KEY TAKEAWAYS
Alcoholics eat so little due to gastritis, liver disease and alcoholic ketoacidosis [1] [2].
Alcoholics will eat little whilst having an alcohol use disorder to either:
Why Don't Alcoholics Eat?
Alcoholics become more focused on drinking and neglect the rest of their needs, including eating a balanced diet [5].
Alcoholism may be caused by, or co-occurring with, depression and anxiety, causing sufferers to eat less [6].
Why Does Alcohol Suppress My Appetite?
Consuming alcohol causes a temporary drop in blood sugar levels and hormones that suppress the appetite [7].
The sugary and carbonated liquids in alcohol cause feelings of fullness [4].
Alcohol As A Hunger Suppressant
Alcohol contains empty calories, filling the stomach without providing the nutritional value usually obtained from food [9].
An alcoholic's sense of taste and smell is dulled due to loss of zinc through excessive urination, further suppressing hunger [10].
Focus On Drinking And Not Eating
Alcoholics prioritise alcohol financially, both by choosing to buy alcohol instead of food, and buying cheaper foods with lower nutritional value [10].
Some drinkers choose to replace food with alcohol, to offset the calories in alcohol, with consistent food replacement being described as 'drunkorexia' [12].
Alcoholic ketoacidosis occurs after a prolonged drinking binge when the body is in a malnourished state [13].
Alcoholic ketoacidosis may begin when the alcoholic has not eaten food for a day, meaning that the longer an alcoholic is not eating, the more they risk developing alcoholic ketoacidosis [13].
Anion Gap
Anion gap blood test results below 4 mEq/L indicate alkalosis, whereas results above 12 mEq/L indicate alcoholic ketoacidosis [15] [16].
Alkalosis is caused by alcohol abuse, and loss of electrolytes from eating little food [17].
What Does It Mean When An Alcoholic Stops Eating?
An alcoholic stops eating when they have become focussed exclusively on drinking.
Alcoholics obsess exclusively about access to the next drink, and how and when the next drink will occur [18].
Co-occurring issues trigger eating less as a form of attention seeking, including:
How Eating Less Develops Over Time
79.1% of university students have been reported to suffer from drunkorexia, with these behaviours being shown to continue into later life, as users rely on alcohol to stay thin [23].
Alcohol use affects digestion, storage and utilisation of nutrients, meaning that even if alcoholics are not consciously consuming less food at first, they are still becoming malnourished, leading to alcohol ketoacidosis [24].
Drinking Alcohol And Not Eating For Days
The pattern of binge drinking means the effects of alcohol are experienced quicker and therefore the brain is unable to prioritise eating over drinking [25].
Alcoholics may give the impression that they are eating well as alcohol's calories are quickly available in the body and boost energy, allowing the alcoholic to keep up drinking and not eating [26].
How Alcoholics Eat So Little
Valencia Martin et al found patterns in how alcoholics consume food including:
These patterns are linked to alcoholics not prioritising eating [30].
Triggers that cause alcoholics to eat little include a history of trauma and societal or family expectations about physical appearance [31].
Drinking and eating little are rationalised by alcoholics by:
These behaviours allow the alcoholic to continue eating little and drinking excessively without changing their actions [32].
Alcoholics mask eating little by:
Those closest to the alcohol use disorder sufferer may begin to enable the destructive behaviours around drinking, including avoidance, denial and making excuses [34].
Eating Less Due To Alcoholism vs Eating Less Due To Eating Disorder
Header | Alcoholism | Eating Disorders |
|---|---|---|
Eats less to drink more | ||
Eats less as a coping mechanism | ||
Eats less due to peer pressure | ||
Eats less due to perceived societal pressure | ||
Eats less during binge drinking | ||
Avoids social occasions with food |
When Do Alcoholics Eat So Little
Alcoholics begin to eat less as a result of chasing the original feeling that alcohol gave them before the addiction became chronic, as well as ensuring the feeling of being drunk as tolerance increases.
The cycle that occurs is:
Although alcohol gives temporary relief from emotional distress, it later enhances negative emotions such as stress, guilt, anger and trauma [40].
This leads to further heavy drinking, and disordered eating, as the negative emotional cycle continues [41].
When An Alcoholic Eating Less Isn't Obvious
Subtle signs of an alcoholic eating less are:
An alcoholic may be eating less, upon sudden onset of:
These symptoms indicate not eating food whilst drinking alcohol, even if the alcoholic is still appearing to eat food in front of loved ones.
Additional Risks As A Result Of Not Eating While Drinking
Female drinkers run a 5-fold increased risk of developing eating disorders compared to female non-drinkers [49].
The risk of developing an eating disorder increases by 64% when drinkers believe that their reduced food intake does not offset calories provided by alcohol [50].
Alcoholics Who Do Eat Well
Family and friends provide food for an alcoholic to eat well, thinking that it will help minimise alcohol causing long term damage [51].
High functioning alcoholics do eat well because they use meal times as an excuse to start drinking [52].
Alcohol abuse sufferers who eat well have a more structured support system, for example, a partner who maintains a regular household environment and provides a balanced diet [53].
Alcoholics on higher incomes manage to eat better because they do not have to make the choice between alcohol and food [54].
How To Improve Eating Habits When Drinking
Alcoholics may improve their eating habits when drinking by:
When Eating Less Is Not A Result Of Alcoholism
Alcoholism increases the chance of suffering from GERT by 95%, therefore those who suffer with GERT are likely to avoid eating due to its symptoms [59].
Alcoholics with co-occurring disorders which may involve food include:
Reduced eating may be indicative of OCD instead of alcoholism when:
Reduced eating may be indicative of BPD instead of alcoholism when there is:
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