In Spain, the combination of eating disorders and a substance-related disorder is usually related, in this order of frequency, to caffeine, the   Alcohol and tobacco. The prevalence can be as high as almost 30%, and varies depending on different times during the course of the disorder.

This combination of alcohol abuse and an eating disorder is more common in cases of bulimia nervosa, binge-purge anorexia nervosa, and, to a lesser extent, restrictive anorexia nervosa. According to some studies, this is related to the greater impulsive behaviors in bulimia as an attempt to manage depression and chronic tension, as well as a more addictive personality, significant body dissatisfaction, and physiologically, greater serotonin dysfunction in the brain .

When this happens, alterations in appetite and satiety, obsessive and impulsive behaviors, self-destructive behaviors, and serious medical consequences appear.