How did you spend your days in college? These days, four out of five college students use alcohol — and half of all college drinkers are binge drinkers (meaning that men consume 5+ drinks and women consume 4+ drinks over the course of two hours). 

Binge drinking is dangerous on its own, but when combined with an eating disorder like anorexia nervosa or bulimia nervosa, it can become even more deadly. As many as 30% of women between the ages of 18 and 23 report dieting so that they can drink, a phenomenon known colloquially as “drunkorexia.”

Someone exhibiting “drunkorexic” behaviors will restrict their caloric intake so they can drink as much as they want without gaining weight. At the core of these behaviors lie the same fears present in traditional eating disorders: low self-esteem and fear of weight gain. However, in addition to the dangers present in a typical eating disorder, “drunkorexia” also presents unique risks associated with the consumption of alcohol, often on an empty stomach.

Read on to learn more about alcohol use, eating disorders and “drunkorexia,” and especially how they present on college campuses!

Eating Disorders on College Campuses

Eating disorders like anorexia nervosa and bulimia nervosa are not a new risk for college students. In a study of eating disorder behaviors on college campuses, 13.5% of women and 3.6% of men in college reported symptoms that could be classified as a full-blown eating disorder.

The general population’s risk is much lower: women have a lifetime risk of 0.9% of developing anorexia nervosa and a lifetime risk of 1.5% of developing bulimia nervosa. So, why are college students so vulnerable to developing an eating disorder? Below, we explore some of the cultural risk factors that make college students more likely to develop an eating disorder than the general population.

The “Freshman 15”

When you went to college, friends or family may have cautioned you against gaining the “Freshman 15.” There’s a common misconception that college students will gain a lot of weight in their first year away at school, leading to many obesity prevention resources directed at college students. In reality, most college students only gain 2.5 to 3.5 pounds on average in their first year away at school — only ½ pound greater than their peers of the same age who do not attend college. Thus, anti-obesity campaigns on college campuses may lead students to embark on diets that are not medically necessary and may actually be harmful to their mental health.

College Athletics

If you or a loved one played competitive sports in college, you know how intense the training can be to compete at such an elite level. This competitive environment can increase the risk of disordered eating behaviors and full-blown eating disorders among college athletes. There is a high emphasis on diet as a component of training, as well as having a low percentage of body fat, that makes college athletics a risky environment for athletes vulnerable to developing eating disorders for genetic or sociocultural reasons.

Among college athletes, the NCAA has found that women competing in “lean” sports (in which being thin is viewed as a strategic advantage) are at the highest risk of developing disordered eating or a full-blown eating disorder. In a survey of women competing in college sports, the National Eating Disorders Association found that over ¼ of students exhibited subclinical signs of an eating disorder, and 2% of students qualified for an eating disorder diagnosis.

Increased Stress

College is a new environment — and new environments can be unpredictable. Especially for students who struggled with perfectionism prior to attending college, this new environment can create a sense of overwhelm and lack of control that leads to using eating disorder behaviors to cope. After all, college comes with academic and social challenges, including a greater workload and a whole new set of friends. Add in the fact that many students are becoming responsible for themselves for the first time, leading to unscheduled, unhealthy eating that may take a toll on vulnerable students’ self-esteem — especially if that means slipping up on a fad diet they’ve started while away — and it’s no wonder that college students are at such high risk of developing an eating disorder.

Binge Drinking on College Campuses

In addition to the high risk of eating disorders, college campuses offer an environment where binge drinking runs rampant. Many students try alcohol for the first time long before they go to college — the average age of first drink is 11 for boys and 13 for girls — but college offers a newfound sense of independence (and lack of supervision) that often encourages students to experiment with substances.

It shouldn’t come as a surprise, then, that nearly 10 million young people between the ages of 12 and 20 report drinking in the past 30 days. By age 20, 55% of young people report being current drinkers — and of college students who drink, approximately half report binge-drinking, or drinking a large amount in a period of two hours or less.

While older adults drink to socialize, statistics suggest that more than ever, young people are now drinking to get drunk. Within the past few decades, college students have begun to drink more hard liquor and less beer and wine — and thanks to liquor’s high alcohol percentage by volume, students are now consuming more alcohol with every drink.

Binge drinking comes with a number of negative consequences, many of which are dangerous. Some of the phenomenon associated with binge drinking include:

• Blackouts. Binge drinking can be associated with memory loss, known colloquially as “blacking out.” Mild memory loss associated with binge drinking may also be referred to as “browning out.” Blackout drinking can increase the risk of passing out while drinking and make people vulnerable to poor decision-making — especially considering they won’t remember what they did the next day.
• Alcohol poisoning. Binge drinking is also associated with alcohol poisoning or alcohol overdose, which results in thousands of college students being transported to emergency rooms every year. Alcohol poisoning can be deadly if not treated properly (typically by having one’s stomach pumped in the emergency room). Signs of alcohol poisoning include stupor or coma, vomiting, slow or irregular breathing and hypothermia. 
• Serious injury. You may remember the case of Timothy Piazza, a college student who was left to die in 2017 after he fell down the stairs of a fraternity house while binge drinking during a hazing ritual. Drinking can greatly increase a person’s risk of injury, since alcohol impacts decision-making and motor skills; in fact, the higher a person’s blood alcohol content (BAC), the higher their risk of serious injury. Every year, 600,000 college students unintentionally injure themselves while binge drinking, with consequences ranging from bruises to broken bones. 
• Sexual assault. While sexual assault is never the victim’s fault, binge drinking can put a person at a higher risk of being in a situation where a sexual assault may occur — and make a person more likely to commit assault. Perpetrators may also try to get victims drunk or take advantage of victims who have been binge drinking, knowing that they won’t be able to fight back. Nearly 700,000 students between the ages of 18 and 24 have been assaulted (sexually or otherwise) by a student who was drinking prior to the offense, and approximately 97,000 students have experienced an alcohol-related sexual assault.
• Academic consequences. Students’ drinking behavior can also negatively impact their academics, with 1 in 4 college students reporting that their drinking has led to missing class, falling behind in class, doing poorly on assignments or receiving lower grades. Binge drinking can be directly linked to these poor academic consequences: binge drinkers who consume alcohol three times or more per week are six times more likely than those who drink but do not binge to perform poorly on a test or project due to drinking.

The Risks of “Drunkorexia”

College students are clearly at high risk of binge drinking and eating disorders alike. Combine the two, and you get what many students are now calling “drunkorexia:” the combination of alcohol abuse and disordered eating, which are often intricately linked.

Eating disorders and binge drinking both have serious negative consequences which may even include death. Together, however, these behaviors become especially dangerous, due to the interaction between disordered eating behaviors and excess alcohol intake.

According to the University of Texas, here’s how “drunkorexia” may negatively impact someone who engages in disordered eating behaviors to compensate for binge drinking:

• Drinking large amounts of alcohol on an empty stomach may lead to overconsumption of alcohol and getting drunker faster, often unexpectedly. This creates a higher risk of poor judgment, injury and alcohol poisoning.
• Metabolizing alcohol increases the need for certain nutrients, but restricting food intake may result in these nutrients being less available in the body. As a result, students with “drunkorexia” run a higher risk of nutrient deficiencies, which come with a host of negative health consequences of their own.
• Drinking alcohol after working out slows the recovery process and impairs fitness improvements, since alcohol inhibits protein synthesis and muscle repair.
• Alcohol consumption limits judgment, meaning it may lead students to engage in unhealthy behaviors like binge-eating. Later, students may feel the need to compensate for binge-eating, resulting in purging behaviors. This combination can lead to the eating disorder known as bulimia nervosa.

Getting Help for “Drunkorexia”

As a slang term, “drunkorexia” is not an eating disorder that a student can be diagnosed with; however, it still presents underlying mental health issues that require prompt treatment by a qualified professional. Students who engage in eating disorder behaviors alongside binge drinking run a high risk of mental health problems, including anorexia nervosa, bulimia nervosa, binge-eating disorder and substance use disorders (i.e. alcoholism).

Here at The Meadowglade, we understand the complex situations that drive college students and other adults to develop an eating disorder in conjunction with heavy drinking. If you’re looking for your first stop on the road to recovery, look no further than at The Meadowglade. Contact us to find out how we can help you heal!