Eating disorders and substance abuse

Eating disorders and substance abuse

A more common combination than people think, substance abuse and/or dependence is often found in people presenting with eating disorders. Here are some things you may not have known about this combo.

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Surviving Thanksgiving with an eating disorder

Overwhelmed about the holidays? Worried about making it through a day filled with food with your recovery intact? Hopefully these tips can help you.

Overwhelmed about the holidays? Worried about making it through a day filled with food with your recovery intact? Hopefully these tips can help you.

It's that time of year when people start talking about gorging themselves full of food, loosening up a couple notches on their belts, and fasting to make room for the feast. 

For some it's a dinner time tradition, while others celebrate it during lunch. Whenever it's held, one thing is for sure: this holiday is all about the food, food, food. 

If you have an eating disorder, you may not be thankful for Thanksgiving. Many people report being scared, anxious, and overwhelmed by this holiday. And why wouldn't you be!!

What would it be like for an alcoholic to sit down for Thanksgiving dinner and have the whole table filled with alcohol? I don't think the analogy is far off for someone with an eating disorder, except a table full of alcohol with people sitting around waiting to binge drink is not socially acceptable and probably wouldn't happen. 

So, how do you survive this day without binging, purging, or restricting? Use the tools that have gotten you this far, and maybe a few more. 


Thanksgiving is not just about food (even though it may seem like that). It's also about being around those you are thankful for. 

If you're lucky, that means you may be surrounded by your support network. Use them! If you are struggling with an urge, talk to someone. Maybe even before the big meal, you could give them a list of things they could say or do to help you through. Have them check out this blog on tips for talking to someone with an eating disorder.

Practice your mindfulness

"If you want to conquer the anxiety of life, live in the moment, live in the breath." - Amit Ray

In moments where you feel overwhelmed by the situation or you feel an urge, remember to use your mindfulness skills to get you back to being centered in the moment. 

Focusing on your breathing is a great tool to use. 

  • Breathe in through your nose for a count of 6
  • Notice how the air is cool coming in
  • Exhale to a count of 6
  • Notice how the air is now warm as it leaves your body

Focusing on your big toe is another fast, easy mindfulness tool

  • Focus entirely on your big toe
  • Fill your toes with warmth
  • Continue breathing normally as you do this
  • Wiggle your toes and notice how it feels

Acts of mindfulness can seem silly when reading them on paper or talking about them, but they are powerful when put to the test. 

If all of your energy is focused on your breath or your toe, your anxiety has no choice but to decrease. 


Sometimes you just need to get away!

Whether physically getting up and distracting yourself or using cognitive distraction, sometimes escaping the urge may be the best option. 

Removing yourself from the urge and keeping your mind occupied doing something else will help. Try watching tv, reading a book, taking a walk, getting outside and enjoying the weather, playing a board game, playing with the dog, helping with dishes, and so on and so on. The list could go on forever.

Cognitive distraction takes place in the mind. My body is here but my mind is not!

I came up with a couple of ideas for cognitive distraction to get your mind going:

  • Run through all the lyrics to your favorite song
  • Create a movie in your mind: who would the actors be? where is it set?
  • Plan your dream vacation

Notice the wins

"At the end of the day, you can either focus on what's tearing you apart, or what's holding you together." - Rob Dyer

Yes, Thanksgiving can be challenging, and you will probably face many obstacles throughout the day. Some you may conquer and some you may not. What you focus on will make a difference. 

This is about progress, not perfection. You don't have to get it all right to celebrate your wins. 

Focus on the wins you had throughout the day. 

Recovery is hard and you are doing it, even on what is considered one of the most challenging days of the year for those with an eating disorder. Hold on to that truth. Rejoice in it. 

I’d love to hear about the tools you use to get through tough food-focused days like Thanksgiving. Please sound off in the comments section below and share your ideas. 


Tamara Werner

Tamara Werner is a counselor, author, speaker, and activist. Her private practice, Get Centered Counseling in Vancouver WA, helps women with food and body issues learn to love themselves, their body, their life, and their relationships. Her life’s work is steeped in personal experience, having fifteen years in recovery for anorexia, in addition to being a breast cancer survivor. An up and coming force in the counseling community, Tamara has been published in a textbook called Treatment Strategies for Substance and Process Addictions, and has sat on a panel at the American Counseling Association Conference, where she spoke to her peers on strategies and tools to use with clients struggling with eating disorders. Having a deep, personal understanding of what it takes to recover from this condition, she seeks to be an example to those she treats, to let them know that recovery is possible.

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