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Disappearing in plain sight : an exploratory study of co-occurring eating and substance abuse dis/orders among homeless youth in Vancouver, Canada Luongo, Nicole Marie

Abstract

How are disordered eating and substance abuse embodied, experienced, and articulated within a context of multi-dimensional marginalization? Existing studies that address this question emphasize medical influences and gather clinical samples, thereby overlooking those for whom structural constraints such as poverty make accessing costly and time-intensive treatment unrealistic. In this study, I fill methodological and empirical gaps in the literature by using qualitative methods to explore the co-occurrence of eating and substance use disorders among homeless youth. This study consists of two parts: (1) semi-structured interviews with youth and (2) structured interviews with key informants employed by low-barrier support services. Results show several indicators of co-occurring disordered eating and substance abuse among homeless youth. There is a strong link between conscious self-starvation due to body image concerns and compensatory substance abuse behaviours, while youth also engage in substance abuse to mitigate the effects of hunger related to food insecurity. Further, there is a significant disparity when comparing youths’ eating disorder and food-related health literacy to their substance use disorder health literacy. Finally, patterned responses among youth and front-line workers suggest that while service providers have several supports in place to assist youth who are engaging in problematic substance use, there is a shortage of existing infrastructure to assist youth who are struggling with disordered eating. I conclude by offering suggestions for further research on co-occurring eating and substance abuse disorders among vulnerable populations.

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Attribution-NonCommercial-NoDerivatives 4.0 International

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