Search

Background: Drunkorexia refers to limited intake of high-calorie food to avert gaining weight and the need to increase in alcohol excessive consumption. The present study aimed to check for an association between depression, anxiety, and stress with drunkorexia behaviors/motives among Lebanese adults, while evaluating the mediating role of inappropriate eating attitude in those associations. Methods: Two hundred and fifty-eight participants enrolled in this cross-sectional study, who filled an online survey (September–December 2020). Results: Drunkorexia behaviors were considered as the dependent variable; the path coefficients from stress to anxiety, from anxiety to eating attitudes, from eating attitudes to drunkorexia behaviors and from anxiety to drunkorexia behaviors were all significant. The indirect relationships showed that eating attitudes mediated the association between anxiety and drunkorexia behaviors. When taking the drunkorexia motives as the dependent variable, the path coefficients from stress to anxiety, from anxiety to eating attitudes, from eating attitudes to drunkorexia motives, and from anxiety to drunkorexia motives were all significant. The indirect relationships showed that eating attitudes mediated the association between anxiety and drunkorexia motives. Conclusion: This study highlighted that individuals with more psychological problems (depression, anxiety, and stress) and inappropriate eating habits exhibit more drunkorexic motivations and behaviors. Level of evidence: Level V, Cross-sectional study.

Purpose: This study investigated the associations between retrospective reports of body image victimization (i.e. body shaming) perpetrated by peers and by parents during childhood or adolescence, and food and alcohol disturbance (FAD) in young adulthood, considering the possible mediating role of psychological distress (i.e. subthreshold symptoms of anxiety and depression). Methods: The study involved 1624 young adults aged between 18 and 30 (69% women), who completed an online survey. Results: Our findings revealed that participants who reported more frequent body image victimization episodes during childhood and adolescence exhibited higher levels of psychological distress and, in turn, higher scores of FAD in young adulthood. Conclusions: This result represents a novel contribution to understanding the psychological correlates of FAD in youths. Limitations and implications are discussed.

This study investigated binge behaviors during COVID-19 lockdown in Italy, exploring individual and contextual risk factors. Participants were 1925 emerging adults (Mage= 24.18, SDage= 2.75; 71.9% women), recruited during the national lockdown in Italy. An online survey investigated binge behaviors both prior and during quarantine. Binge drinking significantly diminished during quarantine, while binge eating episodes did not vary in frequency. However, participants with pre-existent binge eating disorder (BED) reported a worsening in BED symptoms. Lower education, lower SES, job suspension due to lockdown, and higher pandemic-related stress were associated to an increase in binge behaviors during home confinement, whereas living with family was a protective factor. Participants reporting co-occurrent binge behaviors also had significantly higher pandemic-related stress and lower perceived support during home confinement, in comparison with no-binge participants. The study provides new insights about protective and risk factors for binge behaviors in emerging adults during COVID-19 lockdown.

Purpose: Although drunkorexia seems to represent a new form of eating disorder, it shares several features with traditional eating disorders. However, very little is known about the association between drunkorexia and a widely studied correlate of eating disorders, such as psychological distress and about mechanisms underlying this association. The present study aimed to investigate the relation between symptoms of anxiety and depression and drunkorexia, and to explore the role of emotional dysregulation as moderator of this relationship. Methods: The sample was composed of 402 adolescents (222 females, 180 males; range 15–21) who completed self-reported measures: Drunkorexia Motives and Behaviors Scale, which assesses different behaviors and motivations associated with drunkorexia, Emotional dysregulation scale from the Eating Disorder Inventory-3, reflecting difficulties regulating emotions, and Anxiety and Depression scales from the Symptom CheckList-90 Revised, assessing general signs of anxious and depressive symptoms. Results: Anxious symptomatology resulted a significant statistical predictor of drunkorexia behaviors (β= .28, p= .001). Furthermore, emotional dysregulation moderated the relation between anxiety and drunkorexia; specifically, a positive relation was found both at medium levels (β= .22, p= .007) and at higher levels of emotional dysregulation (β= .38, p= .000), whereas at lower levels of emotional dysregulation, this association became nonsignificant. Conclusions: Findings suggest that adolescents who experience both elevated anxiety and emotional dysregulation may be more likely to turn to drunkorexia to reduce their unregulated negative affect in the absence of more adaptive emotion regulation strategies. Implications for intervention and prevention programs are discussed. Level of evidence: Level V, descriptive study.

Purpose: The COVID-19 lockdown measures have had a significant impact on risk behaviors as alcohol use and disordered eating. However, little is known about a serious health-risk-behavior named “food and alcohol disturbance” (FAD), characterized by engaging in dysfunctional eating on days of planned alcohol consumption. The aim of the present study was to investigate potential factors that may have put young adults at risk or protected against FAD during the COVID-19 lockdown. Methods: A sample of 447 young adults (280 females, 167 males; range 18–26) completed an online survey during the country’s nationwide lockdown composed of self-reported measures assessing FAD behaviors, alcohol consumption, compensatory behaviors, eating and weight concerns, social support, emotion regulation strategies, and living arrangement. Results: Our findings showed that FAD was significantly and positively correlated to alcohol consumption, use of laxatives, self-induced vomiting, eating and weight concerns, and expressive suppression, and negatively correlated to social support and living with family. Hierarchical regression analysis revealed that alcohol consumption, eating concern, and expression suppression positively predicted FAD, while social support and living with family were negative predictors. Conclusions: Our results suggest that during the COVID-19 lockdown, preoccupation with eating and the use of expressive suppression may have increased vulnerability to FAD; conversely, perceived social support and living with family may have been a source of protection against this dysfunctional behavior. Level of evidence: Level V, descriptive study.

Purpose: Drunkorexia represents an emerging phenomenon that is still understudied especially among adolescents. The present study aimed to investigate the relation between drunkorexia and psychological characteristics relevant and commonly associated with existing forms of eating disorders. Methods: The sample was composed of 849 adolescents (513 boys, 334 girls, 2 unknown; range 14–22) who completed a survey composed of Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale and Psychological scales of the Eating Disorders Inventory-3. Results: Our findings highlighted that drunkorexia was associated with low self-esteem, personal alienation, interoceptive deficits, emotional dysregulation, and asceticism. Hierarchical multiple regression analysis indicated that difficulties with emotion regulation and ascetic tendencies were significant predictors of drunkorexia among adolescents. Conclusions: Our findings suggest the importance for programs preventing drunkorexia to be focused on training adolescents in using more adaptive strategies to manage emotions and accepting both emotional and physical signals without feeling guilty or threatened. Level of evidence: Level V, descriptive study.

Purpose: The role of body image in adolescent binge eating is widely confirmed, albeit the various facets of this relationship are still mostly unexplored. Within the multidimensional body image framework, this study hypothesized the indirect effects of three body image coping strategies (positive rational acceptance, appearance fixing, avoidance) in the expected relationship between the perceived impact of body image on individuals’ quality of life and binge eating symptoms. Methods: Participants were 715 adolescents aged 15–21 years (49.1% girls) recruited in Italian schools. An anonymous self-report online survey was administered. A multiple mediation model was tested. Results: A more positive perceived impact of body image on quality of life was a negative predictor of adolescents’ binge eating, controlling for individual levels of body satisfaction. Three indirect effects were found in this relationship: on one hand, the positive body image impact reduced binge eating via increasing positive rational acceptance (M1), and via reducing avoidance (M2); on the contrary, the positive body image impact also enhanced binge eating via increasing appearance fixing (M3). Conclusions: The body image impact on quality of life can be alternatively protective—when adaptive coping is solicited, and maladaptive strategies are reduced—or a risk factor, which may increase binge eating by soliciting appearance fixing. Level III: Evidence obtained from cohort or case–control analytic studies.

Binge eating is predicted by emotion dysregulation and poor emotional awareness. Dysfunctional metacognition is also implied in several eating disorders, but research has not yet investigated the interactions among emotional and metacognitive processes involved in binge eating. The present study investigated the relation between metacognition and binge eating in a sample of adolescents, testing the interaction effect between the need to control thoughts and the lack of emotional awareness on binge eating. Participants were 804 adolescents (age range 15–20; 49.7% female), who completed self-report instruments assessing binge eating, emotion regulation, and metacognition. Binge eating was predicted by gender, BMI, emotion dysregulation, lack of emotional awareness, and dysfunctional metacognition dimensions (cognitive confidence and need to control thoughts). An important moderating effect was found, whereby the relationship between binge eating and lack of emotional awareness was only significant for individuals with a high need to control thoughts. Results described emotional and metacognitive functioning in binge eating adolescents, suggesting that the need to control thoughts is a risk factor, whereas good metacognitive competencies are protective from binge eating, even in presence of poor emotional awareness. Level V, cross-sectional descriptive study.