The Relapse
Nobody Screened For

Eating disorders and addiction travel together far more often than chance would predict. When a man gets sober but his disordered eating is never named or treated, that untreated disorder becomes one of the most common, and most missed, reasons recovery does not hold.

Two problems, one root

Addiction and eating disorders are not really separate conditions that happen to co-occur. They are often two expressions of the same underlying difficulty: a nervous system that has learned to manage unbearable feelings from the outside. Alcohol, drugs, restriction, bingeing, and compulsive exercise all do the same job. They numb, they soothe, they punish, they give a sense of control when everything inside feels out of control.

Seen that way, it is no surprise that studies repeatedly find people with an eating disorder are several times more likely than the general population to struggle with substances, and that a large share of people in addiction treatment carry disordered eating alongside it. The two are wired to the same source.

Why sobriety can make an eating disorder worse

Here is the trap. In early recovery a man removes his primary substance, but the feelings it was managing do not disappear. They have to go somewhere. Very often they move into food and the body, which are always available and rarely questioned. Restriction, bingeing, or punishing exercise quietly take over the regulating job the substance used to do.

In the recovery world this is sometimes called cross-addiction, or swapping seats on the same ship. It can look, at first, like progress. He is sober, he is at the gym, he is "being disciplined with food." Underneath, the same disorder is running, and it is building pressure. Left untreated, it becomes the fault line the next relapse runs along.

Why it gets missed in men

Men are screened for eating disorders far less than women, and they rarely raise it themselves. In a treatment setting focused on alcohol or drugs, disordered eating is easy to read as healthy restraint or commitment to fitness. The man himself may not have words for it, or may feel too ashamed to admit that alongside the addiction there is also a "women's illness", as many still wrongly think of it. So it stays hidden, and it stays untreated, and it keeps pulling him back. You can read more about how it hides in the pieces on male anorexia and bigorexia.

What lasting recovery actually needs

Recovery holds when both problems are treated as what they are: linked strategies for surviving the same pain. That means not treating the addiction in one place and the eating disorder nowhere, but working with the whole man. Steadying the behaviours, yes, but also understanding what they regulate, and repairing the shame, trauma, or sense of not-enoughness underneath that has driven the need to escape at all.

This is the ground Dr Philippe Jacquet works on. He is trained as an addiction specialist and holds a doctorate in male eating disorders, and he supervises clinical teams in recovery settings, so he sees exactly where the two meet. At Men Who Heal that understanding shapes individual therapy, male-only groups, and residential work built for men, and an approach that looks beneath the symptom to what it protects.

Can an eating disorder cause a relapse?

Yes. An untreated eating disorder keeps the underlying emotional dysregulation active, and can escalate in early sobriety, which frequently precedes a return to alcohol or drugs.

Should addiction and an eating disorder be treated together?

Wherever possible, yes. Treating one and ignoring the other leaves the shared root in place, which is why integrated, whole-person treatment tends to hold where single-track treatment does not.