Excessive alcohol consumption is undoubtedly a contributing factor to the dreaded "freshman 15" — but at what point does compensating for those liquor calories become a full−blown eating disorder?
"Drunkorexia," though not a medical or technical term, is colloquially used among researchers and mental health professionals to describe behavior that combines disordered eating — like extreme restrictions and purging — with alcohol abuse and binge drinking. Particularly prevalent on college campuses, "drunkorexic" behavior includes starving one's self or limiting food intake in order to offset alcohol consumption later on.
Though the prevalence of this tendency is difficult to track, "drunkorexia" sheds light on a noted correlation between eating disorders and substance abuse. A comprehensive 2003 study conducted by the National Center on Addiction and Substance Abuse at Columbia University concluded that close to 35 percent of drug and alcohol abusers also have eating disorders and that nearly half of those suffering from eating disorders also abuse substances.
"Let me state it this way — we're aware of this issue," Tufts Director of Alcohol and Health Education Ian Wong said.
While there are individual dangers inherent in alcohol abuse and eating disorders, Wong said, their effect when compounded is exponentially worse.
"When we're talking about a substance abuse disorder or binge drinking, regardless if you have an eating disorder or not. We know that when you reach a certain amount of consumption with alcohol, you're more apt to get hurt, get in a fight, have problems academically and in relationships," Wong said. "When we're talking about someone who's not eating, it's worse. The relationship between food and alcohol is that if you have food in your stomach, it takes a little longer for the alcohol to be absorbed. When there's nothing there, there's obviously nothing to stop it from being absorbed at a quicker rate."
In addition, alcohol consumption can injure organs like the kidney, which may already have been harmed by conditions such as anorexia or bulimia, according to Wong.
Professor of Psychology Robin Kanarek, who conducts research on the relationship between nutrition and behavior, said that the origins of bulimia and alcoholism might be rooted in the same neurobiological issue.
"We know that, among women in particular, there's a very high comorbidity," she said. "If they have bulimia … they're more likely to become alcoholics. It looks like there may be similar neurochemical mechanisms in that both really good−tasting foods with sugar and fat [consumed during binges] can affect the same brain chemicals that alcohol does."
Though recognition of "drunkorexia" is a fairly recent development among health care professionals and is not yet a considered a formal diagnosable disorder, the long−term effects of both starvation and binge drinking, according to Kanarek, are acknowledged by medical professionals — and are severe.
"We know that if you're [starving prior to binge drinking] on a regular basis, if you're doing it every weekend, that's certainly detrimental, and if you're drinking to excess in general, that's detrimental, and if you're not consuming enough calories in general, that's also detrimental," she said. "It's such a bad idea … it definitely affects your health."
Replacing meals with late−night tequila shots can actually inspire the weight gain that "drunkorexics" aim to prevent, Kanarek said.
"Alcohol also has no vitamins and no minerals, and those calories are more likely to be stored as body fat than something like protein," she said. Pure alcohol contains about seven calories per gram, compared to the four calories per gram of protein and carbohydrates.
In addition to failing to provide people with necessary nutrients, binge drinking can also disturb the body's ability to process food when it is subsequently consumed.
"Alcohol can destroy the lining of the stomach, and by destroying the lining of the stomach … certain vitamins aren't absorbed as well as they are if you aren't an alcoholic," Kanarek said. "If someone is doing a lot of binge drinking, they can do a lot of damage to the lining of the stomach, which causes malnutrition."
As such, Kanarek noted that chronic alcoholics often suffer from Vitamin B1 deficiencies, with potentially fatal impacts on the cardiovascular and peripheral nervous systems.
But the point at which the price of "drunkorexia" outweighs the perceived benefits for students is, of course, determined on an individual basis.
"Speaking for me, I wouldn't do that," a sophomore said on condition of anonymity, as she is not of legal drinking age. "If anything, I think I would make sure to eat a decent amount [prior to drinking] to ensure that I wouldn't throw up."
But a junior girl, who is also under 21, had a different take.
"To me, it just kind of makes sense," she said. "It's not like I starve myself, really. I'm just careful about my portions that day because I know I'll be having a lot of calories later. That's just being smart."
