Drunkorexia definition
Drunkorexia is a relatively new term and is not an officially recognized diagnosis, but one that's quickly become more common, leading many people to ask, "What is drunkorexia?"
While the condition has yet to be included in the Diagnostic and Statistical Manual of Mental Disorders (DSM), physicians and clinicians have come up with an informal definition of the issue. It involves alcohol consumption on a regular basis and a simultaneous restriction of calories.
People who struggle with drunkorexia will limit their food intake and take other measures to "make up" or "save room" for the alcohol-related calories they consume. For many people with drunkorexia, weight loss or weight control is the biggest concern. Sometimes, restriction is also done to maximize the impact of alcohol. Generally, these behaviors are accompanied by a deep-seated fear of gaining weight.1,5
Drunkorexia vs. other eating disorders
Drunkorexia actually combines two problematic disorders: an eating disorder with substance abuse.
Anorexia nervosa and other restrictive disorders involve a fixation on, and restriction of, caloric intake. With bulimia nervosa, compensatory behaviors are used to "make up" for or “undo” calories consumed. In this case, those calories are more likely to come from binge drinking than from binge eating.2 And like most eating disorders, drunkorexia involves a fear of weight gain and/or a fixation on physical appearance, particularly when it comes to body image.1
It's the central role alcohol plays in drunkorexia that distinguishes it from most other eating disorders. While many people struggle with a co-occurring eating disorder and substance use disorder, with drunkorexia, alcohol consumption and weight control are often the catalyst for disordered eating behaviors, with people planning or modifying their diet or exercise routine around the prioritization of drinking in their daily intake.3
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Causes of drunkorexia: Alcohol abuse and eating behaviors
Drunkorexia is a relatively new medical consideration, and unfortunately, few studies have been done to explore the deeper causes of the issue. Researchers are still unsure whether the condition is best defined as an eating disturbance or a form of alcohol abuse. However, aspects of both are involved in the consideration of the diagnosis.3
What research has been done shows that high stress levels, anxiety, and depression may be risk factors for developing drunkorexia.2 Additional psychological characteristics connected to the condition include:2
- A drive for thinness
- Body dissatisfaction
- Poor body image/self-esteem
- Ascetic (or severe self-disciplining) tendencies
- Difficulties regulating emotions
Who's at risk for drunkorexia?
More is known about the populations who are more likely to develop drunkorexia than the initial causes of the condition.
Studies done internationally have found anywhere from a 14% to 46% prevalence of the condition in the general population, with a higher risk for:4
- Women of all ages
- Individuals between 10 and 19 years old
- Caucasian individuals
Many other studies have connected the issue to college students. In fact, most studies on drunkorexia place college students as the most at-risk population for the condition.1,2,3,4,5 These studies found the following:1,3
- Anywhere from 39-46% of university students intentionally restricted food calories or altered food intake before consuming alcohol.
- 67% said calorie restriction was primarily driven by concerns over gaining weight.
- Anywhere from 22-66% of college-age women induced vomiting to compensate for calories consumed while drinking alcohol.
One study found that, in general, women were more likely to participate in compensatory behavior around alcohol consumption.4 Still, it's possible for drunkorexia to affect anyone, regardless of age, race, gender, or any other consideration.
Drunkorexia effects: Drunkorexia symptoms and signs
Drunkorexia can look many different ways, but some common signs and symptoms include:1,2,3
- Deliberately skipping meals or restricting food or calories, especially with consideration given to alcohol consumption
- Excessive exercise, self-induced vomiting, or other purging behaviors with the intention to reduce caloric intake of alcohol
- Intentionally drinking to the point of throwing up
- Planning or modifying meals or exercise routines to plan for the use of alcohol
With drunkorexia, these behaviors are used specifically as ways to make room or compensate for alcohol consumption. But they're often accompanied by other drunkorexia symptoms, including:1
- Binge drinking, which is generally defined as:
- Five or more drinks in a single occasion for men
- Four or more drinks in a single occasion for women
- Hyper-fixation, feast or worry about associated caloric intake
- Depression, anxiety, and other mood disturbances
- Frequent dieting
- Low self-esteem
Physical signs of the condition may also include:1
- Weight fluctuations
- Discolored skin or nails
- Thinning hair
- Gastrointestinal issues
- Immune response issues
Drunkorexia effects: Potential health risks
Disordered eating and alcohol use can both negatively impact health and well-being. Combining the two can be even more dangerous.
Alcohol consumption combined with fasting or other caloric restriction can exacerbate the effect of alcohol, potentially leading to:5
- Increased risk of brain damage
- Memory loss
- Loss of consciousness
- Increased risk of organ damage, particularly cirrhosis
- Increased potential for risky behaviors, including driving drunk or practicing unsafe sex
- Increased potential for violence or sexual assault
The condition also impacts the body in many similar ways to alcohol use disorder, anorexia nervosa, or bulimia nervosa, including:5
- Rapid mood changes
- Cardiovascular issues
- Hormone dysfunction
- Gastrointestinal issues
- Nutrition deficiency
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Drunkorexia treatment and prevention
Again, the relative newness of drunkorexia as a medical concern means there's no specific recommendation when it comes to treatment. But there are certainly methods that have been shown to help create positive changes in similar thoughts and behaviors.
Cognitive behavioral therapy (CBT) is not only the leading treatment for bulimia nervosa and binge eating disorder, but has also been used effectively to curb binge drinking behaviors.6,7 This form of psychotherapy involves helping patients identify unhelpful thoughts and redirecting them to help eliminate unhelpful behaviors.
Other standard therapeutic techniques for eating disorders and/or alcohol use disorder include:
Prevention is also important, especially for younger patients and college students. If you or a loved one are regularly drinking more than you mean to or fixating on calories consumed, even if you don't recognize other drunkorexia symptoms, it may be time to seek out help.
With a caring and comprehensive treatment team, it's possible to walk away from the unhelpful thoughts and behaviors that drive drunkorexia and step into a new, healthier, and happier future.