Alice*, who lives in the UK, remembers the advice her sister gave her before her first year of university. "I was in recovery from an eating disorder, and one thing that really stuck with me was that my big sister had told me about the 'fresher's stone,' [or] all the weight you gain from boozing," she said in an email.
Her sister recommended that she only drink hard liquor with diet mixers that didn't have a lot of calories. Alice took it one step further. "Before nights out, which would be, like, four times a week in my first year, sometimes even more, I'd just eat Special K or another bowl of low-calorie cereal, no milk. I figured I'd need to spend less money on booze to get drunk, and it would be less calories, so it was win–win," she said glibly, which is perhaps the only way to look back on something dumb—and potentially dangerous—you did in your college years.
The phenomenon of drunkorexia, or restricting one's calorie intake to "make room" for carb-heavy alcoholic beverages, has appeared in the news before. In 2008, the disordered eating pattern was written about, eyebrow raisingly, in the "Fashion & Style" section of the New York Times, but the evidence for it at the time was only anecdotal, and some called it an overhyped, youth-shaming myth. However, new analysis from the Research Society on Alcoholism reveals that drunkorexia is very real—and common among college students who either want to minimize weight gain, get exceedingly wasted on a small amount of Burnett's, or both. Researchers say this is closely linked to alcohol abuse and can have especially negative health effects, though many who would qualify as "drunkorexic" tend to think managing their calories to compensate for partying hard is reasonable.
"We know that it's not just the amount or frequency that college students drink, but the way in which they drink that puts them at higher risk of experiencing problems related to alcohol use," Dr. Dipali V. Rinker, an assistant professor in the department of psychology at the University of Houston who worked on the study, told Broadly over the phone. "I wanted to look at the ways students behave before, during, and after drinking," she said.
After surveying college students on campus and online, Dr. Rinker found that many students form complex webs of compensatory drinking behaviors. "People will [eat less] to get drunk more quickly—obviously, there's a big difference between drinking on a full stomach or drinking on an empty stomach; restrict their food during the day [when they plan to drink later]; consume low-calorie drinks during; or the next day they will make up for it by not eating or over-exercising. There are also bulimic-type compensatory behaviors," she said.
When I went to the gym I felt like I gave myself the OK to drink that night.
Melissa* described these methods in practice. "When I went to the gym, I felt like I gave myself the OK to drink [later] that night because I had burned off most or all of the calories I had ingested," she said in an email. But if you want hard numbers (Dr. Rinker's research on the subject has not been published yet), a study published in Australian Psychologist reports that 57.7 percent of female students surveyed said they made up for their alcohol intake in some way.
Dr. Rinker said that people who are drunkorexic end up drinking more and experiencing more problems related to drinking than those who do not engage in compensatory drinking behaviors. While this confluence of an eating disorder and a drinking problem is obviously risky, people who engage in the dieting-to-drink pattern don't often realize it, she said.
"Someone who thinks that the typical college student drinks [a lot] is more likely themselves to drink," Dr. Rinker said of problem drinking in general. The same holds true for drunkorexia, which appears to be a sort of self-perpetuating problem. While compensatory drinking behaviors are "more common than [she] expected," Dr. Rinker said, college students think that their peers are doing it even more frequently than they actually are. She adds that women with a history of disordered eating are more likely to engage in these behaviors.
Surprisingly, simply informing students that their peers are not, in fact, getting tanked on the regular can help curb disordered drinking. "It's the whole idea that everybody's doing it, so I'm doing it, when that's not really true. We've found that when we report to people that the actual amount a typical college student drinks is a lot less than they [themselves] drink, they do reduce their drinking," she said. This could be a first step in addressing drunkorexia among student populations. "Providing accurate drinking norms could certainly be a component of an intervention that actually helps."
*Names have been changed.