Statements

RELEASE
8:30 a.m. ET
January 23, 2001
New York, NY

Welcome to Food for Thought: Substance Abuse and Eating Disorders, the first conference ever held to explore the relationship between substance abuse and eating disorders.

It is a privilege to co-sponsor this event with the National Institute on Drug Abuse, The National Institute of Mental Health and the Commonwealth Fund.

We have a phenomenal group of people here today. We are honored to have three distinguished individuals delivering keynote presentations: Dr. Alan Leshner, Director of the National Institute on Drug Abuse; Dr. Steve Hyman, Director of the National Institute of Mental Health and Steven Levenkron, one of the nation's premier clinical psychotherapists in this field.

We also have many of the top experts in the fields of substance abuse and eating disorders and a four star group of moderators.

All speakers, panelists and moderators have waived their customary fees and are donating their time to CASA and this unprecedented conference. We extend our special appreciation to them. We could not hold this conference without their generosity.

The National Center on Addiction and Substance Abuse at Columbia University--CASA--is the only national organization that brings together under one roof all of the professional disciplines necessary to deal with all forms of substance abuse in all facets of society.

CASA works to convince Americans that the single most important thing they can do to reduce the public costs and private agony caused by diseases like cancer, heart disease and respiratory illnesses, child and spousal abuse, teen pregnancy, AIDS, welfare dependence, incarceration, crime, much of urban school deterioration and other social ills is to address substance abuse and addiction.

Today's conference is the third in our series of CASACONFERENCES, a venture that seeks to encourage interested policymakers, local leaders, researchers and individuals to develop more effective policies, raise public awareness among professionals in various fields and create and target research agendas. CASACONFERENCES seek to raise consciousness of how substance abuse is implicated in other problems and conditions.

CASA has already presented two conferences: Substance Abuse in the 21^st Century, Positioning the Nation for Progress at the Ronald Reagan Presidential Library in California last year, and Substance Abuse and Learning Disabilities: Peas in a Pod or Apples and Oranges? held in 1999 here in New York.

The next CASACONFERENCE--on Substance Abuse and Gambling--cosponsored by the National Institute on Drug Abuse, the National Institute of Mental Health and the Century Foundation, will be held here at the CASA Conference Center on June 12. An East Coast version of Substance Abuse in the 21^st Century: Positioning the Nation for Progress is scheduled for 2002.

Today's conference is the first step in CASA's systematic exploration of the relationship between eating disorders and substance abuse. Are people with eating disorders more likely to develop substance abuse problems? And are substance abusers at higher risk for eating disorders? We will issue a CASA White Paper on this subject that will be enriched by the discussions here today.

More than five million Americans, predominately (but not solely) women, suffer from eating disorders—anorexia nervosa, bulimia nervosa and binge eating disorder. Millions more periodically display symptoms of eating disorders or constantly worry about their weight.

This is a life threatening problem. The death rate of a young woman with anorexia has been found up to 12 times greater than that of a woman of the same age without anorexia--and up to twice that of a young woman with any other psychiatric disorder.

More than five million women currently use illicit drugs; some 1.5 million are addicts. At least three million are alcoholics and several million more abuse alcohol. Some 30 million women are addicted to nicotine. More than one million girls ages 12 to 17 are current illicit drug users; more than one and a half million girls are addicted to nicotine; and more than 1.2 million binge drink or are heavy alcohol users.

Today our participants will discuss who, what, why, when, where and how eating disorders and substance abuse intersect.

Here are a few of the disturbing facts:

FACT: Between 12 and 18 percent of individuals with anorexia and between 30 and 70 percent of those with bulimia abuse tobacco, alcohol, pills or over the counter substances.

FACT: The adolescent years are when women are at greatest risk of eating disorders. These are precisely the years when they are at greatest risk of substance abuse.

FACT: During substance abuse treatment and early recovery, it is not unusual for an individual to turn to binge eating.

FACT: A student who has dieted in sixth grade is more than 20 percent likelier to drink alcohol in the ninth grade than one who has never dieted.

FACT: The more often and more severely an incoming college female diets, the more likely she is to use drugs and abuse alcohol. 72 percent of severe freshmen dieters and bulimics have used alcohol in the past month, compared with less than 44 percent of those who did not diet. Freshmen women with bulimia are more than four times likelier to have smoked in the last month than those who did not diet. The more severe the dieter, the more likely the abuse will involve more than one substance.

FACT: More than twice as many individuals with a history of weight control respond positively to two or more questions on the CAGE Questionnaire assessing alcoholism, signaling the likelihood of a serious alcohol problem, than those without such a history.

FACT: A People magazine survey revealed that 12 percent of women consider smoking a weight reduction method.

FACT: Girls who smoke to suppress their appetites are among the largest group of new nicotine addicts. Among white teenagers who smoke, girls are three times likelier than boys to smoke to supress their appetites.

FACT: Women who smoke are more than twice as likely as men to cite weight concerns as a reason not to quit.

The tobacco companies understood the relationship between smoking and weight control long before the public health experts. Nicotine pushers began pitching cigarettes as a route to thinness in the 1920s when they first tried to reach women as a market. Lucky Strike Ads told women to "Reach for a Lucky instead of a sweet."

When the 1964 Surgeon General's report spotlighted the harmful effects of smoking and the male market leveled off, tobacco companies targeted women. They created Virginia Slims with its tagline "slimmer, longer, not like those fat cigarettes men smoke." They placed their ads in women's magazines that rarely reported on the health dangers of tobacco. Thanks in part to these ads, the rate at which girls started smoking rose sharply from between 1967 and 1973: among 12 year old girls, by 110 percent; among 17 year old girls, by 35 percent.

Polls repeatedly show that the number one wish for females ages 11 to 17 is to lose weight. Sixty percent of 12 and 13 year old girls with low self-esteem are watching their weight and on diets. Tobacco companies manipulate this desire, capitalizing on girls' low self esteem, a risk factor for both eating disorders and substance abuse.

The slogan for Misty cigarettes is "Slim n' Sassy." Capri claims "There's no slimmer way to smoke" and calls its cigarettes, "The Slimmest Slim in town." Virginia Slims' famous tagline is "You've come a Long Way, Baby." But as Gloria Steinham once pointed out, "If we've come such a long way, why are we still smoking?"

Cigarettes and eating disorders are linked in more ways than the tobacco companies let on. Cigarette smoking and eating disorders share many of the same health consequences—osteoporosis, heart problems, infertility.

The most sordid exploitation of the connection between eating disorders and substance abuse is found in the fashion industry. Drug use—especially heroin and cocaine—is not uncommon, and for many models it is the chosen route to wafer thinness. Grotesque as it may be, heroin chic—the thin, hollow-eyed, emaciated figure caricatured as social X-rays by novelist Tom Wolfe--has been promoted as the standard of beauty by fashion photographers and their principals.

These facts and commercial exploitations provide ample evidence of a need for professionals to be sensitive to the increased risks of substance abuse among patients with eating disorders—and vice versa—and for researchers to explore the relationship between the two conditions. Though research has assembled some prevalence estimates, researchers still do not know or fully understand all of the driving forces behind the comorbidity of eating disorders and substance abuse.

It is our goal today to put on the table what we know about this connection between substance abuse and eating disorders--and what we don't know.

This conference brings into play two important CASA findings.

• An individual who gets through age 21 without using drugs, smoking cigarettes or abusing alcohol is virtually certain never to do so.

• The single greatest influence on children is parents. This is true even during the difficult years of adolescence when we may think our teenagers don't care at all what we say.

Parents' attitudes about dieting and drugs and alcohol have an important influence on kids. A Harvard Medical School study found that a parent's influences, more than their peers or the media, predicts whether or not a youngster becomes highly concerned with weight or a constant dieter. CASA's Teen Surveys reveal that teens who never used marijuana are most likely to credit their parents with their decision.

By making parents, teachers, counselors, and health professionals aware of the connection between substance abuse and eating disorders, we will be better equipped to help children, students and young women. By identifying the risk factors, we will be better equipped to prevent both these disorders from developing in our children. By bringing attention to common characteristics and shared risk factors, we can better focus our research agendas.

Welcome, and enjoy the day.

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