A key element in most eating disorders is the fear of weight gain. In anorexia, this fear fuels the desire to avoid food. In bulimia, it fuels the desire to eliminate food once it's eaten. In both of these eating disorders, the fear compels people to unhealthy behaviors.
Drunkorexia is similar. Fear of weight gain seems to motivate at least some of those who avoid food and still drink very purposefully. And the parallels don't stop there.
Is drunkorexia like bulimia nervosa? Yes, in a way. We think of bulimia as a cycle of binge eating and purging (vomiting), but the definition of bulimia allows for any kind of compensatory behavior for binge eating. It could be exercise, restriction, or use of laxatives, for example. If we think of the drinking in drunkorexia as an "eating" binge (a high number of calories in a short time), we could see the avoidance of food at other times as the behavior to compensate for binging.
Is drunkorexia like anorexia nervosa? Again, in a way. Most think of anorexia as a disorder involving only self-starvation. But there is a subtype of anorexia called purging type, and drunkorexia is similar. A person with anorexia, purging type will eat, but will still maintain a weight that is under 85% of the expected weight. To do so requires a commitment to weight loss behaviors.
While drunkorexia may well be an eating disorder, there are other possibilities:
- Some may restrict food intake not to avoid weight gain, but simply to enhance the high from the alcohol. This is very dangerous behavior, but it does not have the same attributes of an eating disorder.
- Some may intentionally spend a day's calories on alcohol here and there, but not routinely.
- For some, drunkorexia may actually be two problems at once -- alcohol dependence (or abuse) and an eating disorder. In this case, drunkorexia itself would not classify strictly as an eating disorder. It would be a tragic setup, however. To avoid food, one has to be desperate to avoid weight gain. But an alcohol addiction would demand to be fed even though it would supply feared calories. The emotional stress for a person in this position would be enormous.
My take: It will depend on the situation until drunkorexia is better defined. Of the people who restrict calories and still drink, there will likely be those who
- do it for the novelty of it, or to enhance the effects of the alcohol
- try it a few times, and then stop
- restrict food to compensate for alcohol intake or who have a general calorie limit in mind and choose to use most of it on alcohol
- fear gaining weight and at the same time struggle with alcohol dependence or abuse
- fear gaining weight and still use alcohol, but who drink in moderate amounts and do not have alcohol dependence
Those above who do fear weight gain or maintain hard-core calorie limits may fall into the eating disorder not otherwise specified (EDNOS) category.
It takes years (and a lot of debate in the psychological and psychiatric communities) for a set of symptoms to become a "disorder" of any kind. So it's a bit cavalier to label drunkorexia as an eating disorder at the moment. But there was a time when anorexia and bulimia were basically unknown. Whether drunkorexia obtains status as a unique eating disorder may well depend on whether there is enough interest and funding to encourage targeted research.
