“… because I'm so drunk at the time, the last thing I'm going to think about is calories”: Strengthening the argument for Drunkorexia as a food and alcohol disturbance, evidence from a qualitative study

Abstract

Objectives. Drunkorexia are inappropriate compensatory behaviours in response to alcohol consumption (restricting food intake, excessive exercise, and purging). Past (predominantly quantitative) research shows that Drunkorexia is prevalent in 18-26year-olds, and has significant negative health-related consequences. There is a debate whether Drunkorexia constitutes an eating or substance disorder, or a Food and Alcohol Disturbance (FAD). To further explore this, and understand underlying motivators, this study utilized qualitative methods.Design. Qualitative interviews with ten participants (aged 18-26).Methods. Interviews were analysed with Thematic Analysis.Results. Three themes were developed: (1) Appearance concerns as motivators, (2) Drunkorexia behaviours to get value for money, and (3) "It's just a pattern. . . something I've always done": Drunkorexia as a routine. Results show that Drunkorexia is driven by appearance-related concerns, such as, wanting to look better/slimmer, engaged in, in relation to an event, such as going out drinking, and carried out despite negative healthrelated consequences. However, disregard for compensatory behaviours once drunk was also described, culminating in the consumption of high-calorie food. This suggests that Drunkorexia is not a persistent pattern of maladaptive behaviour as found in eating or substance use disorders. Wanting value for money (i.e., feeling the maximum intoxication) was described as another reason for Drunkorexia engagement; thus showing that participants consider compensatory behaviours part of their routine of going out drinking.Conclusions. These result support the view of Drunkorexia as a FAD, rather than an eating or substance use disorder, and show that 18-26-year-olds are an at-risk group for Drunkorexia and its negative health-related consequences.

Loneliness and Alcohol-Related Problems among College Students Who Report Binge Drinking Behavior: The Moderating Role of Food and Alcohol Disturbance

“…Identifying FAD as a moderator of the association between loneliness and alcohol-related problems is noteworthy as FAD appears to partially be the result of a rational-decision making process [ 72 ], perhaps making it more amenable to information-based interventions [ 73 ]. For example, there is evidence that a low-cost normative feedback intervention aimed at reducing FAD successfully decreased alcohol consumption and frequency of binge drinking among college students [ 73 ].…”

Food and alcohol disturbance among people who have undergone bariatric surgery

“…18 Since hard liquor is associated with increased intoxication and negative consequences among non-clinical populations, [19][20][21] this type of consumption is particularly concerning among people who have undergone bariatric surgery, given the metabolic propensity toward experiencing high blood alcohol concentration levels relative to the quantities of alcohol consumed. This perspective examines the concept of Food and Alcohol Disturbance (FAD), colloquially known as drunkorexia 22,23 or alcoholimia, 24 as an emerging area of research that holds promise for elucidating the nature of some alcohol problems after bariatric surgery. FAD is an intentional compensatory pattern of behavior exhibited by restricting calorie consumption due to heightened concerns with weight while maximizing alcohol intoxication.…”

“…Since then, proposed diagnostic criteria for FAD include dysfunctional compensatory behaviors, such as severe food restriction, induction of vomiting or drinking so much that vomiting occurs, laxative or diuretic usage, stimulant usage, and exercising to an extreme (e.g., 2 h or more) on days when consuming alcohol is anticipated; moreover, those experiencing FAD might also elect to restrict their calories prior to consuming alcohol in order to become intoxicated more quickly following alcohol use 24 . For some individuals with FAD, dietary restriction precedes binge drinking later in the day, perhaps followed by binge eating and/or purging behaviors 23 …”

Drunkorexia Among a Sample of Lebanese Adults: The Role of Early Maladaptive Schemas

“…Drunkorexia is thus a food and alcohol disturbance (Vogt et al, 2022) described as being a range of disordered and compensatory eating behaviors that co-occur with excessive alcohol consumption (Barry & Piazza-Gardner, 2012). More specifically, this phenomenon is characterized by the following behaviors (Chambers, 2008): (1) skipping meals in order to save calories for later consumption of alcoholic beverages or to compensate for an increased caloric intake from previous alcohol consumption, (2) exercising excessively in order to compensate for the calories consumed by drinking, and/or (3) consuming enormous amounts of alcoholic beverages in order to become ill and purge previously ingested foods.…”