"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."
"In the United States and many Western cultures, thinness, fitness, and youth are prized physical attributes, especially for women. As such, many women feel tremendous pressure to maintain a thin and youthful appearance, because the cultural message is this: If you look beautiful, you will be successful, happy, healthy, and popular ( Ata et al., 2015). Conversely, if you are overweight or "unattractive," you are personally responsible."
Weight dissatisfaction is commonplace in the United States. Emerging research indicates many women use substances as a method of weight loss. Clinical data show substantial co-occurrence: 34.6 percent of 182 women in an eating-disorder treatment sample reported substance use, most commonly alcohol and OTC medications, and a meta-analysis found 21.9 percent lifetime co-occurrence of eating disorders and substance use disorders. Western cultural emphasis on thinness, fitness, and youth creates intense appearance-related pressure and negative stereotypes toward overweight individuals. Addressing body-image disturbance as a motivation for substance use is essential for effective treatment when present.
Read at Psychology Today
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