A Wharton sophomore admits she’s done it a couple of times, but only by accident. She didn’t plan well enough in advance, and ended up getting drunk on an empty stomach, which made her feel sick.
But she has friends who purposely don’t eat before drinking alcohol. They say it “helps them process the alcohol better,” but many have suffered negative consequences for this behavior.
The sophomore, who wishes to remain anonymous due to the sensitive nature of the issue, recalls one instance in which an intoxicated and unconscious friend fell asleep in the snow. And in another instance, a different friend spent the night convulsing on the bathroom floor, “making all the colors of the rainbow,” she said.
This disorder — called drunkorexia by the media — usually involves bingeing or skipping meals in order to either compensate for alcohol calories consumed later at night, or to get drunk faster. In more severe instances, it is a co-morbid disorder — the combination of a diagnosable eating disorder and alcohol dependency, both of which are genetically-driven.
Although there are no official numbers, Counseling and Psychological Services director William Alexander said he’s personally seen “plenty of cases” at Penn.
Some individuals in the medical field do not believe in the media’s use of the term drunkorexia.
“Drunkorexia is just a term,” said Cynthia Bulik, Ph.D. Director of the University of North Carolina Eating Disorders Program. “It’s part of a parade of ‘orexias’ the media has come up with.”
Although she believes the two illness are important to bring to the public’s attention, “calling it drunkorexia trivializes it,” said Bulik, author of The Woman in the Mirror: How to Stop Confusing What You Look Like With Who You Are.
“It’s two disorders, both of which require treatment,” she said, adding that it is becoming increasingly common to see people who suffer from multiple disorders.
Some, such as Sondra Kronberg, founder and Nutritional Director of the Eating Disorder Treatment Collaborative of New York and National Eating Disorder Association spokesperson, say that drunkorexia is a recent development.
“It hasn’t always been there. Drinking on college campuses is more rampant, and there’s more pressure [to drink],” Kronberg said.
A stressful environment
Sufferers of the disorder are often portrayed as purposely not eating or binge eating, Bulik said. But she explained that the researchers are “still unpacking” the question of how both illnesses work.
CAPS psychologist Leilani Crane explained that the causes of drunkorexia cannot be attributed to the college environment, but she added that peer pressure to drink can exacerbate symptoms.
“There’s an ‘everyone parties’ attitude,” she said.
Kronberg agreed that, “there’s an attraction to drinking while in school. [Students] see a need to drink their way through the weekend.”
People who suffer from the disorder, according to Kronberg, feel guilty about consuming so many calories. “They feel like they need to do something over the week to compensate for the calories consumed.”
For people who suffer from drunkorexia, partying can also tap into emotional vulnerabilities. Crane said that a person who has had a negative experience at a party might later binge and purge as a coping mechanism.
Additionally, academic pressures can affect patients. “Stress and pressures are great at the Ivies,” she said. Students with these disorders “might turn to these kinds of behaviors to cope.”
Crane compared it to students who cut themselves, another harmful behavior.
“Bottom line: it’s not healthy, whether willfully or biologically driven,” Bulik said.
College senior Celia Harrison said there are certain aspects of the Penn environment — such as stress — that may foster this kind of behavior. “Kids here do things in the extreme.”
Populations at risk
No segment of the population is immune to the disorder. Even though Crane noted that males at Penn seek treatment less frequently than females, athletes sometimes exhibit symptoms of the disorders because their trainers might push them to maintain a certain body weight.
Kronberg explained that although both men and women might engage in drunkorexic behavior, men are likely to work out more, while women are more likely to binge or eat less.
Harrison said she knows people who have done this, adding that some people might not have enough time to eat dinner. “Some girls might also want to look slimmer at the party,” she added.
Engineering freshman Lily Wang agrees girls at all colleges are more likely to have the disorder. “I don’t think it’s a Penn thing. I think it’s a girl thing.”
Furthermore, Kronberg and Crane agreed that bulimics are more likely than anorexics to abuse alcohol.
“My anorexic patients would be less likely to drink alcohol because of the calories,” Kronberg said.
Crane added that drinking can lower one’s inhibitions to the point where he or she might be more likely to binge.
However, Crane commented that anorexic students might be more likely to compete to be the thinnest, which is “very dangerous.”
Bulik estimates that about a quarter of bulimics and 10 to 15 percent of anorexics exhibit an alcohol dependency.
Kronberg explained that this behavior over time can lead to electrolyte imbalances, brain damage and cardiac problems.
“If you’re genetically predisposed to alcoholism, you’re fostering that manifestation,” she added.
More immediately, it can lead to alcohol poisoning, accidents like falling down stairs and even death.
“You get to that sick point much faster,” the Wharton sophomore said.
“Food restriction can be dangerous, and adding alcohol doubles the danger and doubles the toxicity,” Kronberg said.
As for treatment, Bulik said, “There aren’t a lot of programs in the country that treat both disorders simultaneously. So people sometimes ping-pong between eating disorder programs and drinking ones.”
She said this can be an obstacle to recovery since drinking can influence eating habits. “It’s important to understand how one influences the other to completely recover from both,” she said.
CAPS offers a group session for women with eating disorders, and an option for private therapy, Krane said.
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