Eating Disorders and Alcohol

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Reviewed by Kim Dennis, MD, CEDS (SYR) provides helpful information for people who are dealing with substance use issues — and their family members, friends, and co-workers, too. SYR knows that there is no one-size-fits-all solution to the challenges faced by those who misuse alcohol, prescription or illegal drugs, or other substances, and they aim to break through the clutter to help people at any stage of recovery.

You might drink alcohol when socializing, celebrating, or relaxing after work. However, recreational use of alcohol can become unhealthy. And some people with eating disorders may be at greater risk of alcohol misuse and dependence.1

If you or a loved one is experiencing disordered eating and misusing alcohol, know that help is available and treatment works.

What is Alcohol?

Alcohol is the drug in beer, wine, and spirits that causes intoxication. Consuming small amounts of alcohol, a depressant, can make you feel at ease and cheerful. 

But drinking can also cause many problems. Drinking impairs your judgment, motor skills, and memory, which can lead to accidents, crashes, falls, poor decisions, and social discomfort or conflict.2,3

After drinking, you may experience hangover symptoms, such as anxiety, fatigue, headache, nausea, and thirst.4,5

Drinking a lot of alcohol in a short period can lead to alcohol poisoning or overdose.6 Signs of an alcohol overdose include vomiting, unconsciousness, seizures, difficulty breathing, slow heart rate, clammy skin, and low body temperature.

If you frequently drink large amounts of alcohol, you may also experience symptoms of withdrawal if you try to stop using alcohol. And long-term heavy drinking increases the risk of cancer, stroke, and liver disease.3

In the United States, more than 140,000 people die from alcohol-related causes each year, making it one of the leading causes of preventable death.7

What is Safe and Unsafe Alcohol Use?

Safe alcohol use, as defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), is:8

  • For women, no more than one drink per day or seven drinks per week.
  • For men, no more than two drinks per day or 14 drinks per week. 

Unsafe drinking includes: 

  • Binge drinking. For women, this is consuming four or more drinks in a two-hour period. For men, it’s consuming five or more drinks in two hours.
  • Heavy alcohol use. NIAAA defines this as exceeding the weekly drink totals for safe use, shown above; women who have more than three drinks in a day and men who have more than four drinks in a day also meet NIAAA’s criteria for heavy alcohol use. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines heavy alcohol use as binge drinking on five or more days in a month.

Someone who is dependent on alcohol may be diagnosed with alcohol use disorder. AUD — colloquially known as alcohol abuse, alcohol addiction, or alcoholism — is a common behavioral condition; over 28 million adults in the U.S. had AUD in 2021.9 Fortunately, dependence on alcohol can be treated with medication, behavioral therapies, support groups, and self-help tools.

Reducing and stopping use of alcohol benefits your health.10 And if you are dependent on alcohol, recovery is possible.11

Why Does Alcohol Affect Different People in Different Ways?

Drinking the same amount of alcohol can have different effects on different people. Drinking may be more dangerous if you:5,12,13,14

  • Drink without food in your stomach.
  • Consume liquor “straight” instead of diluting it with water, soda, or juice.
  • Are malnourished or have an eating disorder.
  • Drink while on illegal drugs or certain medications.
  • Have a low tolerance for alcohol or don’t normally drink.

Link Between Eating Disorders and Alcohol Misuse

Both eating disorders and alcohol misuse can be serious. People with binge eating disorder or bulimia may be at higher risk of alcohol misuse or dependence.15 People with anorexia and atypical anorexia are at risk of more severe medical complications when they also have alcohol use disorder. Alcohol and other drugs are known to impact appetite in a variety of ways.  Some people who drink in large amounts limit their food intake to compensate for the calories in alcohol. This unhealthy behavior is sometimes called “drunkorexia” and can indicate or lead to an eating disorder.16

People with an eating disorder are significantly more likely than the general population to have a substance use disorder, and vice versa.17 Recent data shows that the risk of premature death increases for people with eating disorders who also have alcohol use disorders.These disorders share common risk factors, such as:18,19,20,21

  • Anxiety.
  • Depression.
  • Family history of these or other mental illnesses.
  • Low self-esteem or social pressures.
  • Traumatic life experiences.
  • Genetic predispositions.

Find Treatment and Start Your Recovery

Recovery from eating disorders and alcohol misuse is a personal journey, and there’s no single solution that works for everyone.22

Start by finding a trained health care professional to assess your mental and physical health needs. They can work with you to create a recovery plan.23 Find treatment and support for eating disorders and substance misuse. 

Learn More


[1]Qeadan, F., English, K., Luke, A., & Egbert, J. (2023). Eating disorders and substance use: Examining associations among US college students. The International journal of eating disorders, 56(5), 956–968.

[2] Australian Government Department of Health and Aged Care. (2022, November 15). What are the effects of alcohol? 

[3] Centers for Disease Control and Prevention. (2022). Alcohol and Public Health: Frequently Asked Questions. CDC.  

[4] National Institute on Alcohol Abuse and Alcoholism. (2021). Alcohol’s Effects on Health: Hangovers.  

[5] Paton A. (2005). Alcohol in the body. BMJ (Clinical research ed.), 330(7482), 85–87. 

[6]  National Institute on Alcohol Abuse and Alcoholism. (2023). Alcohol’s Effects on Health: Understanding the dangers of alcohol overdose. 

[7] National Institute on Alcohol Abuse and Alcoholism. (2023). Understanding alcohol’s adverse impact on health. 

[8] National Institute on Alcohol Abuse and Alcoholism. (2023). Drinking levels defined. 

[9] National Institute on Alcohol Abuse and Alcoholism. (2023). Understanding alcohol use disorder. 

[10] Centers for Disease Control and Prevention. (2022). Why drinking less matters. 

[11] National Institute on Alcohol Abuse and Alcoholism. (2023). Treatment for alcohol problems: Finding and getting help. 

[12] Australian Government Department of Health and Aged Care. (2022). It’s different for each person, What are the effects of alcohol?  

[13]Penn State. (2022). How can body weight affect the mortality risk of excessive drinkers? ScienceDaily.

[14] Agarwal, K., Demiral, S. B., Manza, P., Volkow, N. D., & Joseph, P. V. (2021). Relationship between BMI and alcohol consumption levels in decision making. International journal of obesity, 45(11), 2455–2463. 

[15] Lilenfeld, L. R., & Kaye, W. H. (1996). The Link Between Alcoholism and Eating Disorders. Alcohol health and research world, 20(2), 94–99. 

[16] Weishaupt, J. (2021). Why is drunkorexia so dangerous? What does it do to the body? WebMD.

[17] Ganson, K. T., & Nagata, J. M. (2021). Associations between vaping and eating disorder diagnosis and risk among college students. Eating behaviors, 43, 101566.

[18] National Center on Addiction and Substance Abuse at Columbia University. (2003). Food for thought: Substance abuse and eating disorders. Commonwealth Fund & National Institute on Drug Abuse. Available at:

[19] Eskander, N., Chakrapani, S., & Ghani, M. R. (2020). The Risk of Substance Use Among Adolescents and Adults With Eating Disorders. Cureus, 12(9), e10309. 

[20] Ressler, A. (2008). Insatiable Hungers: Eating Disorders and Substance Abuse. Social Work Today, (8) 4, 30. Available at: 

[21] Munn-Chernoff, M. A., Grant, J. D., Agrawal, A., Sartor, C. E., Werner, K. B., Bucholz, K. K., Madden, P. A., Heath, A. C., & Duncan, A. E. (2015). Genetic overlap between alcohol use disorder and bulimic behaviors in European American and African American women. Drug and alcohol dependence, 153, 335–340.  

[22] Bahji, A., Mazhar, M. N., Hudson, C. C., Nadkarni, P., MacNeil, B. A., & Hawken, E. (2019). Prevalence of substance use disorder comorbidity among individuals with eating disorders: A systematic review and meta-analysis. Psychiatry research, 273, 58–66.

[23] Substance Abuse and Mental Health Services Administration. (2011). Clients With Substance Use and Eating Disorders. SAMHSA Advisory, (10) 1. Available at: