Skipping dinner so you can drink your calories? There’s a term for that — drunkorexia — and studies show that it is associated with binge drinking and disordered eating patterns. A recent study published in the Addictive Behaviors journal seeks to look at social variables that can be protective or risk factors for engaging in drunkorexia behavior.
Drunkorexia is broadly defined as a pattern of behavior involving either over or underconsumption of calories to become drunker or to “save” calories for drinking alcohol. This is especially prevalent and normalized with college students due to the extremely social nature of drinking on college campuses.
“I have long been interested in disordered eating behaviors, including co-morbidities and risk factors,” explained study author Erin Hill, an associate professor of psychology at West Chester University of Pennsylvania.
“Drunkorexia (also referred to as food and alcohol disturbance) is particularly interesting because of the fact that the disordered eating behaviors take place in the context of alcohol use — and the motivations can include body image concerns and/or a drive to enhance the effects of alcohol. This study focuses on social comparison orientation (SCO) — the degree to which individuals compare themselves to others — as well as social norms, which are important for understanding a range of health behaviors.”
Hill and her colleague Robert Ruark recruited 501 undergraduate introductory psychology students to make up their sample. All participants were required to be 18 years old or older and to have consumed alcohol at some point in the last 3 months. They gathered demographic info, asked about perceived norms, had participants complete a series of SCO scales (global SCO, eating disorder-related SCO, alcohol-specific SCO), and asked participants to fill out a drunkorexia engagement scale. Hill & Ruark used moderated linear regression to measure the roles of SCO, norms, and the interaction between them in predicting drunkorexia engagement.
The study showed that descriptive norms (perception of how often the behavior occurs) is a significant predictor of drunkorexia engagement, but injunctive norms (perception of peer approval of behavior) is not, though both are positively correlated with said engagement. The number one predictor of drunkorexia engagement found was a high eating disorder-related SCO. This connects with previous research that links drunkorexia to disordered eating.
“There were two notable correlates of drunkorexia in the present study: eating disorder-related social comparison orientation (the degree to which an individual compares themselves to others in terms of their body, eating, and exercise behaviors) and descriptive norms (how common they believe drunkorexia behavior is),” Hill explained to PsyPost. “Therefore, drunkorexia seems to be linked to comparing oneself to others — particularly in relation to one’s body, eating, and exercise, and it is also related to social norms — and those who believed drunkorexia was common were more likely to engage in the behavior pattern.”
This study takes important steps toward identifying risk and protective factors for this problem, but it is unable to measure a bidirectional relationship. It is possible that higher social norms lead to more drunkorexia behavior and that more drunkorexia behavior leads to higher social norms as well. It is also important to consider that the mean age of this sample was under 20 years old, below the legal drinking age in America, so it is possible that these results would not generalize to older adults, or even older students.
“The behavior pattern is multifaceted, so it is critical to explore a wide range of possible risk factors, and to understand what risk factors are differentially related to drunkorexia dimensions,” Hill said. “It will also be especially important for longitudinal studies to be conducted to understand what risk factors precede drunkorexia engagement.”
“It is important to know that drunkorexia, like other forms of disordered eating, exists on a spectrum,” the researcher added. “Some individuals engage in behaviors that might be considered more socially acceptable (like cutting down on calories during meals or compensatory exercise), while other aspects of the behavior are more severe — such as skipping meals or engaging in bulimia-oriented behaviors in relation to alcohol consumption. As researchers continue to study drunkorexia, I think it is important to acknowledge the full spectrum of behaviors — and to examine factors that might serve as risk or protective factors in terms of drunkorexia engagement.”
The study, “An Examination of the Role of Social Comparison Orientation and Social Norms in Drunkorexia Engagement“, was published online on August 31, 2021.