EDs are complex psychiatric illnesses that impair psychological, social, and physical functioning. It has been argued that the treatment of co-occurring ED and AOD use should be provided using an integrated approach to minimise the potential for deterioration in one disorder when symptoms of the other improve [726, 1415, 1426]. Regardless of the eventual treatment plan, the assessment of ED should involve a multidisciplinary team of health and mental health workers, and include a thorough physical exam (with blood and urine tests) to identify complications that may need immediate attention and/or hospitalisation for medical stabilisation [1414, 1415, 1427, 1428].
There are several options available for the treatment of ED alone, including psychotherapy, pharmacotherapy, e-health and telehealth interventions, physical activity-based interventions, as well as complementary and alternative therapies. The evidence base surrounding each of these treatments is briefly discussed below, with regards to each ED. A detailed summary of the evidence relating to each disorder is also provided in a systematic review undertaken by the Australian National Eating Disorders Collaboration [1429].
There is limited evidence about the treatment of co-occurring ED and AOD use disorders specifically, due to the exclusion of people with AOD use disorders from the majority of ED treatment trials [1430]. The preliminary evidence that does exist, however, suggests that structured programs incorporating elements of established psychotherapies such as CBT, family-based treatment (FBT), and DBT, including individual psychotherapy sessions, family therapy, group therapy, and nutritional planning, may effectively reduce symptoms of ED among people with co-occurring AOD use in ED treatment programs [1404, 1431, 1432]. There is also some evidence to suggest that treating a person’s AOD use disorder may lead to improvements in ED symptoms [1430].