(PS1-B30) Drunkorexia Behavior Increases Risk for Other Drug Use

Substance use and disordered eating are two vital public health topics that have particular relevance among the college population. A phenomenon related to both — drunkorexia — is an evolving area of research concerning limiting, or compensating for, caloric consumption to allow for heavy alcohol use without weight gain. Research to date has primarily focused on the mechanics of drunkorexic behaviors, influence of gender on drunkorexia, motivating factors, and international prevalence. However, less is known about the overlap between drunkorexic behavior and other substance use.
 

As part of a larger study investigating drunkorexic behaviors and correlates, we investigated the relations between a variety of substances commonly used by college students and drunkorexia. Second, we tested the extent to which alcohol use (a necessary prerequisite for drunkorexia) mediated these relations. A total of 200 students at a Midwestern university (63% female; M age = 20.34; 73.5% White) provided data. Alcohol use was measured using the AUDIT (Saunders et al., 1993) and drunkorexia was captured with the CEBRACS (Rahal et al., 2012).
 

Zero-order correlations revealed significant associations between the CEBRACS and any recreational stimulant use (r = .158), any use of cigarettes/cigars (r = .146), any vape/e-cigarette use (r = .206); the CEBRACS was not associated with cannabis use (r = .082). The rates of benzodiazepine use (1%), opioid use (0%), and party drug use (7%) were too low for meaningful analyses. Mediation analyses using Hayes PROCESS macro allowed for identification of direct and indirect effects.
 

Results indicated that alcohol use (AUDIT) directly mediated the relation between the CEBRACS and any cigarette/cigar use and between any recreational stimulant use and CEBRACS scores, such that the associations were eliminated once alcohol use was entered. In contrast, a direct effect of alcohol use on the relation between vaping/e-cigarette use and CEBRACS scores was present but less pronounced as the c’ path remained marginally significant (p = .059). However, all three substances—cigarette use, vaping/e-cigaretette use, and use of recreational stimulants showed significant indirect effects on CEBRACS scores through alcohol use. These results suggest that cigarette use, vaping/e-cigarette use, and use of recreational stimulants share associations with alcohol that cannabis use does not, and that these associations are linked to the risky alcohol use patterns associated with drunkorexia. Notably, more of the sample used cannabis (58%), than combustible (24%), vapor/e-cigarettes (45%), or recreational stimulants (17%). Future research should investigate why cannabis use appears to function differently than other classes of substances in predicting drunkorexia, with a particular focus on factors known to be associated with nicotine use such as externalizing behaviors and negative affective management.