Drunkorexia: Dual Diagnosis with a Twist

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Drunkorexia is not an official diagnosis, but it serves to describe a condition involving a group of college and post- college age individuals, mostly women, who starve themselves all day to save calories for binge drinking. The term has been associated with serious eating disorders, specifically bulimia where the person binges on food or, in this case, alcohol followed by purging. Anorexics with “drunkorexia” may severely restrict their caloric intake to alcohol. There are some who use drugs like cocaine and methamphetamine to suppress their appetites and also use alcohol.

The dual diagnosis, that being the eating disorder and the substance abuse problems require treatment in a setting where both conditions can be identified and treated. In the treatment of addiction, we know that a person can switch addiction to maintain the psychological effects they desire even if they stop the initial addictive behavior. One young woman went into treatment for her bulimia and started drinking following her inpatient treatment. She found it easier to purge alcohol than food and then to re-consume the alcohol in her attempt to remain drunk. People like this can easily end up in an emergency room with dehydration or an electrolyte imbalance or even worse. The problem of finding a treatment center equipped to handle both an eating disorder and a substance abuse problem can be daunting. Similarly, the long term aspects of sobriety and maintaining healthy eating can be difficult for the person who has both an eating disorder and a substance abuse problem as they deal with managing both sets of symptoms in their life.

A 2010 article in the Journal of Biological Psychiatry indicated that 25-33 percent of bulimics also struggled with alcohol or drugs and that 20-25 percent of anorexics faced the same issues. As there is a growing link between the psychological issues in addiction and the neurologic link to the brain and behavior, is it possible that the eating disorder and the substance abuse issues stem from the same part of the brain?

Treatment centers for dual diagnosis individuals are challenged by the problem of an eating disorder coupled with substance abuse. We can help a person to stop drinking or using drugs, yet with food addiction we face a problem that people need to change their relationship with food, something that doesn’t involve abstinence.

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