Drunkorexia: Eating Disorder Plus Binge Drinking

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As the prevalence of eating disorders continues to increase, experts are seeing a concomitant rise in substance abuse, including binge drinking. According to a recent report from the Eating Disorder Center of Denver, there has been an increase in patients who have eating disorders and who also engage in binge drinking, a disorder that has the unofficial name of drunkorexia.

Eating disorders, including anorexia nervosa, bulimia, and compulsive overeating, affect an estimated 8 million Americans, according to the National Association of Anorexia Nervosa and Associated Disorders. It is estimated that 4 percent of women suffer from bulimia, about 0.5 percent suffer from anorexia, and 1 percent have a binge eating disorder. Ten to 15 percent of people who suffer from anorexia or bulimia are males.

Drunkorexia is a condition that combines two behaviors that are consistently glorified in the media and especially among young people: dieting to lose weight and binge drinking. Individuals most likely to engage in drunkorexia are college-age females who are bulimic and who binge drink. These individuals typically either starve all day to offset the calories they will consume when they drink at night, or they binge on food and alcohol and then purge. People who are anorexic are more likely to avoid alcohol because they severely limit their calorie intake, although some do drink alcohol rather than eat and others drink to relieve anxiety.

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Research shows that between 20 and 40 percent of women who suffer with bulimia also have a history of alcohol and/or drug problems. In one study, for example, 37.5 percent of bulimic individuals reported excessive alcohol use and 26.8 percent had a history of alcohol abuse or dependence. In another study, 39 percent of patients with bulimia reported substance abuse issues. Bulimics and binge eaters are more prone to alcohol and drug abuse than are anorexics.

In a 2009 study conducted at the University of North Carolina at Chapel Hill, investigators evaluated the association between eating disorders and substance use in more than 13,000 women. Five groups were studied: anorexia, bulimia, anorexia and bulimia, binge eating disorder, and no eating disorder (controls). Overall, people who had an eating disorder were more likely to engage in substance use when compared with controls. Those in the bulimia and anorexia/bulimia groups were more likely to report alcohol abuse or dependence than the anorexia group.

Binge drinking appears to be a growing problem among college students. A study published in the September 2009 issue of Behavioural Pharmacology notes that among a sample of 428 students, 72 percent reported drinking at or above binge drinking thresholds regularly. While the amount of alcohol consumed by men was similar to that reported in previous studies, the frequency of binge drinking among women was higher.

The National Association of Anorexia Nervosa and Associated Disorders reports that 72 percent of women who are addicted to alcohol also have an eating disorder. Among people who have mental disorders, those with an eating disorder have the highest death rate. The combination of an eating disorder and binge drinking is an especially dangerous one, and one that needs to be addressed by health professionals. Yet among all Americans who have an eating disorder, only 10 percent seek treatment. Unless people who engage in drunkorexia behavior admit they have a problem, the chances they will try to get help appear to be slim.

SOURCES:
Balodis IM et al. Behavioural Pharmacology 2009 Sep; 20(5-6): 518-26
Eating Disorder Center of Denver, October 1, 2009
Mitka M. Journal of the American Medical Association 2009; 302(8): 836-37
New York Times, March 2, 2008
Root TL et al. Psychological Medicine 2009 Apr 20: 1-11.

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