For some people recovering from alcohol problems, food can become part of the struggle too.
A new review led by Bournemouth University and published in the Journal of Eating Disorders found that disordered eating is common among people receiving treatment for alcohol use disorder. That can include binge eating, restricting food, body image concerns or using food to cope with difficult emotions.
The review does not show that alcohol problems cause eating disorders, or the reverse. Instead, it found that the two often overlap and may share some of the same emotional and behavioral patterns.
Researchers reviewed 44 studies published between 1988 and 2026. Bulimia nervosa was the eating disorder most often reported, although the studies used different definitions and screening tools, making it difficult to pin down one reliable prevalence rate.
Several themes appeared repeatedly. People struggling with both alcohol and eating problems often reported difficulty coping with distress, impulsive behavior and low self-esteem.
“Health care systems have well established recovery programs for alcohol problems and disordered eating,” said lead author Anna Preece, a PhD student at Bournemouth University. “However, treating them as distinct problems does not reflect reality for many people with alcohol problems who also struggle with overeating, restricting what they eat or using food to cope with their emotions.”
Some studies also suggested that eating problems may make alcohol recovery harder. In one, eating disorder symptoms were linked with a greater likelihood of leaving treatment against medical advice.
But the evidence is still limited. Much of the research was observational, so it cannot prove that disordered eating directly worsens alcohol recovery.
The review also found that eating problems can show up in different ways. Some people reported binge eating during periods of distress. Others struggled with restrictive eating or used food as a substitute coping strategy during recovery.
That is important because disordered eating does not necessarily mean someone has a diagnosed eating disorder.
The researchers say alcohol treatment services may benefit from asking about eating behaviors early in recovery, rather than waiting for a separate eating disorder diagnosis to emerge.
They also raise a question about whether very rigid treatment approaches could be difficult for people who already struggle with restrictive eating. That idea is still preliminary, and more research is needed before drawing conclusions about the best way to combine alcohol and eating disorder care.
There are also major gaps in the evidence. Many studies focused on women, even though men in recovery report eating and weight concerns too. Most of the research also came from Western, higher-income countries.
“Health care services are organized around diagnoses and specialties, but patients aren't,” Preece said. “If alcohol services ask about alcohol but not eating, they may be missing a significant part of the problem.”
The review was supported by Bournemouth University. One author also receives support from the National Institute for Health and Care Research Southampton Biomedical Research Centre.