As college campuses participate in Fat-Talk Free Week – a national campaign to raise awareness of the perils of conversation that regularly includes "I'm so fat" and "You look great! Have you lost weight?" – anorexia and bulimia aren't the only eating disorders on the table.
Over the past few years a new dietary trend has popped up on celebrity chatters and websites and in newspaper articles. The New York Times and Jezebel.com have covered it, and just this week Denver Post columnist Kirsten Browning-Blas reported on it in an article that's being widely reprinted.
The trend is "drunkorexia."
"Abuse counselors are putting the word 'drunkorexia' in line with other eating disorders because the patient uses the same type of methods as anorexia and bulimia- they just mix it with alcohol too," said Dr. Kevin Prince, Alcohol & Other Drug Education Program Coordinator at the University Health Services in Austin, Texas.
Diet blogs and studies describe a drunkorexic as someone who restricts food intake to reserve those calories for alcohol and binge drinking, and note that people are more susceptible to drunkorexia in college. A recent study by the University of Texas School of Public Health and the University of North Texas Health Science Center found that in the past 10 years binge drinking has increased among young men and women.
With fall semester in full swing, universities nationwide are striving to crack down on the behavior. The University of Minnesota is displaying "anti-binge drinking" ads across campus, while administrators at New York University are strictly enforcing "no drinking" dormitory rules more than ever.
They have a tough fight ahead.
"I've Done It for Years, and I'm Still Healthy"
Savannah, a 22-year-old University of Texas graduate from Houston, agreed to be interviewed by ABCNews.com as long as her last name was not used.
An alumna of the Greek community, Savannah says it was easy to abstain from food when it came time to party, with the help of a support system made up of friends and sorority sisters.
"I've always watched my weight and skipped meals to account for the high calorie count of alcohol," said Savannah. "It was just something I always did while in college as a normal part of my diet so that I could stay skinny but still go out and drink."
Savannah says she and her friends would trade methods for skipping meals: working out late at night instead of eating, having one medium meal during the day, in some cases throwing up before going out.
Even though the group knew it was wrong, it became part of the young women's weekend routine.
"I do know a lot of people who skip meals to drink, drink heavily, and don't gain any weight. Obviously their success in this way encourages others to try it," Savannah said.
During her four years in college, Savannah attended counseling sessions for anorexia, at her mother's suggestion. (According to the National Eating Disorder Association, as many as 10 million females suffer from some sort of eating disorder. Of those 10 million, 40 percent of newly identified cases of anorexia are in young women.)
"I've done [drunkorexia] for years and I'm still healthy. And I'm skinny," she said. "That's the best of both worlds to me, so it's not likely that I'll stop doing it any time soon."
Men Consider the Finance Factor
The National Eating Disorder Association shows that while women are more commonly affected by eating disorders, more than a million men and boys battle the illness every day. Between fraternity binge drinking and the social norms of alcohol on campus, college males also try to control their weight while having a good time.
Rodney, a 20-year-old public relations major at UT who also agreed to an interview under the terms that his identity be kept secret, says drunkorexia in men starts with optimizing intoxication levels.
"When you consume on an empty stomach, you feel the effect quicker," Rodney said. Last semester, "during the day on Friday I only ate a pint of ice cream all day, knowing I'd be drinking liquor later that night."
Rodney says it's also a money factor for men. If it comes between eating dinner or spending it on beer, it's often easier to go the beer route.
"Alcohol advertisements have definitely made an impact, considering you see more and more commercials associated with low cost and low-cal beers, or what I call 'diet beers.'"
Some students believe it is these sorts of advertisements that push peers to try drunkorexia and other drastic measures in order to stay thin.
Women as Targets
"On Facebook when we put our gender as female, we're not only targeted with bridal ads but how-to-lose-weight ads, diet ads," said Micaela Neumann, a 19-year-old communications student at UT. "Men don't get that. We are targeted to lose weight."
Advertisements aren't alone in supporting weight loss. Pro-anorexia blogs have been popping up over the past few years and becoming popular internationally. Most websites focus on a "pro-ana" approach, which promotes the eating disorder anorexia nervosa as a lifestyle choice. Ana is a sort of mascot, the personification of an anorexic girl.
Pro-thinspo.com gives strategies for staying thin and how to "look like a model." Trends range from the "5 bite diet," in which a person only eats five bites of food every meal to stay skinny, to different detox methods. On some sites, each week there's a new technique for drinking and not gaining weight or using other forms of drugs.
"It's scary to think that there are support groups like this," said Dr. Prince said.
"A lot of women I've worked with have used these drunkorexic strategies. It's a habit they've formed, and they have this mentality that you can't get your last 'hoorah' in without thinking about the consequences. Every calorie counts," Dr. Prince said.
Along with skipping meals altogether, purging is also a danger associated with drunkorexia. A person binge drinks then binge eats (usually with foods high in salt and sugar according to drugrehabtreatment.com) and throws it back up after.
"It's not good for you nutrition-wise, and the alcohol is going to hit your system harder because there's nothing to slow it down at first," Prince said.
Drunkorexia's Roots in Addiction
Psychologists stress that the main cause of drunkorexia is addiction.
According to the National Institute of Alcohol Abuse and Alcoholism, "alcoholism and eating disorders frequently co–occur and often co–occur in the presence of other psychiatric and personality disorders."
Because drunkorexia isn't a defined medical condition, however, doctors have to look at the conditions of these separate addictions and treat them one at a time. Prince says he works through the effects of a patient's eating disorder before counseling for alcoholism, or vice versa.
Addressing the links between alcoholism, bulimia and anorexia, "where there's a great deal of overlap is in commonalities of the addiction, when there's planning and focus on engaging the addiction itself," Dr. Stewart Cooper, Director of Grad Psychology Programs and Counseling Services at Valparaiso University said.
"I think it's not uncommon with chemical addictions that when ones thing's not available, they'll use another," Dr. Cooper said. "They use different means to alter the experience and get away from feeling."
Ewa Kacewicz, a psychology doctoral candidate and volunteer at the center for students in recovery at the University of Texas, knows this escape from reality all too well. Prior to her volunteer work, she suffered from alcohol abuse. Based on her personal experience and the experiences of those around her, she says of drunkorexia and the blogs devoted to it, "People are taking it so lightly, as if it's some type of diet fad."
"Whether it's alcoholism, drug abuse or some type of eating disorder, an addiction is still and addiction and has to be helped," Kacewicz said. "If not, the results could be deadly."