Eating Disorders and Substance Use Disorders (SUD's)

-Reblogged from THEFIX.com-

"Drunkorexia" is Double Trouble

The dangerous duo of disordered eating and substance abuse is "extremely common," experts tell The Fix.

The term "drunkorexia" describes the practice of engaging in disordered eating or excessive exercise during the day to "save up" calories to spend on binge drinking at night. Although not an official disorder, the term gained attention after a 2011 study found 16% of college students (most of them women) admitted to starving themselves so they could get "drunk faster." In a recent article in the Atlantic, health experts and college health professionals point out that alcohol companies are now profiting off the behavior with new ad campaigns promoting low-calorie beverages to young people, especially women. Ads for products like Beam Inc.'s "SkinnyGirl Cocktails," created by reality star Bethenny Frankel, declare "it's time to drink like a lady," promising "all of the cocktail options you want, without the extra calories you don’t." And Anheuser-Busch advertises its "Select 55 beer" directly on Weight Watchers' website, assuring dieters that they can "be good...and still have a good time." These tactics may help companies sell more products to weight-conscious consumers, by claiming to defy the fact that booze is high in calories; but they could also increase the overlap between substance abuse and eating disorders.

Jeneane, a recovering alcoholic in New York, tells The Fix that she used to starve herself during the day to "save up" her calories for drinking. "But then I would get drunk quickly on an empty stomach, and I'd be ravenous and uninhibited, so I would binge eat," she explains, "I would wake up the next day, realize all the calories I'd consumed the night before, and starve myself again. It was a vicious spiral." The co-occurence of substance use disorders and eating disorders is extremely common, Rebecca Berman, LCSW-C, MLSP, the Clinical Supervisor of Renfrew Center in Maryland, which treats eating disorders, tells The Fix. According to Berman, substance use disorder in an eating disorder population occurs 50% of the time, as opposed to 9% in the general population. And 35% of people in the substance use community strugge with eating disorders, compared to only 3% of the general population. "It's usually more bulimic tendencies that are struggling with substance use disorder because both correlate with trouble with impulse control," she tells us. She says 30-50% of people struggling with bulimia, and 12-18% of people with anorexia, abuse or are dependent on drugs and alcohol. "The most common way we hear girls and women talk about it is with the terms 'weekend eating' or 'drunk eating,'" she says. "They eat 'good food' during the day, and 'bad food' in the evenings (or on weekends) when they drink. It promotes rigid beliefs about food, with labeling certain food as 'good' and other food as 'bad. It might become an eating disorder for one person, and it might not for someone else."

The combination of disordered eating and substance abuse can also increase the health risks associated with both issues. Drinking on an empty stomach leads to greater likelihood of blacking out or passing out, and increases the potential for physical injuries. And in the long term, substituting alcohol for food can lead to malnutrition, and from there to organ damage and weak bones, Dr. Harris Stratyner, Vice President of Caron Treatment Centers and the New York Regional Clinical Director, tells The Fix. "The thing that worries me as a psychologist and addictionologist is the combination of the two," he says. "Alcohol robs you of very important vitamins—such as Vitamin A, B12, and folate. And anorexia, bulimia, and over-exercising rob you of some of the same vitamins at an additional volume. We're seeing girls and women destroying their reproductive systems, getting clacium deficiencies. It's frightening to me as a doctor."