Skipping meals in order to save calories to consume more alcohol – a pattern of behaviour called drunkorexia – is becoming worryingly popular

Pasta or pinot grigio? A healthy meal or a half pint?

As the weekend arrives, these are the questions considered by a drunkorexic – someone who skips meals so they can binge drink without putting on weight.

The preferred option is usually the liquid one.

Drunkorexia is a phenomenon which can be traced back to the cocktail bars of New York in the 1960s.

A recent study in the United Kingdom revealed that more than one in 20 women in Britain admit to skipping meals or eating less to drink alcohol.

This poll of 2,000 adults, carried out by YouGov and funded by drugs company Lundbeck, showed that only 23 per cent believe their health would improve if they cut down on drinking.

Of the respondents, 840 were female drinkers and of these, more than one in 20 admitted to skipping a meal or counting calories because they were drinking alcohol or planning to do so later in the evening.

Experts warn that alcohol contains ‘empty calories’ offering no nutritional value. Swapping food for spirits could starve the body of essential vitamins and potentially lead to alcohol poisoning.

Anton Grech, chairman of psychiatry at the Health Department and chairman of Fondazzjoni Kenn ghal Saħħtek, says that his impression is that the drinking problem in Maltese young women is similar to that of other European countries.

“As far as I know, there are no epidemiological studies to give a definite answer to how big the problem is. However, my experience, both as a clinician and as an administrator in mental health services, tells me that we have a significant problem, both in terms of frequency and gravity.

“At present, in certain women, this problem is wrecking careers and relationships and in severe cases often leads to death from liver failure,” Dr Grech says.

Drunkorexia is not regarded as an eating disorder but is considered an evolving and new pathological condition.

While it is not yet classified as a mental illness by the World Health Organisation, the indications are that it might be in the near future.

Dr Grech says that this condition is gaining ground in Malta. It is present mostly in youths, starting from teenage years, with the majority of sufferers being women. Lately, however, men – though to a lesser extent – are also falling victims to this condition.

Drunkorexia can be a stepping stone to the more serious illness of anorexia nervosa. During prolonged periods of starvation, the individual is in a state of irritability and dysphoria.

There are women who are afraid to put a grape in their mouth but have no problem drinking a beer or down a couple of cocktails

Getting nearly all your calories from alcohol will lead to metabolic imbalances that in the long-term can lead to psychological problems similar to dementia.

There are women who are afraid to put a grape in their mouth but have no problem drinking a beer or down a couple of cocktails. The obsession with being skinny and the social acceptance of binge drinking – along with the sense that among celebrities, checking into rehab is almost a given, if not downright chic – are considered to be mostly to blame.

Both disorders are behaviours that are glorified and reinforced in today’s society. Binge drinking is almost cool and hip, while being thin is a cultural imperative for young women. It is not surprising that people are trying to achieve both but it has now reached a tipping point in terms of public awareness.

Eating disorders, like other addictions, are often rooted in the need to numb emotional pain with substances. Such disorders are often driven by childhood trauma like sexual abuse, neglect and other sources of mental anguish.

The road to recovery is long and hard but accepting that you have a problem is the first step.

There is no specific treatment for drunkorexia as it is not a medically diagnosable disorder. But since it is a combination of two different disorders, treatment needs to address both the eating disorder and the alcohol abuse.

There may also be an underlying mental health disorder driving both the eating disorder and the alcohol addiction. An accurate diagnosis is vital to arresting both conditions.

Regaining healthy eating habits and maintaining abstinence is possible with the right information and tools. A dual diagnosis programme supervised by addiction-certified physicians, psychiatrists and therapists can create an individualised plan for the patients and provide the support, knowledge, and skills necessary to rebuild their life. The earlier the intervention, the better the outcome.

In Malta, government offers support through various services offered by the Department of Psychiatry as well as Fondazzjoni Kenn ghal Saħħtek, which is a collaborative project between the government and the Malta Community Chest Fund.

To use any of these services, a referral letter from a medical doctor is required.

Symptoms of Drunkorexia

Drunkorexia consists of three major aspects: alcohol abuse, decreased consumption of food, and excessive physical activity. It is commonly categorised in the following activities:

• Counting daily calorie intake – known as ‘calorie counting’ – to ensure no weight will be gained when consuming alcohol.

• Missing or skipping meals to conserve calories for consumption of alcoholic beverages.

• Over-exercising to counterweigh for calories from alcoholic beverages.

• Consuming an extreme amount of alcohol in order to vomit previously digested food.

This weekend, Dar Kenn ghal Saħħtek in Mtarfa is organising an open weekend. A fun walk for children and parents will be held as part of this activity on Sunday at 10am. Participation is free and complimentary water and fresh fruit will be provided. Participants will be given a certificate. Registration is still open.

This event is being held under the auspices of the Health Promotion Unit of the Ministry of Health. For further details and information contact Dar Kenn ghal Saħħtek on 2145 3690.