Problematic Labelling: The Case of “Drunkorexia”

Recently, I was browsing the Twittersphere and came across (yet another) tweet about so-called “drunkorexia,” or the phenomenon of drinking to excess coupled with restrictive behaviours around food. After firing off a mildly miffed tweet bemoaning our societal tendency to add the suffix “orexia” to all “new” potentially problematic behaviours around food, I took to Scholar’s Portal to see if academics, too, were using this term. I wondered if “drunkorexia” was piquing scholarly interest, or just circulating in media headlines.

Beyond its problematic moniker, coupling problem drinking and restrictive eating is a phenomenon that might be worth delving into in greater detail, particularly if, as the reports claim, its incidence is rising. Barry & Piazza-Gardner (2012) explored the co-occurrence of weight maintenance behaviours and alcohol consumption, and their article clarifies what people mean when they say “drunkorexia.” I’ll get more into my issues with this terminology following a brief overview of the authors’ study.

Alcohol and “Weight Management” Behaviours

Barry & Piazza-Gardner begin their article with reference to an interesting trend observed by those studying problem drinking in college students: “the incongruous alcohol-activity association” (Musselman & Rutledge, 2010).

Essentially, researchers have revealed that drinkers may in fact be more active than non-drinking peers; some even go so far as to suggest that as drinking increases, so too does physical activity, in a dose-response relationship (Piazza-Gardner & Barry, 2012). The “why” of this relationship is left unexplained, and the authors argue that studying the weight-management behaviours of drinkers may help to understand these links.

What Do People Mean When They Say “drunkorexia”?

Try as I might, I can’t seem to find a way to write this article without using the term that irks me. Importantly, “drunkorexia” is not a diagnosis. It is not even well-represented in the scientific literature; the authors acknowledge the colloquial nature of the term. With this in mind, the term could be used in a number of different ways. When they say “drunkorexia,” Barry & Piazza-Gardner are referring to engagement in one or more of the following:

  • “Saving” or compensating for calories consumed in the form of alcoholic drinks by skipping meals
  • Engaging in excessive exercise as a compensatory mechanism for calories consumed in the form of alcoholic drinks
  • Drinking alcoholic beverages in excess in order to facilitate purging

They suggest, using these guidelines, that “drunkorexia” is comprised of the use/abuse of alcohol, disordered eating, and physical activity.

Disordered Eating and Alcohol Use

Despite claims to the “novelty” of this phenomenon, disordered eating and alcohol consumption have long been associated. For example, the documented incidence of comorbidity between bulimia nervosa and substance abuse/dependence averages at 22.9% (Holderness, Brooks-Gunn, Warren, 1994), with lower rates of comorbidity for anorexia nervosa (particularly restricting subtype; Bulik et al., 2004).

However, as the authors suggest, prior research examining the relationship between alcohol use and physical activity has largely left disordered eating out of the equation. Accordingly, they sought to examine whether drinking behaviours can be predicted by physical activity and disordered eating, and whether there are social and environmental factors that may mediate the “incongruous alcohol-activity association.”

Why College Students?

The authors used a sample of college students to study these behaviours, because:

  • Young adults 18-24 are among the highest consumers of alcohol
  • This age group is generally more physically active than older adults
  • There is a relatively high prevalence of disordered eating (clinical and sub-clinical) in this age group

To ascertain the links between weight management behaviours and drinking, the researchers used data from a large school study assessing college student health, the American College Health Association’s National College Health Assessment (ACHA-NCHA). The study from 2008 surveyed 40 U.S. campuses with varied demographics.

The authors used responses on items related to:

  • Alcohol use: (1 item) assessed students’ drinking behaviours; those who reported binge-drinking one or more times over a week’s period were classified as “binge drinkers”
  • Physical activity: (3 items) looked at students’ levels of moderate, vigorous, and strength-training activities
  • Disordered eating behaviours: (4 items) examined dieting behaviour, vomiting/laxative use, diet pill use, and exercise with a weight-loss goal

The authors also took the following sociodemographic factors into account: gender, age, racial background and ethnicity, membership in fraternity/sorority, and place of residence.

The responses to the above items from 22,488 students were included in final statistical analysis.


Overall, the researchers found some support for the idea that students who are highly active are relatively more likely to drink heavily (vs. non-active peers), supporting the “incongruous activity-alcohol association.”

Importantly, when taking into account the above-mentioned sociodemographic characteristics of the sample (i.e., holding these constant), both engagement in vigorous physical activity and disordered eating were predictive of binge drinking.

As the authors point out, we are still unable to fully explain the “why” using this kind of secondary data analysis; future studies might delve deeper into these connections to explore the motivations behind engagement in physical activity and disordered eating behaviours for individuals who binge drink.

Among disordered eating behaviours, vomiting, laxative and diet pill use were particularly likely to predict binge drinking. I think there might be a lot more to this link than the authors are able to claim based on their data and analysis techniques; once again, it would be interesting to explore causal mechanisms behind this link.

So, If Links Exist, Why Contest the Use of the Term “drunkorexia”?

I’d like to answer this question with several more questions…

1. Are the behaviours identified above (i.e., limiting caloric intake, engaging in excessive exercise as a compensatory mechanism and/or other “dieting behaviours”) in their own category of disordered eating (i.e., “drunkorexia”) when they are linked to alcohol consumption, or are they simply part and parcel of disordered eating in general?

2. Does the use of the term “drunkorexia” and subsequent media coverage of this phenomenon actually lead to better recognition and treatment, or do medical professionals brush off these behaviours as fad-like and a passing phase?

  • This is particularly likely, I would say, given the extent to which media coverage of “drunkorexia” is linked to college students, who are often represented as being in a period of flux in their lives
  • Problematically, this might feed into stereotypical perceptions of eating disorders as a passing phase, which they are certainly not

3. Putting my critical feminist hat on, do we need to create categories and labels for all “disordered behaviours”?

  • There are a wide range of behaviours associated with disordered eating; it is possible that problematic alcohol consumption and restrictive/ “dieting” behaviours fall into these variations, without requiring a “buzz-word” or label

I’m sure there are many more issues with calling these behaviours “drunkorexia.” I’m curious to know how readers feel about the term and other, similar terms (e.g., pregorexia etc.). Any opinions?


Barry AE, & Piazza-Gardner AK (2012). Drunkorexia: understanding the co-occurrence of alcohol consumption and eating/exercise weight management behaviors. Journal of American College Health, 60 (3), 236-43 PMID: 22420701


Andrea is a PhD candidate focusing on individual, familial, and health care definitions and experiences of eating disorder recovery. She has an MSc in Family Relations and Human Development and a BA in Sociology. In her Masters research, she used qualitative and arts-based approaches (digital storytelling) to explore the experiences of young women in recovery from eating disorders. Andrea has recovered from EDNOS. She can be reached at andrea[at]scienceofeds[dot]org.


  1. This is one of the best things I have read in a long, long time. Just last weekend I saw one of those “drunkorexia” articles and was disgusted. As someone who has struggled with both anorexia and alcoholism in the past, the term drunkorexia honestly makes me sick. Thank you so much for shedding some light on this issue!

    • Thank you for your kind comment! It was an interesting post to write; I’ve been grappling with why these kinds of labels irk me so much for quite some time. I think that especially given the significant comorbidity between eating disorders and alcoholism it is somewhat irresponsible for the media to use a label like “drunkorexia,” which, in it’s “buzz word”-ness may trivialize the experiences of those who have experienced eating disorders and/or alcoholism/substance misuse.

  2. When I was bulimic twenty-plus years ago I thankfully never learned how to make myself sick. I mainly used to fast, but sometimes would use laxatives, and at other times I would swig down neat spirits fast, then hug a plastic-bag-lined bin for some time until the drunkenness turned into nausea and I would throw up my binge.

    This behaviour felt like pure bulimia to me.

    • Thanks for commenting; I think it is very interesting that you describe the behaviour feeling like pure bulimia; I haven’t studied the phenomenon in any great depth, but to me this would also seem to be simply bulimia, as opposed to “drunkorexia.” The inability to purge is something I’d like to investigate in greater detail; drinking to achieve this same end could easily be an alternative end-point to a binge, in bulimia.

      • Once I drank vinegar to achieve the same effect. It was utterly vile, and physically painful. I would have drunk what it took to rid my body of the food. Nothing to do with alcohol per se.

  3. Thanks for the criticisms of the term “drunkorexia.” I am an ED therapist and I treat mostly college/graduate school students. It’s a term that gets thrown around and I agree, it’s annoying. It minimizes very serious behaviors that have a multitude of consequences. Making it seem like this is just how young women drink or that it’s a joke misses the point entirely.

    ED behaviors are dangerous and made more so by by other factors like alcohol abuse, self-harm, pregnancy, etc. It annoys me that terms like drunkorexia and pregorexia are used to dismiss eating disorders and the consequences.

    • Thanks for your thoughtful comment. I think you’re hitting the nail on the head when you write how this framing of the issue misses the point and trivializes behaviours that may cause a great deal of distress.

  4. Thank you for writing such a thoughtful piece on this issue! Having struggled from anorexia and bulimia, and then having worked with many disordered eating patients, I find this term incredibly loose and flippant in describing the seriousness of this issue. As if anorexia or bulimia were not enough of a mental and physical health problem, this term adds insult to injury. Additionally, I find it adds more of the same stigma as “anorexia” and “bulimia” do to their respective traits.

    • I think it’s interesting that you see the potential issues with this language and framing both as someone with lived experiences of eating disorders and as a health care professional. I would agree that such terms have the potential to exacerbate existing stigma surrounding eating disordered behaviours. Thanks for commenting!

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