Substance use and impulsive behaviors among adolescents with eating disorders.

Results of past research suggest that the existence of bulimic behaviors (binge eating and/or purging) may be an indicator of increased likelihood of substance use. We investigated incidence of substance use among adolescent girls (mean age = 15.4 years) with anorexia nervosa (n = 59) or bulimia nervosa (n = 58). The incidence of substance use among girls with anorexia nervosa was low, particularly after removing those anorexic adolescents with bulimic symptoms. Nearly one-third of girls with bulimia nervosa had smoked tobacco cigarettes, had used marijuana, and were drinking alcohol at least weekly. Among those exhibiting bulimic symptoms, increased experience with use of different substances was related to increased incidence of attempted suicide, stealing, and sexual intercourse but was unrelated to age or incidence of intentional self-harm behavior. Our findings are discussed in relation to the results of past research and the clinical implications of our data.