Maybe you’ve heard the term drunkorexia before. It’s long been discussed as an issue among young adults, particularly college-aged women and femmes. But the link between alcohol abuse and eating disorders goes far beyond skipping dining hall meals and binge-drinking at sorority formals. In fact, it’s an issue that affects adults and teenagers of all ages.

First, a disclaimer: I’m an eating disorder dietitian, but I’m not a mental health therapist or addiction expert. If you think you might be abusing alcohol, call the Substance Abuse and Mental Health Services Administration (SAMHSA) hotline at 1-800-662-4357. Or reach out to a local therapist for help.

What is drunkorexia?

According to the National Eating Disorders Association (NEDA), “Drunkorexia is a colloquial term that refers to altering eating behaviors to either offset for planned caloric intake from alcohol or to increase/speed the effects of alcohol.” It’s particularly common on college campuses — thanks to diet culture, many students are terrified of gaining weight in college. But it affects adults and teenagers of all ages. 

Some examples of drunkorexia are:

• Skipping dinner in order to “save calories” for alcohol
• Eating far less throughout the day on days when you plan to drink alcohol
• Ordering a very low-calorie meal so that alcohol will “hit you faster” 
• Skipping meals or eating far less than usual on days after you’ve had a lot of alcohol
• Timing meals so that you have less food in your stomach while drinking, in an effort to get drunk faster

Outside of these examples, there are also behaviors that tend to accompany drunkorexia, like:

• Drinking liquor straight or with zero-calorie mixers in order to get the most alcohol for the least number of calories
• Avoiding higher-calorie drinks like craft beer and sweet cocktails
• Frequent binge drinking (rapid consumption of large quantities of alcohol over a short period) that can result in vomiting, extreme drunkenness, confusion (“blacking out” or “browning out”) or loss of consciousness (passing out)

What’s the link between alcohol abuse and eating disorders?

You can’t be diagnosed with drunkorexia, since it’s a colloquial term and not a clinical disorder. But, many people with drunkorexia fit the criteria for another eating disorder.

Overall, evidence suggests a strong association between eating disorders and alcohol abuse.

In a study published in Psychological Medicine in 2009, the authors looked at data from 13,297 Swedish female twins. Those with anorexia nervosa were significantly more likely to use illicit drugs. Those with bulimia or a history of both anorexia and bulimia were more likely to report alcohol abuse. 

Another study published in Addictive Behaviors in 2020, looked at how alcohol use among adolescents was associated with eating disorders. Researchers found that adolescents who reported making themselves sick because feeling uncomfortably full, recently losing a significant amount of weight, and other disordered behaviors were more likely to engage in both drinking and abusing alcohol. 

According to NEDA, “Up to 35% of individuals who were dependent on alcohol or other drugs have also had eating disorders, a rate 11 times greater than the general population.”

Why do folks with eating disorders abuse alcohol?

For starters, some experts think of eating disorders as a type of addiction. Not everyone agrees that this is true. But it’s fair to say that folks with eating disorders are dependent on their disordered behaviors in some way. And, they typically have a really hard time breaking free from them.

The hypothesis? Those with addictive tendencies are more likely to have an eating disorder, and more likely to abuse alcohol. 

(Illicit drug use and nicotine use are also higher among those with eating disorders than in the general population.)

But I’m not sure that this fully explains or does justice to the drunkorexia phenomenon. Because the relationship between alcohol and food restriction goes beyond just diagnosed eating disorders.

Diet culture is absolutely to blame.

The University of Texas cites a statistic that 30 percent of women between 18 and 23 diet so they can drink. 

Surely, this stems from a fear of weight gain. For all women, but particularly college-aged women, the fear of weight gain is so huge that it can cloud judgment.

Diet culture takes advantage of this in the way it talks about alcohol. How many women’s magazines used to warn about the calorie counts in various cocktails and print endless charts showing “low-calorie drink options”? A lot, and I imagine that many still do.

The fearmongering about alcohol and weight gain is so, so real. What really strikes me is the fact that drinking too much alcohol has proven health consequences. Yet most of the conversation around alcohol focuses solely on weight gain. Clearly, it’s not really about health when magazines and influencers are recommending *skinny margaritas* and low-calorie beers as “healthier,” without mentioning the fact that any type of alcohol, no matter the sugar or calorie content, comes with health risks.

When food is restricted, alcohol might take its place as a comfort and coping mechanism.

When someone is denying themselves food, they might look to alcohol for the satisfaction and pleasure they’re missing. (The same goes for drugs, but that’s not what we’re talking about here.) That makes sense; food is and should be pleasurable, and it’s fine to use food as one of your many coping mechanisms.

When you lose the pleasure and comfort of food, you’ll look for it somewhere else. And sure, there are many other ways to find pleasure and comfort. But alcohol and food are often consumed together, so alcohol is an easy, obvious substitute for food. (At mealtime, at home on the couch, while socializing, at celebration gatherings, etc.)

Dieting and eating disorders make you feel disconnected from your body, which might also be to blame.

Your body is smart. It will let you know when you’re hungry, full, satisfied, tired, restless, and any number of other things. If you listen.

When you ignore hunger cues (while dieting or when you’re in an eating disorder), you might have a hard time hearing other cues as well. That means you might be less able to know when it’s time to stop drinking. 

There’s also the matter of body respect.

When you’re more connected with your body, you’re less likely to binge drink or restrict food for alcohol. When you’re restricting and disconnecting from your body, you might not care as much about feeling good. Because you already don’t feel good

Sometimes, healing your relationship with food will lessen your desire for alcohol.

The good news is that when you recover from disordered eating and/or an eating disorder, you might start drinking less. I’ve definitely seen this happen with my clients. When people are able recover from disordered behaviors, they often find that they start drinking less without much effort. (Again, I’m not a mental health therapist or addiction specialist. If you’re struggling with alcohol, reach out to one who can help.)

That’s yet another reason to start healing your relationship with food.

Drunkorexia is a very real phenomenon, but it’s not a moral failing. There are plenty of reasons why eating disorders and restriction go hand-in-hand-with alcohol abuse.

If you’re struggling with an eating disorder or disordered eating, I can help! I’m a dietitian who takes an anti-diet, body-positive, identity-affirming approach to recovery and healing your relationship with food. . Learn more about my nutrition counseling, offered in Raleigh, NC, and virtually to clients in several states. Not ready to commit to counseling but want more information about the anti-diet approach? Subscribe to my weekly newsletter.

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