Drunkorexia: Substance Use or Eating Disorder?
Alcohol consumption is often associated with obesity, though the opposite problem is surfacing among young adults. Let’s talk about Drunkorexia.
Drunkorexia is the conscious increase in food restriction to compensate for planned binge drinking. This disorder has become a common behaviour among young adults. Between 14 and 34% of university students report restricting food intake prior to alcohol consumption, in order to limit weight gain and enhance intoxication.
Though Drunkorexia appears to be a widespread phenomenon, it has received little academic attention.
So, what kind of a disorder is this?
Drunkorexia is rather interesting in terms of comorbidity, addiction and psychiatry as it is such a fusion of disorders. Mental illnesses are more often than not comorbid — if you have one disorder, it is likely you have another (or at least manifest certain symptoms of others).
The root to substance use problems and eating disorder is not in the drugs of food consumed, but a deeper-rooted issue. Drunkorexia likely has underlying similarities to both of these disorders. However, much more research is needed to understand Drunkorexia’s presentation and whether it is an isolated disorder.
Why are young people becoming Drunkorexic?
The root of Drunkorexia appears to be socially motivated. Alcohol is a massive aspect of many people’s social lives — especially so at university. Students have a very different and unique relationship with alcohol, living in a bit of a binge drinking bubble during their uni years.
There are many reasons for why people drink, but they largely fall into three categories: social motives, coping motives and conformity.
Drunkorexia appears to stem from social motives and conformity. You want to enjoy yourself without the calorific consequences but also enhance the effects of alcohol. Plus, drinking culture is so ingrained in student life, many feel the need to conform.
Eating less to get drunk quicker and cheaper (very important to us students) can be seen as a beneficial behaviour to some.
The desire for weight control is one of the reasons why women are more likely to display Drunkorexic tendencies (although men can and do engage in these behaviours too). One of the issues with this area is that research is predominantly conducted on middle-class educated white females, so we don’t know whether the true demographic is different.
What are the deeper-rooted explanations for Drunkorexia?
There are links between difficulties regulating emotional states, unhealthy eating and drinking behaviours. A lack of emotional regulation could be at the root to Drunkorexia, leading to a need to control impulsive behaviours. Impulsivity also underlies both disordered eating and substance use.
Food and alcohol are substances which individuals use to regulate emotions. So drinking and eating behaviours may be a strategy for emotional regulation, to influence and alter affective states.
Drunkorexia may also be a way of controlling bodily needs, as a means of having power and autonomy over one’s body. A lack of more adaptive coping skills puts these individuals at risk.
Why should we bother studying Drunkorexia?
This intersection of eating and substance use disorder is dangerous.
Engaging in extreme forms of fasting enhance the intoxicating effects of alcohol. Although this is a goal for some, it can lead to alcohol poisoning, blackouts, brain damage and engaging in risky behaviours. Ethanol also reaches the blood rapidly, increasing blood-alcohol concentration to life-threatening levels. The health risks of this behaviour are varied but high.
Studies have also found correlations between Drunkorexic attitudes and the use of other psychoactive substances such as ketamine, cocaine and MDMA. So, Drunkorexia may be a gateway to poly-drug use. It is likely that the worry over calorie intake increases the use of illicit drugs among young adults as a means of getting that intoxicating altered state without the additional calories.
It is particularly interesting how social pressures to drink meet societal pressure to maintain a certain body type of weight. What is even more worrying is that these individuals view the consequences of gaining weight as worse than the consequences of Drunkorexia.
It is without a doubt that more research is needed in this area with so many questions to answer. It is important we understand Drunkorexia so that this behaviour so that harm can be minimised.
