What Is Drunkorexia? Definition, Effects, & Treatments

What Is Drunkorexia?

Drunkorexia combines features of both alcohol use disorder and disordered eating habits, particularly those of anorexia nervosa. Some people with drunkorexia fully substitute food with alcohol, while others consciously restrict calories during the day or week to compensate for drinking. Although drunkorexia is not a diagnosable condition, it is a significant problem among certain populations.

How Common Is Drunkorexia?

Research shows that drunkorexic behaviors are common among female college students and possibly in high-level athletes who follow strict diets.² Additionally, with so many college-age individuals also being “weight-conscious,” many may utilize disordered eating habits to control their bodies.

However, current data is correlational, so it is impossible to discern if one variable “causes” another. That said, college students who restrict calories before drinking are more likely to engage in binge drinking. Likewise, students abusing laxatives or taking diet pills (often seen in bulimia) are also more likely to report binge drinking.³

It is also important to note that approximately 45% of women with bulimia or binge eating disorder also experience alcohol abuse, and 15-32% of women with alcohol use disorder struggle with bulimia or anorexia with a binge/purge subtype.⁴

Drunkorexia Vs. Alcohol Addiction

Drunkorexia symptoms may overlap with alcohol addiction symptoms, but they are not the same conditions. Alcohol abuse entails a combination of physical and emotional symptoms, and those who abuse alcohol typically cannot control their intake and regularly drink excessively. Alcohol consumption interferes with daily tasks and may cause problems in one’s relationships.

Drunkorexia often entails problematic drinking patterns, such as binge drinking. However, a person with drunkorexia has a preoccupation with their weight and body size. Furthermore, someone does not need to meet the criteria for an alcohol addiction to exhibit signs of drunkorexia.

Warning Signs of Drunkorexia

Many people occasionally drink on an empty stomach, but someone with drunkorexia limits food calories when consuming alcohol to prevent weight gain. Drunkorexia, like other mental health conditions, exists on a spectrum. However, specific signs of drunkorexia are usually recognizable.

Signs of drunkorexia may include:

• Persistent worries about body image and weight gain: People with drunkorexia tend to be preoccupied with their physical appearance. They may frequently complain about their appearance or seek positive reassurance from others.
• Obsessively counting calories or macronutrients: Drunkorexic people often track their calories and nutrients to help them determine how much room they can allocate for alcohol consumption.
• Intentionally restricting calories during the day: Along with tracking calories, people with drunkorexia try to eat as little as possible. They believe this caloric deficit will allow them to drink freely or binge drink without the repercussions of gaining weight.
• Binge drinking at night: Although binge drinking alone does not indicate drunkorexia, it is something to pay attention to if your loved one also restricts food and engages in disordered eating.
• Binge eating while intoxicated: Some people with drunkorexia overeat or binge eat when drinking. Combined caloric restriction during the day and alcohol-induced cravings can trigger this urge.
• Excessive exercise: Drunkorexic behavior may lead to other compensatory eating disorder behaviors, such as excessive exercise.
• Complaints of stomach issues or hunger: Disordered eating and binge drinking can both trigger gastrointestinal distress.
• Drinking to the point of vomiting: People with drunkorexia may intentionally binge drink to vomit and purge food.

The Dangers of Drinking Alcohol & Not Eating

Even mild or moderate drunkorexia symptoms can be dangerous because inadequate nutrition commonly results in fatigue, irritability, and poor concentration. Drinking on an empty stomach may also quicken intoxication, possibly leading some people to drink more than they intend.⁵

Chronic drunkorexia patterns can lead to substantial health conditions, and binge drinking is associated with numerous psychological and physical problems. In addition, disordered eating can impact every part of the body. The combined effects of both conditions can be particularly detrimental.

The effects of drunkorexia may include:⁵

• Blacking out: The interaction between alcohol and factors like dehydration, fatigue, alcohol tolerance, and lack of eating can induce loss of consciousness or black outs.
• Dehydration: Drinking in excess can make people urinate more often. This, in turn, leads to a loss of bodily fluids and thus dehydration.
• Malnutrition: Alcohol consumption along with inappropriate eating habits like skipping meals can lead to malnourishment.
• Stomach issues: Alcohol can produce acidity in the stomach. Consequently, a person may experience nausea, vomiting, and other gastric problems.
• Long-term effects of substance use disorder: Drunkorexia may increase the risk of developing alcohol use disorder or worsen an existing substance-related issue.

What Causes Drunkorexia?

Drunkorexia stems from a combination of factors. Research shows that various genetic, emotional, and social influences may increase the development of an eating disorder. For instance, low self-esteem, a history of trauma, and high societal or family expectations are all risk factors. People with co-occurring conditions like depression, PTSD, or an anxiety disorder may also be at an increased risk.

Additionally, peer pressure likely plays a role in drunkorexia on college campuses. Just as binge drinking is often standard behavior, disordered eating may also be normalized (and even encouraged). People may view patterns as socially acceptable if their friends or roommates engage in such conduct.

How to Recognize Drunkorexic Behavior

Just like an eating disorder or any other mental health condition, drunkorexia can be hard to self-assess as the signs may be subtle, there may be shame-related issues, and it may overlap with other psychological concerns. Nevertheless, learning about it and having a better understanding is key in order to address it. If you suspect that you may be drunkorexic, there are ways to tell.

Here are some questions that can give you an idea if you may be struggling with drunkorexia:

• Are you constantly worried about or meticulously keeping track of your caloric intake?
• Are you skipping meals or eating very little during the day to “save” calories for drinking later?
• Are you drinking large amounts of alcohol or binge drinking regularly, especially on an empty stomach?
• Are you exercising more often as a way to “burn off” calories from alcohol consumption?
• Do you get annoyed, irritated, or defensive when questioned about eating habits or alcohol consumption?
• Do you experience physical symptoms such as rapid weight fluctuations, frequent hangovers, fatigue, or signs of malnutrition such as hair loss or brittle nails?
• Do you only seek out social situations that involve drinking, stay away from ones that don’t involve alcohol, or avoid eating in social settings?

How to Stop Drunkorexic Behavior

Drunkorexia is a serious condition that can worsen progressively without intervention. Taking better care of yourself is crucial for your well-being. Implementing healthier changes in your daily routine and considering professional treatment options can make a difference in your life.

Below are six tips for overcoming drunkorexia:

1. Abstain from alcohol or substance use: It may be helpful to stop drinking for a designated period. This commitment may provide important insight into your drinking patterns.
2. Journal: Journaling can help you recognize specific triggers or patterns of drunkorexia to facilitate necessary changes.
3. Mindfulness: Consider how to be more present and engaged with the here and now. Practicing mindfulness can help reduce anxiety and depression, helping to reduce the urge to engage in drunkorexic behaviors.
4. Meditation: Meditation supports mindfulness and can help with self-esteem, gratitude, and self-compassion.
5. Have an accountability partner: Even if it feels scary, consider telling a friend about your situation. See if you can check in with them whenever you are struggling.
6. Pursue other hobbies: If you spend most of your free time partying, consider alternative sources of fun. Explore some hobbies or activities that don’t entail any drinking.

Why Recovery From Drunkorexia Can Be Challenging

Overcoming drunkorexia can present significant challenges, especially in a societal context where excessive drinking is encouraged and being thin is highly valued. Across various cultures, drinking is not only prevalent but also celebrated, while environments endorsing heavy drinking and emphasizing conformity can exacerbate drunkorexia. Moreover, the pervasive influence of diet culture, whether via social media, familial expectations, peer pressure, or other sources, can further hinder the recovery process and increase the risk of relapse.

Consequently, people in recovery from drunkorexia should not only address their alcohol and food behaviors but also confront the cultural and societal pressures fueling their condition. Seeking support from mental health professionals and other medical experts, attending therapy and/or support groups, and proactively addressing signs of disordered eating and/or alcohol misuse are crucial steps toward establishing and maintaining a healthy lifestyle.

Treatment for Eating Disorders and Alcoholism

Drunkorexia may be situational, and young adults may simply “grow out of” behaviors after graduating college. Sometimes, lifestyle changes can reduce or eliminate drunkorexia tendencies. But, in more serious cases, drunkorexia can be a combination of anorexia, binge eating, bulimia, OSFED (“other specified feeding and eating disorder”), or alcohol use disorder diagnoses. Regardless of where you might fall on this spectrum, drunkorexia can quickly spiral and worsen. For this reason, it’s worth seeking professional support. A combination of therapy and lifestyle changes can be influential for change.

Therapy

Therapy offers a safe, compassionate environment to learn more about yourself and change problematic patterns. Many different approaches focus on disordered eating and substance use. CBT-E, for example, helps clients address, disrupt, and change the barriers associated with an eating disorder. Motivational interviewing encourages moving through ambivalence, and many addiction professionals use it to increase one’s desire to change their behavior.

Choosing a therapist sometimes requires trial and error. Ideally, you want to find a trustworthy provider who supports and challenges you. You also want to ensure you can be truthful with your therapist, as honesty is essential for helping you change. You can begin your search in several ways, including using an online therapist directory or finding an online therapy program.

Medications

There is no specific medication recommended for drunkorexia. However, prescriptions can be beneficial in treating the common comorbid conditions that may coexist with drunkorexia. For example, antidepressants can help treat underlying depression and anxiety. Likewise, physicians may recommend anticonvulsants to individuals with bulimia or binge eating disorder to reduce binge eating.⁷