The Fraught Relationship Between Alcohol and Eating Disorders
How drinking helped me starve myself — and learn to eat again
On a trip to the library during my senior year of college, when I was at a nadir in my anorexia — three months before entering rehab — I collapsed on a staircase, faint from food deprivation and overexertion. I wasn’t sure I’d make it back to my dorm. There was an apple in my bag that could’ve helped, but I’d already carefully allotted the day’s calories, and the apple wasn’t included. Eating the apple now would mean not having a beer later, and that was unthinkable. In a way I couldn’t have articulated in the moment, that drink was as essential to my anorexia as maintaining my calorie count. I braced myself on the railing and continued up the stairs.
Alcohol may seem an unlikely friend for someone with an eating disorder, but booze has been my accomplice for much of my two-decade struggle with anorexia, and I’m not alone. Up to 50 percent of people with eating disorders abuse alcohol or illicit drugs, a rate five times higher than the general population, while up to 35 percent of those with substance abuse issues also have eating disorders, a rate 11 times higher than the general population. It’s important to take these numbers with a grain of salt, as they’re usually based on the most severe cases — but still, the general consensus is that people with eating disorders have higher instances of alcohol abuse than those without.
The rate of alcohol abuse varies wildly depending on the type of eating disorder. Those with bulimia are three times more likely to misuse alcohol than non-bulimics, and those with substance abuse disorders are more likely than the general population to exhibit disordered eating while remaining below the diagnostic threshold for anorexia or bulimia. Those with anorexia — my eating disorder of non-choice — are less likely to abuse alcohol. Anecdotally, this aligns with my experience: When I fit all the diagnostic criteria for anorexia, you never would’ve classified me as abusing alcohol, because I drank just one Beck’s Light (64 calories a bottle!) per day.
What the research misses, however, is that even though an anorexic doesn’t drink much, the alcohol they do drink may be just as destructive as it is in those who…
