Comorbid eating disorders among women receiving treatment for substance use disorders: a systematic review and meta-analysis

Abstract

Objective

Comorbid eating disorders (EDs) and substance use disorders (SUDs) are common. Most research has explored substance use among individuals with an ED. Few studies describe the prevalence of EDs in samples of women with SUD who are attending treatment. This study is a systematic review and meta-analysis of the point and lifetime prevalence of comorbid ED among treatment-seeking female patients with SUD.

Method

Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline, six databases were systematically searched to identify studies. Prevalence rates of EDs and/or ED behaviors and methodological factors were extracted from each eligible study. Risk of bias was assessed using the AXIS tool. Random-effects meta-analysis was used to pool prevalence estimates. The protocol is registered in PROSPERO.

Results

Full text reviews were conducted on 131 studies and 24 (N = 4767) met inclusion criteria. Point prevalence of disordered eating behaviors (DEBs) was 38.71% and lifetime prevalence 20.95%. The point prevalence of a diagnosed ED was 15.69% and lifetime prevalence was 15.67%. For any ED or disordered eating, the point prevalence was 29.99% and lifetime prevalence was 19.40%. Age was a significant negative moderator for point prevalence of AN which was 5.41%.

Conclusions

This review indicates that there is a high rate of women attending treatment for SUDs with comorbid EDs and/or DEBs. Implications for treatment approaches and suggestions for future research are provided.

Keywords:

• Comorbidity
• substance use
• eating disorder
• meta-analysis
• prevalence
• women

Acknowledgements

PROSPERO registration number: CRD42021146445.

Disclosure statement

The authors report no conflicts of interest.