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Monday, November 3, 2008

Drunkorexia: Dieting Drinkers

When staying slim means drinking your dinner.

By Jay Dixit, Psychology Today.com

My friend Lori used to lose weight using a method she developed herself, one she called the CWAC diet: coffee, water, alcohol, and cigarettes. Though the regimen no doubt wrought havoc on her body, one thing was certain: It worked.

The idea of forgoing food in favor of alcohol isn't new. Dieters everywhere cower in fear of carbs; but alcohol, gram for gram, has even more calories than carbohydrates do. For many people, this creates a dilemma: If you want to restrict calories, you have to cut back on either food or booze. For a college student or 20-something who wants to party and have a good time yet still have a bikini body, the choice is obvious.

The result is a trend among young people, particularly young women, called drunkorexia—restricting food calories to make room for drink calories. The practice is widespread: 30 percent of women between 18 and 23 diet so they can drink, according to one study.

Subbing drink calories for food calories is not necessarily a problem in itself. We all make food choices. You might curtail your food intake slightly because you know you're going to have a drink—skip the potato for a glass of wine. That's fine, so long as you get all the nutrients you need from food, including the essential vitamins, plus enough protein and fats. In theory, skipping the potato in favor of a drink is no different from skipping the potato in favor of cheesecake—in fact, it's probably a smarter choice, particularly because moderate alcohol intake has proven health benefits.

The problem is that, in practice, many drunkorexics don't drink in moderation. Some skip meals entirely then binge on alcohol. Some women say: "I just won't eat on the day I drink." When taken to such an extreme, drunkorexia becomes a combination of alcohol abuse and an eating disorder. Binge drinking is on the rise among women, studies show—and women are also more prone to eating disorders.

Curtailing food calories in favor of drink calories carries several risks: The first is the danger that your body won't get the nutrients it needs, and which it obviously can't draw from the alcohol you substitute. You also wreak havoc on your metabolism, putting yourself on track for a metabolic yo-yo.

A twin danger lies in drinking too much—a risk that is magnified by the act of curtailing food calories. That's because the food in your stomach is like a sponge that absorbs alcohol: Drinking on an empty stomach gets you drunk faster. Being hungry may also cause you to drink faster, which further speeds up intoxication. On top of that, drinking alcohol with artificially sweetened mixers gets you to drink faster, according to a study. If you're not careful, you get drunker more quickly than you intended—and once you're intoxicated, you lose your defenses and you're more likely to binge.

"People end up drinking more alcohol than they anticipate, adding more calories that way," explains Carrie Wilkens, a clinical psychologist at the Center for Motivation and Change in New York. "Because they are disinhibited from drinking, they end up actually binging on food. The problem is, they aren't thinking: 'Okay, what happens when I lose control later in the night?'" That's the problematic paradox of drunkorexia: Drinking on an empty stomach reduces your self-control and predisposes you to make bad decisions. In the eyes of many health professionals, it's a balancing act that's not worth the risks.

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