Eating Disorder/Substance Use Disorder

Integrated Eating Disorder/Substance Use Disorder Program

We understand that eating disorders often occur alongside struggles with alcohol and drugs. This type of co-occurring condition may exist because eating disorders and substance use disorders have a complex, intertwined relationship involving the “reward center” of the brain. If left untreated, these disorders can cause significant ongoing problems and prevent you from recovering fully.

Compassionate Eating Disorder and Substance Use Disorder Care

The Emily Program’s Integrated Eating Disorder/Substance Use Disorder (ED/SUD) program is designed for adults (18+) of all genders who have been diagnosed with anorexia, bulimia, binge eating disorder or other specified feeding or eating disorder (OSFED) and whose recurrent substance use—which is also known as chemical dependency—causes clinically significant impairment or distress. Evidence-based treatment may include:

  • Substance use assessment
  • Treatment planning
  • Skills-based therapy group therapy
  • Individual therapy
  • Medical and psychiatric management
  • Nutrition counseling
  • Care management
  • Family and education support services
  • Access to mutual peer support, 12-step meetings, partnerships with sober housing facilities

Personalized care every step of the way

The Emily Program offers different levels of care to meet you where you are in treatment. We offer an ED/SUD Intensive Outpatient Program (IOP) and Intensive Day Program (IDP). Treatment programs are currently offered in St. Paul, Minnesota.

ED/SUD Intensive Outpatient Program (ED/SUD IOP)

Structured, group-based treatment for ED/SUD
Monday-Friday, 3 hours/day
Time typically spent in program: 6-8 weeks

ED/SUD Intensive Day Program (ED/SUD IDP)

A higher level of care with more intensive, structured treatment for ED/SUD
Monday-Friday, 6 hours/day
Time typically spent in program: 4-6 weeks
Conveniently located lodging available for out-of-town clients

View ED/SUD IOP and IDP sample schedules here. (These sample schedules are for reference only. Your schedule may vary.)

Read more about eating disorders and substance use disorders comorbidity here.

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Related Mental Health Issues

Related Mental Health Issues

The Emily Program helps individuals of all genders struggling with anorexia, bulimia, binge eating disorder, and other mental health and body image issues, including substance use disorders. Our compassionate, experienced staff provides a dual focus to provide personalized treatment that leads to full, healthful living.

Eating Disorders And Other Mental Health Issues Often Present Together

Eating disorders often present with a second disorder, including substance use disorder, anxiety, trauma or depression, to name a few. We believe that simultaneously addressing both disorders in a dual diagnosis is the most effective approach for a lifetime of recovery.

At The Emily Program, our team of medical providers, therapists, dietitians, and psychiatrists brings decades of experience to addressing co-occurring disorders. We understand the complexity of dealing with multiple mental health issues.

We provide a multidisciplinary and integrative approach to healing that combines our evidence-based treatment with personalized care. Typically, dual diagnosis support at The Emily Program includes:

  • Individual and group therapy
  • 12-step facilitation (as needed)
  • Nutritional rehabilitation, therapeutic meals, and snacks
  • Medical and psychiatric services
  • Art and yoga therapy

For a more structured recovery plan for those struggling with an eating disorder and a substance use disorder, we offer Eating Disorder/Substance Use Disorder (ED/SUD) integrated intensive programs in Minnesota.

Read more about the link between eating disorders and other mental health diagnoses here

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Other Specified Feeding or Eating Disorders (OSFED)

Other Specified Feeding or Eating Disorders (OSFED)

People struggling with food issues may not show all the signs and symptoms for anorexia nervosa, bulimia nervosa, binge eating disorder, or compulsive overeating. It’s okay. At The Emily Program, we recognize and treat Other Specified Feeding or Eating Disorders (OSFED).

OSFED Encompasses Anyone Struggling With Food

Not everyone with an eating disorder fits neatly into one group. Sometimes it’s a combination of the disorders, symptoms present to a greater or lesser degree, or a completely unique struggle with feeding, food, exercising, or body image that impairs the health and well-being of an individual. Some conditions within OSFED include:

  • Atypical anorexia nervosa (weight is not below normal)
  • Bulimia nervosa (with less frequent behaviors)
  • Binge eating disorder (with less frequent occurrences)
  • Purging disorder (purging without binge eating)
  • Night eating syndrome (excessive nighttime food consumption)

All of these conditions pose serious emotional, psychological, and physical health risks. And all of them deserve attention.

Read more about OSFED here

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Avoidant/Restrictive Food Intake Disorder (ARFID)

Avoidant/Restrictive Food Intake Disorder (ARFID)

ARFID is more than just picky eating. Avoidant/restrictive food intake disorder (ARFID), which was previously referred to as “selective eating disorder” (SED) is a disturbance in feeding or eating that results in substantial weight loss (or, in children, a failure to put on weight), nutritional deficiency, dependence on tube feeding or oral nutritional supplements, or difficulty engaging in daily life.

ARFID is Not Anorexia

ARFID is commonly confused with Anorexia Nervosa due to the shared symptom of drastic weight loss and nutritional deficiency. However, while some symptoms are similar, the two eating disorders are not the same. The most notable difference being that those with ARFID lack a desire for thinness and obsessive thoughts about body image.

ARFID can affect all populations, regardless of gender, age, race, and socioeconomic status. ARFID is commonly connected to another psychiatric diagnosis, typically to an anxiety disorder or to obsessive compulsive disorder. ARFID is not the result of a lack of food or the symptom of another medical disorder.

ARFID Risk Factors

  • Those on the autism spectrum are more likely to develop ARFID
  • Those with ADHD are more likely to develop ARFID
  • Children with severe picky eating are more likely to develop ARFID
  • Children with anxiety disorders are at a higher risk of developing ARFID

ARFID Warning Signs and Symptoms

This eating disorder can have severe health consequences due to the lack of meeting nutritional needs. Some indications include:

  • Dramatic weight loss
  • Stunted weight gain and height growth
  • Gastrointestinal issues that seemingly have no known cause
  • Restriction in amount or type of food eaten
  • Fear of illness, choking or vomiting
  • Lack of appetite or interest in food
  • No body image concerns
  • Menstrual irregularities
  • Anemia, low hormone levels, low potassium, slow heart rate
  • Dizziness or falling
  • Muscle weakness
  • Fine or brittle nails

Read more about ARFID here.

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Compulsive Overeating

Compulsive Overeating

People with compulsive overeating typically eat excessive amounts of food—but not because they’re hungry. Instead, they eat to feel better, to feel happy. The opposite happens. They feel a loss of control, as if they have no willpower. And the eating begins again.

Compulsive Overeating Is Not About Hunger

People with compulsive overeating may sometimes eat in binges, but they may also engage in “grazing” behavior, picking at food throughout the day. They may excessively dwell on thoughts about food, sometimes secretly fantasizing about eating and contriving ways to eat alone.

Compulsive overeating often leads to weight gain, but people of all sizes can struggle with it. Psychological illnesses as well as physical medical conditions, such as diabetes, hypertension, and heart disease, often add complexity to the unhealthy behavior.

Compulsive Overeating Warning Signs

This eating disorder is often entwined with other issues that threaten emotional and physical health. Some indications include:

  • Weight gain
  • Depression or anxiety
  • Feelings of guilt or shame
  • Post-traumatic stress disorder
  • Personality disorder
  • Withdrawal from social situations or events
  • Fatigue

Read more about compulsive overeating here.


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Binge Eating Disorder

Binge Eating Disorder

People with binge eating disorder repeatedly and uncontrollably consume large amounts of food. Guilt, shame, and distress builds. Binge eating disorder can also result in excessive weight gain over time, adding to body dissatisfaction which can perpetuate a cycle of yo-yo dieting. Efforts at dieting often end with another binge eating episode, and the cycle and distress continue.

Recovery Breaks The Binge Eating Cycle

Binge eating disorder typically involves excessive food intake while feeling a loss of control with food. Binge eating behaviors may be experienced as comforting or soothing negative emotions, yet the “comfort” does not last. People with binge eating disorder often swing to the other extreme and begin highly restrictive diets, which often ends in bingeing again—and more negative feelings. It’s more than yo-yo dieting, however, it is an eating disorder.

To compound the situation, a diagnosis of binge eating disorder may be accompanied by other mental health conditions such as depression and anxiety. Binge eating disorder may also contribute to physical conditions, such as high blood pressure and cholesterol levels, cardiovascular disease, and Type 2 diabetes. Binge eating disorder can affect anyone at any weight, size or shape, age, or gender.

The Emily Program understands the physical and emotional strain of binge eating disorder. We’re here to help with personalized treatment programs that free you or your loved one from its ravaging ups and downs, paving the way to a more peaceful relationship with food and self.

Binge Eating Disorder Warning Signs

A combination of risk factors may cause binge eating, such as family history, genetics, dieting, related psychological conditions, and substance abuse, but no single factor causes binge eating. Some indications include:

  • Repeated and frequent excessive food consumption without hunger
  • Using food to cope with negative emotions, but feeling distressed, disgusted, guilty, or depressed instead
  • No compensatory behaviors to “make up” for the calorie intake, such as purging or over-exercise
  • Feelings of loss of control, self-loathing, depression, anxiety, shame
  • Insomnia, joint or muscle pain, and/or headaches
  • Menstrual problems
  • Suicidal thoughts

Read more about the physical effects of binge eating disorder here


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