Alcohol and Anorexia
Anorexia and alcohol use co-occur frequently. The National Eating Disorder Association has estimated that half of all people with eating disorders have a co-occurring substance use disorder. To understand the relationship between anorexia and alcohol use, it ’s helpful to first understand anorexia and alcohol abuse as separate disorders.
Anorexia nervosa, more commonly referred to as anorexia, is characterized by restricting caloric intake for the purpose of weight loss. Someone with anorexia is not simply dieting or cutting back on calories. Instead, someone with anorexia will ignore their hunger and refuse to eat.
Minimal amounts of food may be consumed but not without planning and rationalization of all calories consumed. Someone with anorexia is likely to have many obsessive and usually delusional beliefs about their weight, eating, dieting and weight loss in general.
While anorexia and alcohol addiction may seem unrelated, especially when considering that alcohol is full of empty calories, there are several similarities. For example, both disorders:
- Feature obsessive thinking patterns (obsessing over weight, obsessing over the next drink)
- Are based in control, albeit different ends of the spectrum (anorexia is an extreme level of control and alcohol use disorders being an inability to maintain control)
- Are more prevalent in individuals with a history of childhood trauma
- Co-occur frequently with depression, anxiety, and low self-esteem
When examining the similarities of these disorders in addition to the criteria for each disorder, the anorexia alcohol connection can become more apparent.
Some people with anorexia report drinking suppresses their appetite and helps to numb hunger pains. Other people diagnosed with anorexia report that drinking relieves their obsessive thoughts about food and their bodies. When these disorders are present in someone who has a history of trauma, alcohol may be used to further cover-up emotional pain. If treatment has anorexia and alcoholism symptoms it is important that they be transparent with their treatment provider. If a provider is unaware of both disorders, insufficient treatment may be given.
This practice has become so common that a slang term for it has been created —drunkorexia. Someone who engages in drunkorexia may avoid eating or limit eating to be able to drink excessively without gaining weight. The most common drunkorexia side effects include becoming malnourished because alcohol provides no nutritional value.
There are also some people who may choose to restrict their caloric intake during the day so that they can experience intoxication more quickly and intensely. A person with this form of drunkorexia may not present the same symptoms of an eating disorder as those concerned primarily with weight.
Alcohol also causes adverse effects on nutrient absorption and retention even when a regular diet is maintained. Someone with drunkorexia may feel that becoming intoxicated from less alcohol is positive but what is often overlooked is the increased risk for alcohol poisoning, which if left untreated may be fatal.
- Educating the patient about similarities between the disorders and risks of the disorders
- Dietary education and planning
- Challenging unhelpful attitudes and beliefs
- Increasing coping skills
- Identifying potential obstacles
- Creating a relapse prevention plan
Dialectical behavioral therapy (DBT) has been shown to benefit people diagnosed with an eating disorder and a substance use disorder. DBT consists of individual therapy, group skills training, and phone coaching between sessions. Someone in DBT will be taught coping skills and engage in assignments intended to help practice the skills.
- Alcohol use disorders with co-occurring eating disorders like anorexia are extremely dangerous.
- When these disorders co-occur no matter which disorder came first, it is vital that both disorders are treated concurrently.
- Restricting calorie intake to avoid gaining weight from binge drinking is dangerous.
- Avoiding eating to become intoxicated more quickly can lead to negative health consequences including alcohol poisoning.
If you or someone you know struggles with an alcohol use disorder and anorexia, help is available. At The Recovery Village, a team of professionals offers several treatment programs for substance use and co-occurring disorders. Call and speak with a representative to learn more about which program could work for you.
Dialectical Behavioral Therapy for Mental Health Problems. (n.d.). Retrieved from https://www.webmd.com/mental-health/dialectical-behavioral-therapy
Eating Disorders and Alcohol Use Disorders. (n.d.). Retrieved from https://pubs.niaaa.nih.gov/publications/arh26-2/151-160.htm
Gregorowski, C., Seedat, S., & Jordaan, G. P. (2013, November 07). A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders. Retrieved from https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-13-289
NAMI. (n.d.). Eating Disorders. Retrieved from https://www.nami.org/Learn-More/Mental-Health-Conditions/Eating-Disorders
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