it will help us have a healthier perspective. I’m worried that for you, it may be a little more extreme.’”
Of course, there are times when offers to help are met with anger. If this is the case, “Don’t give up. Circle back around a few months later,” says Lipton. “It’s tough—[these disorders] are something that people want to protect.” Dr. Susan Albers, clinical psychologist and eating disorder specialist, explains that restricting food and [abusing] alcohol serve as numbing agents of emotion and are powerful coping skills.
“I think you have to be willing to know that someone might be mad or upset with you in the moment, but hopefully, they will look back and appreciate it,” says Lipton.
And if you’re the one who needs help, don’t be afraid to get it yourself. “There are Eating Disorders Anonymous meetings, Overeaters Anonymous meetings, and ANAD (National Association of Anorexia Nervosa and Associated Disorders) meetings. If you have the courage to go by yourself, that is a place to start. If you have someone you can confide in—a spouse, friend or parent—let them in,” says Stukes.
Lipton says the most important thing to realize is that eating disorders and substance abuse are disease processes, not character flaws. “Most women who develop these disorders are incredibly sensitive, hyper-responsible, highly motivated, and achievement-oriented people. And it is those qualities, which, in the extreme, can cause women to feel they are not measuring up. Those feelings drive the behaviors. You are not alone and help is available!”
Varci Vartanian is a jack (er, Jill) of all trades. After a successful career in healthcare, she traded her lab coat for her current position as chief temper tantrum tamer/play date consultant for her two-year-old. She also enjoys writing short stories, freelance magazine work, and carbohydrates. Follow her on Twitter @varci_vartanian.
Such an informative article. It is so important that the issues of alcoholism, anorexia and bulima are addressed and that young women who suffer from these diseases get the help that they need. This is something that should not be swept under the rug.
