What do you drink when you're trying to shed pounds? Iced tea? Diet soda? What about alcohol?
One cardinal rule of losing weight is limiting alcohol consumption, but can "careful" dieters spike their punch with a little booze and still stand on the bathroom scale with confidence? Can they "outsmart" calories by "trading" them — skipping lunch to enjoy a few beers at the Dodgers game?
The short answer is no. All calories are not created equal. And drinkers who skip meals are quicker to become inebriated, with all the assorted consequences. Nonetheless, experts say the behavior is common.
College-age women and men know this trick all too well. They want to stay slim but feel drawn to pub crawls or frat parties. "Many cocktails popular with young women, such as margaritas, have lots of calories," says Dr. David Heber, director of the UCLA Center for Human Nutrition and professor of medicine at the UCLA Geffen School of Medicine. In order to drink, he adds, some women will skip food and "get their calorie allowance in alcoholic drink."
The acceptance of excessive drinking on college campuses, combined with an obsession with thinness, may be to blame for a type of drinking and dieting behavior casually referred to as "drunkorexia," a condition in which people eat very few calories, if any, during the day and then drink — or even binge drink — later. (Afterward, some people spin out of control and binge on food too.)
Drunkorexia is associated with behaviors such as skipping meals, using laxatives and exercising to compensate for excess alcoholic calories, according to Adam E. Barry, assistant professor at the University of Florida Department of Health Education and Behavior. In such cases, he refers to the "weight-conscious" drinker as someone with "disordered eating," which is not the same as a clinical eating disorder such as anorexia or bulimia.
"I think there are different ways that it is exemplified between men and women," adds Barry, who was the lead researcher on a study of drunkorexia published in the Journal of American College Health. "Women skip meals due to drinking, while men tend to exercise in order to offset the calories from drinking."
Until more research is available, the healthcare community can only make educated guesses about how to treat drunkorexia. Barry suspects it "peaks in college," but it certainly isn't limited to the college years. (Think of the slightly older target audience for Skinnygirl cocktails, which started with a "skinny margarita" from reality TV star Bethenny Frankel and turned into a company purchased in 2011 by Beam Inc.)
David Jernigan, director of the Center on Alcohol Marketing and Youth at Johns Hopkins Bloomberg School of Public Health, says that ads depicting alcohol often claim it as a healthful beverage, "fitness friendly" or "low in calories." (At skinnygirlcocktails.com, readers are told, "We've expanded our family to keep bringing you all of the cocktail options you want, without the extra calories you don't.")
Beer, Jernigan adds, is "well known as the calorie packer … distilled spirits companies advertise their product as low calorie."
When you consider the amount of money spent on aggressive advertising campaigns, it's easy to see why women are drawn to drink — and the promise. Says Jernigan, "We know from Nielsen data that in 2011, the alcohol industry spent $1.7 billion on alcohol advertising and marketing on all measured media, which includes TV, radio, Internet, magazines, newspapers and outdoor."
Experts say drunkorexia is a behavior associated with the need to escape and relieve painful emotions, stress and anxiety, says Susan Albers, a psychologist and author of five books about mindful eating, including "50 Ways to Soothe Yourself Without Food."
"The binge eating or drinking numbs or turns off that feeling, so they aren't feeling it in that moment," Albers says. "The difficulty is when they are done eating or restricting food, or have consumed substances, those feelings come back." At best, it's a momentary comfort measure, she says.
Why alcohol and an empty stomach definitely don't mix
What happens when you drink alcohol on an empty stomach?
If you haven't eaten for several hours, the body could experience low blood sugar, characterized by hunger, headaches or feeling shaky.
"Low blood sugar from under-eating can cause cravings" for high-carb, sugary foods, says Kelley Morrow, assistant clinical director of the Eating Disorder Center of California.
"Cravings for alcohol can also rise dramatically," she adds. "The brain instinctively knows alcohol will hit the bloodstream quickly and raise blood sugar."
To avoid blood sugar fluctuations, eat meals throughout the day.
"Eating some protein and healthy carbohydrates such as fruits and vegetables and whole grains can keep the mind alert and able to maintain abstinence from alcohol," says UCLA's Dr. David Heber.