‘I would pretend I didn’t like food’: The lethal ‘drunkorexia’ cocktail affecting growing numbers of young women

When eating disorders are combined with alcohol abuse, it can prove to be fatal. Maya Oppenheim speaks to two sufferers and considers what can be done to help

A recent study by South Australia University describes ‘drunkorexia’ as the ‘damaging and dangerous’ practice of cutting down on eating while drinking excess alcohol in a bid to stop putting on weight (iStock)

Even now if I know I’m going to drink I will definitely skip dinner, and at most try and only have breakfast in the morning,” Elizabeth tells The Independent. “It’s pretty much automatic now. It’s such an ingrained habit I can’t begin to imagine it being any other way. Even the thought of not limiting food before or because of drinking makes me incredibly anxious.”

The 30-year-old, who is a fitness instructor, says she suffers from a phenomenon routinely described as “drunkorexia” but which is not recognised as a diagnosable eating disorder.

Elizabeth, who does not want her last name used, is not alone. A recent study by South Australia University, which describes “drunkorexia” as the “damaging and dangerous” practice of cutting down on eating while drinking excess alcohol in a bid to stop putting on weight, found over 80 per cent of the 479 female university students they polled had done this in the past three months.

Elizabeth says it was difficult to pinpoint the exact start of her struggles with alcohol and food, but notes she had always had a complicated relationship with body image.

“During my teenage years I went to an all-girls school in one of the most affluent areas of the country,” she adds. “These girls were beautiful, but also rife with insecurities. I remember when we were 16 and first started drinking, the motto ‘eating’s cheating’ would be bandied around. In that drinking on an empty stomach would get you drunk faster, but partnered with this motto was the belief that eating before going out would mean you would bloat. Then came the realisation just how many calories are in each drink. Pile all of these on top of each other and it began to compound to not combining alcohol and food in the same day.”

This spiralled and she developed anorexia and bulimia at age 17, and began charting every item of food or drink that passed her lips.

“I was limiting my calories and ‘borrowing’ calories from other days,” Elizabeth adds. “I’d try and restrict down to under 500 calories, but if I drank alcohol I wouldn’t eat for the day leading up, or a day or two after. This was at the height of my eating disorder struggles. In my early twenties, I got a healthier grip on my eating habits. However, I have never been able to stop the adjustment of nutritional and food calories due to alcohol. There’s a drink called a ‘skinny bitch’ which is vodka soda and fresh lime – it has the lowest calorie amount of any drinks – which has been my go-to for years and I can’t imagine deviating.”

Elizabeth says she continues to have a problematic relationship with exercise and alcohol consumption – explaining she forces herself to exercise before or after drinking to offset the calories from alcohol.

“I tell myself ‘20 more minutes’ over and over, until I’m exhausted so I feel I have the calorie deficit appropriate for drinking,” she adds. “I guess it’s strange as drunkorexia is a less recognised form of disordered eating. People feel they can understand anorexia, and the painfully thin poster-child. They believe they know bulimia, and the image of a girl with her head stuck down the toilet. However, there are so many more nuances and complexities to these two eating disorders alone. Drunkorexia itself can go by totally unnoticed. It can be masked with ‘eating’s cheating’, not wanting to bloat, only drinking clear spirits and mixers due to the low-calorie amount.

“I am clearly very aware of the dangers of substituting food calories for alcohol, but it’s so deeply ingrained in my fibres I can’t imagine not operating in this way. My relationship and awareness of calories in solid or liquid form is incredibly disordered, not to mention dangerous. Sadly, old habits die hard.”

Maria, whose name has been changed to protect her identity, says her tricky relationship with alcohol and food developed on a date when she was 21.

“I bought a new dress and got the train to London,” she says. “He grabbed my belly when we were sitting down. I really did cut down on food and lose a lot of weight after that. I limited myself to a few Ryvita a day and a bowl of soup. I used to look at the scales a lot.”

The 29-year-old says she started cutting down on food before going out drinking – sometimes just having a bowl of Shreddies for dinner – due to being wary of consuming too many calories but has managed to overcome such issues now.

“I would think I need to look nice and slim and not feel bloated,” Maria adds. “If I had an empty stomach I knew the alcohol would go to my head a bit quicker. I would think the alcohol has got lots of calories in so, I don’t want lots from food. I met another guy when I was 23 and I could barely eat in front of him. I would pretend to him I didn’t like food. But of course, I love food. He would take me to these amazing restaurants, but I poked the food around and barely ate anything. I remember making him drive to buy me a bottle of wine. I liked to feel skinny around guys but actually, it’s really not healthy at all. I did put a lot of emphasis on how I looked when I was younger. It was how I valued myself.”

Researchers recently found almost a third of female Australian university students who were between 18-24 years old were frequently and deliberately missing meals, drinking low-calorie or sugar-free alcoholic drinks, “purging or exercising” after drinking in order to counteract alcohol calories at least a quarter of the time.

Alycia Powell-Jones, a clinical psychologist who led the first of its kind study which was published last week, tells The Independent she was surprised by the findings.

“It is a concerning number of young women who are placing their physical and mental health at risk with serious consequences,” she adds. “Women typically tend to weigh less than men. There is specific planning and intention behind these behaviours. Drunkorexia is not a clinical term, but it is describing a really important behavioural trend. Through understanding this behaviour, we can keep young women safe. There are concerns around social norms of consuming alcohol and peer pressure and pressures around body image.”

Ms Powell-Jones, who works in the young adult mental health sector, says drinking excessive alcohol while engaging in disordered eating patterns can radically increase the risk of hypoglycaemia, liver cirrhosis, nutritional deficits, brain and heart damage, depression, anxiety and cognitive impairments.

Tom Quinn, of Beat, the UK’s leading charity which helps people affected by eating disorders​, says: “‘Drunkorexia’ is not a diagnosable mental illness. However, we know that some people with eating disorders, especially bulimia can also have an unhealthy consumption of alcohol.

“For some, an alcohol binge can be associated with a feeling of loss of control, and someone with an eating disorder who experiences that loss of control may attempt to get that control back through subsequent calorific restriction.”

He urges anyone who is anxious about their health to contact their GP at the earliest opportunity.