Is ‘drunkorexia’ an eating disorder or substance use disorder?

A new behavior trend may be linked to eating disorders and substance abuse disorders, scientists say.

“Drunkorexia” is a behavior pattern of repeatedly fasting or purging to compensate for the amount of calories consumed during binge drinking. Also known as Inappropriate Compensatory Behavior to avoid Weight Gain from consuming Alcohol (ICB-WGA), the behavior has been observed on several college campuses.

A new study in Eating Disorder Behaviors examined the link between ICB-WGA and other disordered behavior patterns. Researchers were also interested in determining whether gender plays a role in this link. The study is the first of its kind.

“No [previous]studies have tested whether ICB-WGA is more strongly related to substance use or disordered eating, which may have future implications for eating disorder and substance abuse research fields,” said Tyler K. Hunt, primary researcher on the project.

The team assessed 579 college students at a large Midwestern University–53 percent of participants were women, and 47 percent were men. Participants took a series of assessments, listed below.

Eating Pathology Symptoms Inventory (EPSI): This questionnaire is used to measure the extent to which participants have engaged in various eating-related behaviors within the last two weeks. It contains statements like “I skipped 2 meals in a row.”

Alcohol Use Disorders Identification Test (AUDIT): This survey contains questions that assess disordered drinking behaviors. Some example questions are “How often during the last year have you found that you were not able to stop drinking once you started?” and “Have you or someone else been injured as a result of your drinking?”

ICG-WGA questionnaire: This questionnaire, developed by the research team, includes five statements designed to assess how much participants have engaged in compensatory and binge-drinking behaviors within the last two weeks. Statements include “I skipped a meal in order to counteract the calories from alcohol.” and “I engaged in strenuous exercise to compensate for calories consumed during drinking.”

The results determined that students who engaged in certain disordered eating behaviors were likely to also engage in ICB-WGA. The most common linked behaviors were skipping meals, binge eating, excessive exercise and purging. The results also showed a strong link between alcohol abuse and ICB-WGA, indicating that the behavior pattern shares properties of both types of disordered behaviors.

Scientists found similar results between men and women–both sexes were likely to engage in disordered eating behaviors and binge drinking. Men were more likely to report engaging in binge eating under the influence of alcohol, while women were more likely to report skipping meals and excessive exercise.

The results may have important implications for future research and treatment.

“These individuals may be at-risk for future development of both full-threshold eating and substance disorders,” said Hunt.

“Our findings highlight the need for future research to identify the potential long-term course and outcome of ICB-WGA and develop secondary prevention programs to reduce the likelihood of ICB-WGA developing into full-threshold eating and substance use disorders.”