Drunkorexia: The Dangerous Link Between Alcohol and Disordered Eating

Understanding the Overlap Between Substance Use and Eating Disorders in Young Adults

“Drunkorexia” is not a formal medical diagnosis, but it is a term that increasingly surfaces in both clinical settings and college campuses alike. It refers to the combination of disordered eating behaviors and alcohol misuse, most commonly seen in adolescents and young adults. While the word may sound casual or even humorous, the reality is serious: drunkorexia is a dangerous and potentially life-threatening behavior pattern that places individuals at risk for both medical and psychological harm.

This blog post explores what drunkorexia is, why it occurs, who is at risk, and what can be done to address it—clinically and culturally.

What Is Drunkorexia?

Drunkorexia is a non-clinical term used to describe the practice of engaging in restrictive eating, excessive exercise, or other disordered behaviors in order to offset the calories consumed from alcohol—or to increase the intoxicating effects of drinking on an empty stomach.

Common behaviors include:

• Skipping meals before a night of drinking

• Using alcohol as a meal replacement

• Excessive exercising to “earn” alcohol consumption

• Purging after drinking or binge eating while intoxicated

• Restricting food the day after drinking to compensate

Though not an official DSM-5 diagnosis, drunkorexia represents a co-occurring pattern of disordered eating and substance use with serious short- and long-term consequences.

Who Is Most at Risk?

Research shows drunkorexia is particularly prevalent among:

• College-aged students (18–25), particularly women

• Individuals who are already at risk for eating disorders or alcohol misuse

• People in environments with high social pressure to be thin and to drink

• Those with perfectionistic, impulsive, or sensation-seeking personality traits

A 2016 study by Barry and Piazza-Gardner found that more than 30% of college students reported engaging in drunkorexia behaviors. Among female college students, that number may be even higher.

Why Do People Engage in Drunkorexia?

1. Caloric Compensation

Many people are taught to moralize calories and view alcohol as “empty” or “fattening.” This leads to behaviors such as:

• Skipping meals to “save” calories for drinking

• Viewing food and alcohol as interchangeable sources of energy

• Internalizing diet culture messages that reinforce restriction as control

2. Body Image and Appearance Pressure

Young adults, especially college women, often report drinking in social situations where appearance is hyper-scrutinized. The desire to appear thin or “fit” while drinking may lead to compensatory eating behaviors.

3. Desire to Increase Alcohol’s Effects

Drinking on an empty stomach increases the effects of alcohol. Some individuals intentionally restrict food in order to:

• Get drunk faster

• Spend less money on alcohol

• “Numb out” or escape from emotions more quickly

This can lead to blackouts, risky behavior, and alcohol poisoning.

4. Underlying Mental Health Issues

Drunkorexia may reflect deeper mental health concerns, including:

• Undiagnosed eating disorders

• Anxiety or depression

• Trauma history

• Maladaptive coping strategies for emotional regulation

Why Is Drunkorexia Dangerous?

Drunkorexia increases the risk of both acute harm and chronic health consequences.

Medical Risks

• Rapid intoxication and alcohol poisoning

• Hypoglycemia from fasting + alcohol (can lead to fainting or seizures)

• Electrolyte imbalances

• Gastrointestinal damage from vomiting or purging

• Long-term liver and brain damage from alcohol abuse combined with malnutrition

Psychological Risks

• Increased risk of developing or worsening eating disorders and alcohol use disorder

• Impaired cognitive functioning

• Poor academic or work performance

• Greater likelihood of risky sexual behavior, victimization, and substance dependency

Studies suggest that the co-occurrence of alcohol misuse and disordered eating leads to worse treatment outcomes for both conditions if left unaddressed.

The Overlap of Eating Disorders and Substance Use Disorders

Research has consistently shown a high comorbidity between eating disorders and substance use disorders:

• Up to 50% of individuals with eating disorders also misuse alcohol or drugs (CASA, 2003)

• People with bulimia nervosa are especially at risk for binge drinking and impulsive substance use

• Those with anorexia may use alcohol as an appetite suppressant or substitute for food

This co-occurrence may stem from shared underlying traits, including:

• Emotional dysregulation

• Perfectionism or impulsivity

• A need for control or escape

• Low self-esteem and trauma history

Warning Signs to Watch For

Signs that someone may be engaging in drunkorexia include:

• Frequently skipping meals before going out

• Talking about “saving calories” for drinking

• Exercising excessively after drinking

• Appearing very intoxicated after only a small amount of alcohol

• Drinking alone or using alcohol to suppress hunger

• Binge eating while or after drinking

• Mood changes, secrecy, or avoidance of eating in front of others

If these behaviors are present, it may indicate a serious health risk and the need for assessment by a medical or mental health professional.

What Can Be Done?

1. Increase Awareness Without Normalizing

Educators, parents, and health providers should:

• Use accurate, non-judgmental language to discuss the risks

• Avoid glamorizing or joking about drunkorexia behaviors

• Address both alcohol and food behaviors in campus health initiatives

2. Screen for Co-Occurring Issues

Many young adults may present with one issue (e.g., alcohol misuse) but not disclose disordered eating. Healthcare providers should:

• Use validated screening tools for both eating and substance disorders

• Ask open-ended, non-stigmatizing questions about behaviors and motivations

3. Encourage Help-Seeking

Therapy options include:

• Cognitive Behavioral Therapy (CBT) for eating disorders and substance use

• Dialectical Behavior Therapy (DBT) for emotion regulation

• Integrated treatment programs that address both conditions concurrently

Early intervention leads to better outcomes. It's important to reduce shame and promote recovery as possible and deserving.

Final Thought

Drunkorexia is more than a buzzword—it’s a symptom of a culture that glorifies thinness, self-control, and binge-drinking, all while failing to address the emotional pain that often drives those behaviors. The intersection of alcohol and disordered eating reflects deeper struggles with identity, self-worth, and mental health.

Talking about drunkorexia isn’t about policing behavior—it’s about protecting health, fostering awareness, and offering support. Young people deserve access to information and care that honors both their physical and emotional wellbeing.

If you or someone you know is struggling, recovery is possible—and help is available.

References

• Barry, A. E., & Piazza-Gardner, A. K. (2016). Drunkorexia: Understanding eating and drinking behaviors in college students. Journal of American College Health, 64(6), 505–509.

• The National Center on Addiction and Substance Abuse (CASA). (2003). Food for Thought: Substance Abuse and Eating Disorders.

• Peralta, R. L., & Barr, P. B. (2017). Gender identity and the problem of drunkorexia. Sociology Compass, 11(6), e12482.

• Eisenberg, M. H., & Fitz, C. C. (2021). Disordered eating and alcohol use among college students: A systematic review. Health Education & Behavior, 48(2), 150–160.

• Mehler, P. S., & Brown, C. (2015). Anorexia nervosa — medical complications. Journal of Eating Disorders, 3(1), 11.