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Drunkorexia: a New Eating Disorder, an Interview with Kristen Fuller

Kristen Fuller is a medical doctor that completed her residency in Family Medicine. During this residency, she became very involved in treating patients with acute psychiatric illnesses such as depression, suicidal ideations, and eating disorders. She currently works as a mental health content writer for Center for Discovery, Psychology Today, and other media. Today Kristen talks with us about a new eating disorder that she terms “Drunkorexia.”

In your Psychology Today article “Drunkorexia and the Rise of ‘Rexias’ in Disordered Eating,” what is Drunkorexia?

“Drunkorexia is the unhealthy practice of engaging in excessive dieting while also consuming large amount of alcohol in a short time. Many individuals will restrict food calories in order to consume calories in the form of alcohol to either feel drunk faster while decreasing their overall daily caloric intake.”

Why do you think this disorder is more prevalent among college campuses?

“There are a few reasons for this:
1) binge drinking is more common among college students because for many, it is their first time away from home. Binge drinking is also more prevalent among this population because of the stress of balancing school, work and social life as well as the peer pressure many college students feel.

2) Physical appearances and social pressure to fit in are extremely high in college, resulting in many college students wanting to lose weight or gain muscle in order to look their best. As a result, eating disorders are very prevalent among college campuses and when mixed with binge drinking, drunkorexia is the final result.”

Why is Drunkorexia more common for women than men?

“In general, eating disorders are more common in women than men. Statistics have shown that 20 million women will be diagnosed with an eating disorder at some point in their life compared to 10 million men. Women often feel a large societal pressure to be skinny due to the constant images from fashion magazines, social media accounts and the Hollywood image. Studies have shown that girls as young as eight years of age are dieting in order to look skinny because that is what society is telling them to do.

Although eating disorders do occur in men, societal pressures are not as ingrained to look skinny and beautiful for men and therefore men do not engage in disordered eating as much as women. Although men are more common to engage in binge drinking behaviors than women, drunkorexia is more common in women due to their increase prevalence in disordered eating.”

What are the consequences of restricting diet while increasing alcohol consumption?

“A higher risk of alcohol poisoning which can be life threatening. In addition, individuals who restrict food caloric intake in order to drink more alcohol are at risk for becoming intoxicated at a faster rate, which can lead to a decrease in inhibition resulting in poor decision-making and even dangerous behavior such as sexual assault, abuse, and driving under the influence. Additionally, drunkorexia is known to have an increased incidence for the development of alcohol abuse disorder and eating disorders such as anorexia nervosa, binge eating disorder and bulimia nervosa.”

Do you feel that there is a link between addiction and eating disorders in general?

“Absolutely. Eating disorders are a type of addiction because individuals who have an eating disorder often see them self as in control of their eating disorder however they are not able to stop these unhealthy behaviors from occurring because each time an individual engages in binging or purging, a large increase in dopamine is released in their brains, creating a pleasurable feeling.

Like with any other addiction, eating disorders are characterized by a need for control in individuals who lack control in all other aspects of their life. Food rarely has anything to do with eating disorders but instead underlying triggers such as past abuse or trauma, low-self esteem, bullying, poor parental relationships, borderline personality disorder, substance abuse, non-suicidal self-injury disorder (NSSI), a perfectionistic personality, difficulty communicating negative emotions, difficulty resolving conflict, and genetics are known to cultivate eating disorders in individuals. Individuals with eating disorders will constantly obsess over food and eventually engage in compulsive behaviors such as binging or purging in order to carry out their obsessions.”

Why do you see this disorder as a category of obsessive behavior?

“Many individuals, who are diagnosed with an eating disorder such as anorexia nervosa, binge eating disorder or bulimia nervosa will often exhibit signs of obsessive-compulsive disorder as well, which is a specific type of anxiety disorder. In fact, approximately 40% of individuals with an eating disorder are diagnosed with obsessive-compulsive disorder and two-thirds of individuals with eating disorders have a previous history of at least one anxiety disorder. Similar to OCD, eating disorders are characterized by obsessive thoughts such as telling oneself they must lose weight, change their body image or restrict calories and these thoughts are followed by compulsive actions that include the following:

  • Counting calories or weighing food
  • The use of diuretics or laxative to reduce weight
  • Excessive exercise
  • Self-induced vomiting
  • Participating in ritualistic behaviors while eating a meal
  • Constantly checking body shape and appearance in mirrors
  • Rigidly tracking weight loss and intake of sugars and carbohydrates
  • Frequently weighing oneself”

In the future, what can we do to recognize and treat Drunkorexia?

“The biggest thing is to keep educating each other on this disorder and if you do see signs or symptoms in an individual then it is important to address in a loving way. Hiding these disorders under the rug and pretending that they do not exist will only make it worse. It is also important to disengage is any form of social media that involves body shaming or bullying as these behaviors are detrimental to individuals in society. Also pay close attention to the individuals you associate with in order to recognize their actions and behaviors. By being more aware of your surroundings, you will pick up on signs and symptoms associated with drunkorexia.”

 

To read more about Kristen Fuller, click here.

If you or someone you know is struggling with an eating disorder, please visit eatingdisorderhope.com.

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  1. This article seems to have a primary focus on anorexia or general eating disorders rather than “drunkorexia”. It would be really interesting to the reader to learn more about the specific possible effects of alcohol consumption in addition to an eating disorder. Such as specific effects on the body, not only focusing on what damage an eating disorder may contribute, but also what the added effects of alcohol damage would be.

    • This article kinda does focus a lot on generalized eating disorders and its link to OCD but I’m guessing its under the assumption that there isn’t much evidence or data on the effects of an eating disorder in combination with high alcohol consumption. It does mention though some of the added effects for example getting more intoxicated quicker and therefore increasing risks of bad things occurring. I think it does lack in how it will physically and physiologically change a person but again I don’t think there’s enough evidence to back up the claims on that. I think it just would have to be inferred from the effects of the two separate disorders until more data can be possessed.

  2. I like that this article is about something new, I had never heard of this term before. I know that I have definitely seen people at university who seem to exhibit some of these symptoms, and it’s good to spread awareness and get the word out.

    I really liked the introduction to the doctor and the topic. I’m surprised that this is such a common thing now that it has its own name. I also really liked that Dr. Fuller talked about the difference in prevalence between men and women and the reasons behind that. She explained it very gracefully that it isn’t just a women’s issue but also a men’s, but also explained why it is more prevalent in women. I also liked that she linked the behaviors with other disorders since many of them overlap.

    More detail and information would be great, but I understand that this is a new disorder so there is not much info about it yet. Over all, really interesting read!

  3. I have to agree with Jonilee. This article does focus more on general eating disorders, and a just a brief discussion of what drunkorexia is definition, consequences, and who it effects. I did enjoy reading this because I was very unaware that this was an issue of counting calories because you want to binge drink. I can definitely see why it effects women more than men, but I’m glad it wasn’t knocked down because it can still be happen with men as well. I would like to know more about drunkorexia. Maybe some questions like: “When did people start noticing this happening more? Where can people get help for this?” Overall, I like how organized and the words flowed great. Also, the speaker mentioned behaviors that are considered compulsive disorders, but I do believe some of those could be mistaken from people who are just trying to better their own health, and might not always be a part of that category.

  4. This is a term that I have never heard about and was intrigued to learn something that could possibly affect my peers seeing as I’m a college student. The article was informative about eating disorders and their prevalence rates in men and women. In addition, it kept my attention and was an entertaining read, however, I would like to know more about Drunkorexia. I know that if I notice any changes in one’s behavior that that could be a possible sign of this disorder but what are some others? Do suffers of this disorder binge drink only on the weekends per say, or is this an everyday behavior where they drink each and everyday? But overall, I enjoyed reading this article.

  5. This article kinda does focus a lot on generalized eating disorders and its link to OCD but I’m guessing its under the assumption that there isn’t much evidence or data on the effects of an eating disorder in combination with high alcohol consumption. It does mention though some of the added effects for example getting more intoxicated quicker and therefore increasing risks of bad things occurring. I think it does lack in how it will physically and physiologically change a person but again I don’t think there’s enough evidence to back up the claims on that. I think it just would have to be inferred from the effects of the two separate disorders until more data can be possessed.

  6. the article introduces this newly coined disorder pretty well. I, however, wonder if there is enough information and research on this phenomenon to consider it a disorder in its own right? The article discusses eating disorders in general, and other than a brief description about what behaviours constitute this disorder, there isnt much information. other than drinking, no distinctive behaviours are listed. With regards to the prevalence in college students, it is also possible that most college students are usually not bothered to cook or buy food and alcohol is a readily available aletenative. Though this behaviour is potentially very harmful, I wonder if there is enough evidence for it to qualify as an eating disorder. This phenomenon deserves attention, but it seems to be a hasty move to call it an eating disorder straight off the bat.

  7. This is an intresting topic since the term “drunkorexia” has not really found it’s place in everyday vocabulary yet. I feel like this should be discussed more because women who are skinny and like to have a few drinks and generally thought to just be social and “like to party” which isn’t considered a flaw. Not until someone looks under the surface and realises that it’s not just for fun, it’s an illness hiding.
    As much as I like to see someone bringing attention to this topic, I feel like this article didn’t provide some mind-blowing informations. I was mostly focused on eating disorders in general.
    I would like to see more tips on how to get close to people who suffer from drunkorexia and how to actually do something helpful for them since many don’t even think there is something wrong with them. I reckon there should be some articles on how one can tell if they are a drunkorexic themselves – often we don’t even think there is something wrong with our behavior until someone points it out.

  8. It has been very interesting to read this interview article on eating disorders, since it has introduced a new term ‘drunkorexia’, which I feel is a phenomena very applicable to the modern college environment. This article highlighted a lot of what I’ve observed in college situations, and it’s great to know that new terms and understanding are emerging from current situations!

    Amongst what I’ve observed from some female friends in college, I notice that many are afraid to consume alcohol because of its high amount of calories. They are often afraid of putting on weight or being fat (e.g. beer belly). However, they often succumb to peer pressure from their peers and consume large amounts of alcohol anyway. In order to get around this situation, they restrict their calorie intake on normal meals to ‘make room’ for the calories from the alcohol. Some of them have also claimed that drinking the alcohol pure (without mixers) will make them put on less weight because they do not consume the sugar from common mixers (e.g. coke). I always thought that this is dangerous thinking as drinking alcohol pure would make them drunk faster.

    I have also wondered why it is mostly my female friends who fall prey to such body-image issues and eating disorders. I did research, in which much pointed to cultural and societal expectations and definitions of men and women as the culprit. In western societies, women are more likely defined by their bodies and men more likely defined by their accomplishments (Frederikson & Roberts, 1997). This emphasis on the importance of shape ideals is reflected in how eating disorders are more prevalent in groups of males whose body weight and shape is of more significance to them, such as bodybuilders and athletes (Byrne & McLean, 2002). Furthermore, it is also reflected in how EDs are significantly higher amongst gay and heterosexual men (Strong et al., 2000) where relative greater importance placed on male physical appearance and attractiveness in gay subculture. Very interesting!

  9. This is certainly a new concept that I have never thought about. Although I’ve have yet to see it first hand, I can understand how this can be a rising problem among college students. Essentially Ms. Fuller is combining two dangerous mental health issues together; eating disorders and alcoholism. Unfortunately, these college women partaking in “drunkorexia” have both the pressures of fitting in (college parties) and being skinny (as promoted my mainstream media).

    It’s interesting that Ms. Fuller combines the psychology behind OCD and addictions to explain “drunkorexia.” The work that goes into restricting yourself to an unhealthy diet does imply symptoms of OCD. I think you did an awesome job at bringing light to a disorder that has yet to be publicly recognized. My only suggestion is you could have asked Ms. Fuller what treatment options are available. Is the treatment similar to a recovering anorexic or does it also require rehabilitation for excessive alcohol use?

  10. This is a very interesting article but I do agree, that since this is so new, can it be called a disorder?
    Since college is getting more expensive and with the amount of classes college kids usually take, it is hard to eat filling meals and alcohol is easily avilable.
    I also wondering if there is a connection between drunkorexia and alcholism?
    Is there any staticts on how many people can be diagnosed with this disorder?

    I do agree that we do need to watch our friends in college. Its a stressful place and people have many way to relive stress

  11. This was an interesting discussion. Until this point, my knowledge of the connection between eating disorders and binge drinking was non-existent, as the two subjects have always existed separately in my mind. But now it actually makes quite a bit of sense that these two issues would be so closely related.

    In all honesty, it is somewhat disturbing to know that there are those who choose to engage in heavy drinking under these conditions, the health risks are unquestionably detrimental and may have lasting consequences, especially for youth. However, to learn of this is not exactly surprising given what I have witnessed among my own peers. At my own university, drinking culture is widely accepted and propagated by the majority of students. So much so that activities such as binge drinking are practically normalized and thus the risks may be understated. I often see plenty of my peers engaging in excessive drinking in order to feel accepted by others. There are many reasons for this, but the most common is certainly aforementioned pressure of wanting to be accepted and fit in. University is a time when many young people choose to reinvent themselves and come into their own and often this is accomplished by engaging in recreational drinking to become more socially likable. While on the surface this sort of campus-wide mindset of tolerance of excessive drinking may not appear overly harmful, the truth of the matter is that the underlying peer pressure felt by some students may be enough to drive them to even more extreme detrimental habits, such as the “drunkorexia” spoken of in the interview. I truly hope this term becomes a greater topic of discussion, especially on college campuses, as a better understanding of the risks may encourage better decision making and more caution from those who engage in binge drinking. Further research into this subject would also allow for the psychological effects of these habits to be understood.

    As for the article itself, I appreciated the fact that the questions were concise and yet were broad enough that many aspects of this complicated subject could be understood. That being said, a bit more detail or insight into specific parts of this disorder (for example the combined effects of addiction and eating disorders) would be an improvement. However, to gain a general understanding of the subject, the interview is excellent.

  12. This was an informative read. I’ve often seen the opposite when people who binge drink likely eat more because it happens at social events. After being in college, I have seen people who drink emotionally and drink a lot. I never really associated it to eating habits, but a lot of them were more lean or underweight. Interesting article.

  13. Drunkorexia is really big problem, and the half of the people, don’t even know about it. Drunkorexia is well know in the modeling world, since the beginig because most of the models feel social pressure and feel like they need to drink, and they want to stay skinny for their job. Now, it is just spreading. I think that the reason why there is so much college students who have it, is because alcohol is cheap and college students are really stressed. Drunkorexia could be just a part of the alcoholism because lots of people lose their appetite after some time. There are few things that is missing. How do you diagnose drunkorexia? After how long? What is drunkorexia connection with anorexia nervosa, does anorexia comes first and drunkorexia second? How could it be treaten?

  14. Wow this was truly fascinating! I personally have never actually heard of the term “drunkorexia” but once I further read the interview it definitely felt familiar to things I’ve seen or heard around my own campus. Nonetheless, this was so informative and really important for everyone to be aware about. I think it’d be awesome to add a conclusion of this interview and what we the audience can take away from it, remind us of the urgency of this issue, make us want to take action. The last question does this to an extent but I think your voice could take it a big step further. Overall, amazing job and I really enjoyed this!

  15. This was a very interesting read. Based on a few of the comments, it seems that Dr. Fuller could have place more emphasis on the deliberateness of food restriction with those identified with Drunkorexia. It seems that she referred to established disorders to draw parallels between the symptoms.

    I find this new disorder intriguing because I have read that, when identifying the Big 5 Personality traits, those with eating disorders tend to be high in conscientiousness. Binge drinking seems to contradict that.

    I am curious as to whether this is being classified as a subtype to binge eating disorder or if it is being explored as an independent condition.

  16. I have definitely witnessed this in college and even consciously thought to myself about restricting my food intake before drinking, but I never really thought of it as a disorder since it seemed so common. However, is “drunkorexia” considered an eating disorder when people only engage in this behavior on the weekends, and eat a pretty normal diet without binge drinking on the weekdays? I feel like anorexia and binge drinking are just two separate problems on their own, with anorexia affecting the person all the time and the drinking only at certain times.

  17. I found this article to be very interesting, and the title caught my eye since it was a term that I have never heard of before, but I could guess the meaning of using context clues. I could see this disorder being found more within college campus, but I wonder if it could be just as prevalent in the high school setting as well. In high school social drinking is something that many high schoolers engage in because of peer pressure, and dieting also occurs a lot around this age group as well as in college. It makes me wonder if drunkorexia occurs just as much in the college setting, but it harder to regulate or record since the participants are usually underage.

    Overall I found this article to be very though provoking, and informative. I also appreciate the background information on Dr.Fuller, and the links so further research could be done.

  18. As someone who has suffered from anorexia, this article really opened my eyes to disordered thoughts and patterns of eating. I have found myself falling into patterns similar to this recently, and now recognize that it may be due to my disordered tendencies.

    In general, when approaching the topic of eating disorders, I think that information regarding the negative impacts of the disordered should be discussed. I’ve found, through research at university, that an increasing number of individuals are falling into a sort of “trend” of eating disorders. They read about eating disorders, think it is a good idea to try, and ultimately develop an eating disorder before they know the negative consequences which may impact them. We must stress that eating disorders are very dangerous diseases that can result in death more often than one would expect, and this one is no exception.

    I also think that included at the end of these articles should be more general information about seeking help instead of just one link. For example, links to NEDA, and online support/counseling sites should be included to assist those who are struggling with eating disorders. Like I said before, they are incredibly dangerous, and speaking from my own experience, I know that while I was in the worst part of my eating disorder, I often searched for articles so I could understand more about it, and how to get better. We should be talking more about how to help people who suffer from these diseases.

    Finally, I’d like to see some more information about the neural basis of the disorders, as this is an incredibly important piece in eating disorders. I think links to further literature so those who wish to read a more in depth scientific study would have immediate access to these instead of having to search the internet for more information, which may happen to be misleading or generally incorrect. A lot of news outlets have reported on this recently, and I think that often times, news outlets can be very misleading or generalizing with their reports on psychological disorders.

    Here is a link to a peer reviewed article about the concept if anyone would like to learn more: http://www.sciencedirect.com/science/article/pii/S1471015316300460

  19. The title of this article was eye catching. I believe many women may be involved in actions like those that describe drunkorexiaband may not even realize it. Drinking without eating can be very dangerous and I know that often college aged people get so caught up in the stress both academic and personal that they forget what is really important: them, their health, their life. This article was articulate and professional. Very well done.

  20. I can relate to this article a lot because as a college student, I am surrounded by people who binge drink. Of course not all college students drink, but I have seen many binge drink because most of us are underaged for at least half of our time at college. Because of the newfound freedom, students tend to binge drink because they don’t know their tolerance but also many people do not have access to alcohol so will drink a lot when they have the means to do so. However, I did not realize that there was an eating disorder related with alcohol. Whenever I think of alcohol, I always thought it made people gain weight, hence the term “beer belly.” I have seen people eat less in order to get drunk more quickly, but this idea of Drunkorexia seems to almost be a replace for food to some extent because of the dieting. This is a very sad reality for college students, mostly women as Dr. Fuller explains since eating disorders are more prevalent for women. Whenever I think of a person who drinks a lot, I will usually attribute it to excessive alcohol use and in extreme cases, alcoholism, but now I know that there is another type of disorder linked to alcohol. This was a very new concept and very informative so thank you!

  21. This is a great interview and article combined in one. Definitely what caught my attention was the word “drunkorexia”, since that was something I never heard before and I definitely wanted to know more. I think you did a great job with the questions and how they all connected with each other. The interviewee did a great job of being concise but at the same time, offering alot of information and explanation of “drunkorexia”. When I was in college, I can definitely remember the pressure to fit in and combined with all the parties, it definitely takes a toll on young women and men alike. I think another interesting segue into this could be how social media also affects “drunkorexia” and how it might make it worse. I think this is one of my favorite articles/interviews because of how much information was given and the many branches of happens when a young adult does have “drunkorexia” and the association between eating disorders and addiction. Great job on the interview and the end where you added that link for people who might have eating disorders.

  22. Sadly, it does not surprise me that an illness like drunkorexia exists. I was unaware of it until this point, and while I am saddened to hear it exists, it makes sense to me that this addiction is a problem. Based on my knowledge and experiences, destructive behaviors evolve to fit a changing society. With the ever increasing pressure to drink and to be thin, drunkorexia seeks to fill both those pressures.

    I am intrigued as to how drunkorexia, anorexia, bulimia, and other self-destructive behaviors are similar to OCD. As someone who has an anxiety disorder that closely resembles OCD, I had never made this connection before, but it makes sense to me. There is an overwhelming need to fill a requirement, sometimes a completely irrational one, and a repetitive and addictive behavior that accompanies it. This is a trait both share, and it’s fascinating to me how similar these illnesses are.

    My question for Fuller is how recent is drunkorexia, if at all? Is this a new disorder, has it just increased in frequency, has it just been recently identified, or is there another explanation?

  23. This is one of the most interesting topics I have ever come across. It wasn’t until I saw this that I realized that this actually exists. We can certainly see, and/or feel, these weights on us from college and what kind of effect it can have on us psychologically. With continued pressure to fit in or be thin, we often find ourselves going to extremes just to make sure we can make these ideals become a reality. From a personal standpoint, I can say that I have certain been drunkorexic at one point in my life. I spent much time trying to watch my calories, eat right, and try to control what went into my body. In doing so, much like the author mentioned, I would cut meals to save calories and use them for drinking. While I do agree that we see this happen more with women than men, that does not reduce the importance of this issue. That being said, since this has not been categorized in the DSM, how to we bring this disorder to the front to make sure that more can be done to stop it? Do we even consider the severity of this “disorder”, or see it as a reason to create more disorders?

    To the author, wonderful work on this interview. This is certainly a topic that needs to be researched more. One thing I would like to suggest is a more centralized focus on what categories this falls under. There were instances where you are hoping to find the connection between addiction and eating disorders, but then also this particular disorder and obsessive behavior. Could we focus, perhaps, on just addiction, or just obsessive behavior? I feel that would make it easier to understand and then going back later to focus on drunkorexia whichever idea you did not touch on. This interview was very well done, congratulations!

  24. This was so intriguing and I wonder if it is being pushed to become recognised as an ‘official’ disorder amongst psychologists?

    Teen-drinking culture is a lot more prevalent in the UK, specifically in London, I believe. A lot of my friends started to binge drink at the age of 14/15, and some as early as 12.
    The link to body image is interesting and it got me questioning if there are other factors that could lead to the body concerns or drinking in the first place?
    For example if there are parenting techniques or links to childhood and perception of others/self that could be linked to drunkorexia.

    The overall layout and writing style is easy to digest and sufficiently detailed with a good amount of statistics.

  25. I found this article very informative. The interview answered both general and narrow questions to the disorder. Very easy to follow and not to technical. I truly love how it not only contained the biological perspective of drunkorexia, but the psychological perspective of the individual engaging in the act.

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