An Ecological Momentary Assessment of Disordered Eating Behaviors within Alcohol Use Episodes: Determining Temporal Sequencing in Food and Alcohol Disturbance
The co-occurrence of disordered eating and alcohol use has been well documented in the literature. Food and Alcohol Disturbance (FAD), previously referred to as “drunkorexia,” refers to the use of disordered eating behaviors within an alcohol use episode for the purpose of increasing alcohol effects and/or offsetting caloric intake from alcohol. There is a relatively limited literature base which examines FAD; however, there is evidence that FAD is associated with alcohol-related consequences and health risk behaviors. As such, further study into this phenomenon is necessary. The current study aimed to address significant limitations in the literature. While the aims of the study were threefold, the primary aim of the study was to examine a proposed theoretical model of FAD. The study used a pre-/post- design to examine longitudinal consequences of FAD, as well as an in vivo examination of FAD using ecological momentary assessment (EMA). The aims were to 1) examine frequency of FAD engagement, 2) test a portion of the proposed model, 3) explore longitudinal consequences of FAD behaviors. Approximately 75% of the current sample engaged in at least one FAD behavior at baseline. While this may be slightly higher due to recruitment requirements, previous studies have found similar rates of engagement. The results of the EMA provided mixed support for the proposed theoretical model. In line with hypotheses, intention to consume alcohol was related to future alcohol use and compensatory FAD. Intention to consume alcohol was only predictive of concurrent alcohol effects FAD, which was not consistent with the theoretical model. Further, FAD behaviors did not predict future alcohol use. In partial support of the model, alcohol use only predicted concurrent compensatory behaviors, but not future compensatory FAD behaviors or alcohol effects FAD. While the null results may have been in part due to methodological limitations, these null results may also suggest key components still not accounted for in the theoretical model (e.g., expectancies for engagement in FAD). Finally, FAD did not predict subsequent alcohol-related consequences which was contrary to previous work. Overall, this study was the first to examine and find partial support for the proposed theoretical model of FAD behaviors. Future research should work to incorporate the findings of the current study to further elucidate the relationships of FAD, alcohol use and alcohol-related consequences as well as other elements which may increase engagement in FAD
