EDs (i.e., anorexia nervosa, bulimia nervosa, binge eating disorder) and AOD use frequently co-occur [1397]. The co-occurrence of ED and AOD use disorders is particularly complex and challenging, in terms of assessment and treatment, associated physical health complications, and the potential negative cognitive impacts of both disorders [1398]. Assessment can be made even more difficult as the minimisation or denial of symptoms can form part of some eating disorder presentations; either due to a lack of self-awareness, shame, or as a result of some EDs being experienced by the person as ‘valuable’ to them and something they must protect [428, 1399]. It is however, important that co-occurring ED and AOD use is identified; the consequences of ED and AOD use are severe, and can include medical complications [1400, 1401], additional severe psychiatric conditions [1402–1404], suicidal ideation and attempts [1405, 1406], and mortality [1407].
It is vital for AOD workers to be able to recognise the clinical and subthreshold signs of ED and have some knowledge about simple management strategies.