Women with substance use disorders have a greater prevalence of eating disorders which can interfere with long-term recovery. In a sample of women (N = 1099) attending treatment centres for substance use issues, this study identified three distinct classes based on substance type and eating disorder (ED) behaviours using latent class analysis. Class 1 (29.5%) had the highest rates of ED behaviours, methamphetamine and tobacco use. Class 2 (60.5%) had some weight-related concerns and 100% tobacco use. Class 3 (9.9%) had some weight-related concerns, and 78.0% reported alcohol as the main substance of use. Compared to women in Classes 2 and 3, women in Class 1 had higher rates of lifetime physical and sexual abuse, and the poorest quality of life. Most women in treatment have weight-related concerns, a subset has more severe clinical profiles with significant co-morbidity. Tailoring treatment to address ED concerns in women may improve treatment outcomes.