“Drunkorexia” Linked To Both Eating and Substance Use Disorders

Binge drinking 'impairs immune system' in young adults
Binge drinking ‘impairs immune system’ in young adults
Approximately 40% of American college students engage in binge drinking at least once in the past 2 weeks.

Researchers from the University of Kansas have found that “drunkorexia,” a behavior pattern of repeatedly fasting or purging to compensate for the amount of calories consumed during binge drinking, may be linked to both eating disorders and substance abuse disorders.

“Drunkorexia” is also known as Inappropriate Compensatory Behavior to avoid Weight Gain from consuming Alcohol (ICB-WGA).

“Binge drinking (defined as drinking 4 or more drinks for women and 5 or more drinks for men in one occasion) and disordered eating are major mental health concerns among college students. Approximately 40% of American college students engage in binge drinking at least once in the past 2 weeks,” wrote Kelsie T. Forbush, PhD, and Tyler K. Hunt, graduate student, from the Department of Psychology at the University of Kansas in Lawrence, Kansas.

While several recent studies have investigated the prevalence of ICB-WGA among college students, none have examined whether ICB-WGA more strongly relates to substance use or disordered eating, which may have future implications on the substance use and disordered eating research fields.

To test whether disordered eating or alcohol use can be predictive of ICB-WGA, and to examine possible gender differences in ICB-WGA, the researchers recruited 579 college participants (53% women) to complete the Eating Pathology Symptoms Inventory (EPSI), the Alcohol Use Disorders Identification Test (AUDIT), and several questions designed to measure ICB-WGA.

The EPSI measures eating-disorder psychopathology and includes statements such as “I did not like how my body looked,” “I skipped 2 meals in a row,” or “I made myself vomit in order to lose weight.”

The AUDIT assesses hazardous and harmful alcohol consumption, and includes questions such as “How often do you have 6 or more drinks on one occasion?” or “How often during the last year have you been unable to remember what happened the night before because you had been drinking?”

During the time this study was conducted, a scale for ICB-WGA had not yet been created, so the researchers developed 5 statements to assess how much participants had engaged in compensatory and binge-drinking behaviors over the last 2 weeks. The statements included lines such as “I skipped a meal in order to counteract the calories from alcohol,” “I engaged in strenuous exercise to compensate for calories consumed during drinking,” and “I drank excessive amounts of alcohol so that I could vomit food I had eaten.”

The researchers found that EPSI Restricting and Body Dissatisfaction scales were not significant predictors of ICB-WGA, but that EPSI Cognitive Restraint, Excessive Exercise, Purging, and Binge Eating scales, as well as the AUDIT scale, significantly predicted ICB-WGA.

Disordered eating and alcohol use both added incremental validity to predicting ICB-WGA, but it was more closely related to disordered eating, especially in women.

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Hunt TK, Forbush KT. Is “drunkorexia” an eating disorder, substance use disorder, or both? Eat Behav. 2016;22:40-45.