Eating Disorder Recovery During Your Freshman Year of College: Part 5, Alcohol
This is the last post in my series on eating disorder recovery during your freshman year of college. If you missed the other posts in this series, you can access them here. In this post, we will look at the topic of alcohol and eating disorders. While the safest thing for your recovery is not to drink (especially early in the process) some people still choose to, so I wanted to provide a few things for you to consider. Topics we will explore are restriction, lowered inhibition, mood disturbances, and problematic drinking.
When we are looking at eating disorder recovery restriction is often a symptom individuals have struggled with regardless of their diagnosis. One of the pop culture terms you will hear regarding alcohol and eating disorders is “drunkorexia” This is a term used to describe restricting food intake in order to compensate for calories consumed when drinking. There are multiple problematic aspects to this but the one I want to highlight is how it is still operating under an eating disorder mindset.
When we think about what typically constitutes a recovery mindset around food, it is one that promotes food as fuel, nourishing our bodies with a variety of food, and in most cases eating intuitively or following a meal plan that does not involve calorie counting. When the stance is taken of purposely restricting calories in an effort to compensate calorically, this is an approach that is driven by the eating disorder. It does not look at food as fuel or the need to get a variety of macronutrients and micronutrients from the food we consume. It looks at food as a transaction, something earned. This often triggers a greater focus on calories and a slide back into daily restriction as a result. If you are unable to drink without compensating by restricting food intake then I would strongly encourage you to skip it for now.
The next thing we need to consider is that alcohol lowers inhibition. Lowered inhibition can be problematic when we think about engagement in eating disorder behaviors like binge eating and purging. With lowered inhibition there is less of an opportunity to pause and accurately assess the situation or play the tape out and identify potential consequences of engaging in eating disorder behavior. If you do engage in binge and/or purge behavior, it is strengthening that pathway in your brain between impulse and action and makes it harder to choose the recovery behavior the next time. Having accountability set up with friends who are going to be with you or a physical reminder to your commitment to recovery (could be a piece of jewelry, a picture on your lockscreen, etc.) can be helpful. If you find that when you drink you are unable to manage binge and/or purge urges, now is not the time to be drinking because of the risk it poses to your recovery.
When we talk about eating disorders, co-occurring issues like anxiety and depression are extremely common. While alcohol may make you feel happier or more at ease in the short-term, in the long run it exacerbates symptoms of depression and anxiety. If you are taking medication to manage any symptoms related to your mood, alcohol can also potentially impact how that medication works. Pay attention to how drinking impacts your mood longer term and make sure you talk to your doctor about drinking with any medication you are on.
Alcohol abuse is a problem in almost 50% of individuals with an eating disorder. You can be especially susceptible to the development of problematic drinking in early recovery when emotions may feel more intense and you have yet to full develop alternative coping skills to manage them. This can lead to symptom substitution which is when an individual goes from using one behavior (like eating disorder behaviors) to another (like drinking) in order to cope. Symptom substitution can lead to a difficult cycle to break where an individual may appear to be in recovery from their eating disorder but has started having difficulties in another area (ex. with drinking) and then when the focus shifts to address the new problematic behavior, the eating disorder flares up again. You are more susceptible to having difficulties with drinking if alcohol use disorders are in your family as there is a genetic link. Make sure to talk with your team about your drinking patterns. If you have concerns, the AUDIT (which you can take here), is a self-test screener and can indicate any problematic patterns that may be there.
Avoiding alcohol is the safest route to protecting your recovery. If you do decide to drink, make sure you are paying attention to how it is impacting your recovery in the areas discussed above. Make sure you are discussing this with your team as well. If you are beginning to wonder if your relationship with alcohol is becoming problematic, it is always easier to address it earlier rather than later.