Drunkorexia: Understanding the Co-occurrence of Alcohol Consumption and Eating/Exercise Weight Management Behaviors

Abstract

Objective: Examine the co-occurrence of alcohol consumption, physical activity, and disordered eating behaviors via a drunkorexia perspective. Participants: Nationally representative sample (n = 22,488) of college students completing the Fall 2008 National College Health Assessment. Methods: Hierarchical logistic regression was employed to determine if physical activity and disordered eating behaviors uniquely predicted binge drinking, while controlling for age, race, gender, year in college, Greek membership, and place of residence. Results: Physical activity and disordered eating made unique, statistically significant contributions. Moreover, including physical activity and disordered eating behaviors allowed for the correct classification of an additional 431 cases (ie, binge drinkers) over and above the predictive ability of the covariate-only model. Conclusions: Findings corroborate prior research indicating highly active college students are more likely to binge drink than their nonactive peers, and highlight the potential of a drunkorexia perspective in explaining the counterintuitive alcohol–activity association among college students.     

Calorie Restriction on Drinking Days: An Examination of Drinking Consequences Among College Students

Objective: This study examined the association between restricting calories on intended drinking days and drunkenness frequency and alcohol-related consequences among college students.

Participants: Participants included a random sample of 4,271 undergraduate college students from 10 universities.

Methods: Students completed a Web-based survey regarding their high-risk drinking behaviors and calorie restriction on intended drinking days.

Results: Thirty-nine percent of past 30-day drinkers reported restricting calories on days they planned to drink alcohol, of which 67% restricted because of weight concerns. Restricting calories on drinking days was associated with greater odds of getting drunk in a typical week. Women who restricted were more likely to report memory loss, being injured, being taken advantage of sexually, and having unprotected sex while drinking. Men were more likely to get into a physical fight.

Conclusions: These results highlight the importance of considering weight control behaviors in the examination of high-risk college drinking.     

Different pathways explain alcohol-related problems in female and male college students

ABSTRACT

Objectives: Comprehensive models elucidating the intricate associations of depressive symptoms, coping motives, alcohol use, alcohol-related problems (ARPs), and gender among young adults have been scarcely examined. This study investigated relationships among these variables and the effect of gender on these pathways. Methods: College students (N = 163; 49.7% female) completed self-report measures on alcohol consumption, depressive symptoms, coping motives, and ARPs. Results: Structural equation modeling showed that the association between depressive symptoms and ARPs was mediated by coping motives in both females and males. However, frequency of heavy alcohol use mediated the association between depressive symptoms and ARPs in females but not in males. Conclusions: Different models explain the association between depressive symptoms and ARPs in male and female college students. Prevention programs aimed at reducing ARPs should focus on increasing alcohol screening among students with depressive symptoms, teaching coping skills, and emphasizing moderation in alcohol consumption.     

Relationship Between Vigorous Exercise Frequency and Substance Use Among First-Year Drinking College Students

Objective: The authors explored the relationship between self-reported vigorous exercise frequency and alcohol, tobacco, and other drug (ATOD) use behaviors among first-year college students who self-identified as drinkers. Participants: The authors recruited 391 freshman college students in Northeast Florida to participate in an alcohol abuse prevention study. Methods: The authors conducted a multivariate analysis of variance to assess the relationship between vigorous exercise frequency and 6 measures of ATOD use at baseline. Results: Frequent exercisers drank significantly more often and a significantly greater quantity than did infrequent exercisers. However, frequent exercisers smoked cigarettes significantly less often than did infrequent exercisers. Conclusions: These findings suggest that vigorous exercise frequency is differentially associated with alcohol and cigarette consumption among college students. Researchers should further examine the reasons for these differences.     

An Examination of Drinkers’ Consequences by Sexual Orientation

Abstract

Objective: This study examined college student drinkers by sexual orientation (SO), alcohol use, and negative consequences in a national sample that self-identified gender and SO. Participants: Students completing the Spring 2005 National College Health Assessment (N = 54,111). Methods: A secondary analysis was conducted examining student responses by SO to items regarding negative consequences associated with alcohol. Results: Bisexual students had the highest mean scores on an index of alcohol-related harm. Significant differences were found by SO among male high-risk drinkers for alcohol-related consequences of “fighting” and “injuring another,” and females for “injuring another” and “unprotected sex.” Bisexual students had significantly greater than expected cell counts for significant results, including a significant finding for bisexual low-risk female students for alcohol-related “regret.” Conclusion: These findings suggest that more research is necessary to discern real differences in alcohol-related risk among college students by sexual orientation.     

The Association of Multiple Risk Factors With Fruit and Vegetable Intake Among a Nationwide Sample of College Students

Few college students meet fruit and vegetable intake recommended requirements, and most receive no information from their institutions about this issue. The avoidable disease burden among students is large, the necessary information infrastructure exists, and Healthy People 2010 objectives indicate efforts should be taken to increase intake. Objective: The authors examined the association of high-risk behaviors and fruit and vegetable intake to inform design of multiple risk factor interventions. Participants and Methods: The authors obtained data from a sample of 40,209 18- to 25-year-old college students who completed the American College Health Association-National College Health Assessment during the spring 2002 and 2003 semesters. Results: Predictors of high fruit and vegetable intake for men and women included better: seatbelt and helmet use, physical activity, perceived health, sleep, self-care behaviors, and grades. Other notable predictors of high intake were reduced likelihood of cigarette smoking, alcohol use, drinking and driving, and feeling hopeless in both sexes; reduced likelihood of drinking and driving among men; and a greater likelihood of anorexia among women. Conclusions: The authors discuss implications of these findings.     

Weight Loss Practices and Body Weight Perceptions Among US College Students

Objective: The authors assessed associations between body weight perception and weight loss strategies. Participants: They randomly selected male and female college students (N = 38,204). Methods: The authors conducted a secondary data analysis of the rates of weight loss strategies and body weight perception among students who completed the National College Health Assessment survey. Results: Half of respondents (50%) were trying to lose weight, although only 28% of students were overweight or obese. Also, 12% of respondents had inaccurate body weight perception. Women and men with inaccurate body weight perception were significantly more likely to engage in inappropriate weight loss strategies than were those with accurate body weight perception. Of all students attempting to lose weight, 38% used both diet and exercise. Conclusions: These data show that college students are interested in weight loss and that body weight perception plays an important role in the desire to lose weight.     

Effectiveness of a Web-based Alcohol-Misuse and Harm-Prevention Course Among High- and Low-Risk Students

Objective: In the current study, the authors assessed whether a new online alcohol-misuse prevention course (College Alc) is more effective at reducing alcohol use and related consequences among drinkers and nondrinkers. Participants: The authors compared incoming college freshmen who reported any past 30-day alcohol use before the beginning of the semester with those who did not. Method Summary: The authors randomly assigned students who completed a precollege baseline survey to either complete a 3-hour noncredit version of College Alc or serve as members of a control group. The authors conducted a follow-up survey 3 months later. Results: Findings indicated that among freshmen who were regular drinkers before college, College Alc appeared to reduce the frequency of heavy drinking, drunkenness, and negative alcohol-related consequences. Among freshmen who did not report any past-30-day alcohol use before college, College Alc did not appear to have any beneficial effects. Conclusions: Results suggest that College Alc may be an effective program for students with a history of alcohol use.     

Suicide Ideation Among US College Students Associations With Other Injury Risk Behaviors

Abstract

Suicide, the endpoint of a continuum that begins with suicide ideation, is the third leading cause of death among the US college-aged population. The first and second leading causes of death among this age group, unintentional injury and homicide, may also be linked to suicide ideation. We used data from the National College Health Risk Behavior Survey to examine the association between suicide ideation and injury-related behaviors among 18- to 24-year-old college students. Students who reported suicide ideation were significantly more likely than students who did not report considering suicide to carry a weapon, engage in a physical fight, boat or swim after drinking alcohol, ride with a driver who had been drinking alcohol, drive after drinking alcohol, and rarely or never used seat belts. Given this clustering of injury-related risk behaviors, college prevention programs should aim to reduce risks for injuries comprehensively, rather than addressing each risk behavior separately.     

Unhealthy behavior clustering and mental health status in United States college students

Abstract

Objective: Examine the association of health risk behavior clusters with mental health status among US college students. Participants: 105,781?US college students who completed the Spring 2011 National College Health Assessment. Methods: We utilized the latent class analysis to determine clustering of health risk behaviors (alcohol binge drinking, cigarette/marijuana use, insufficient physical activity, and fruit/vegetable consumption), and chi-square and ANOVA analyses to examine associations between the class membership and mental health (mental health diagnoses, psychological symptoms, and self-injurious thoughts/behaviors). Results: Three classes were identified with differing rates of binge drinking, substance use, and insufficient physical activity but similar rates of insufficient fruit/vegetable consumption. Students classified with the highest rates of binge drinking and cigarette/marijuana use had the highest rates across all mental health variables compared to other classes. Conclusions: Students who reported engaging in multiple health risk behaviors, especially high alcohol and cigarette/marijuana use, were also more likely to report poorer mental health.     

An Examination of Risky Drinking Behaviors and Motivations for Alcohol Use in a College Sample

Abstract

Objective: The current study examined (1) drinking motives as a mediator of risky drinking behaviors (ie, pregaming and drinking games) and alcohol-related problems and (2) whether gender moderates the association between risky drinking behaviors and negative consequences. Participants: Participants (N = 368; 68% female) were drinkers aged 18 to 25. Data were collected from September to November 2010 and January to May 2011. Methods: Participants completed measures regarding typical pregaming and drinking game alcohol consumption, drinking motives, and alcohol-related consequences. Results: Social, coping, and enhancement motives partially explained relationships, with enhancement motives explaining the most variance for pregaming (31%) and drinking games (44%). Relationships between risky drinking and consequences were not moderated by gender. Conclusions: Drinking to enhance positive affect may be the most salient motivation for drinking related to pregaming and drinking games for college drinkers. Findings have implications for interventions tailored to students engaging in various heavy drinking practices.     

Moderators of the Relationship Between Physical Activity and Alcohol Consumption in College Students

Abstract

Objective: Among college students, several studies have found a positive relationship between physical activity and alcohol use. The current study tested gender, Greek status, and ethnicity as potential moderators of the physical activity-alcohol use relationship. Participants: Participants were college freshmen (n = 310) endorsing alcohol/drug use. Methods: Students completed questionnaires assessing a number of health behaviors. Results: Results indicated that gender and Greek status were significant moderators of the relationship between physical activity and alcohol consumption. There was a positive relationship between physical activity and alcohol use for men and Greeks, but not for females and non-Greeks. Conclusions: These findings suggest that exercise does not serve as a protective factor for any of the subgroups of college students studied and is positively associated with drinking among college students who are men and/or involved with the Greek system.     

Trends in College Binge Drinking During a Period of Increased Prevention Efforts: Findings from 4 Harvard School of Public Health College Alcohol Study Surveys: 1993–2001

Abstract

The 2001 Harvard School of Public Health College Alcohol Study surveyed students at 119 4-year colleges that participated in the 1993, 1997, and 1999 studies. Responses in the 4 survey years were compared to determine trends in heavy alcohol use, alcohol-related problems, and encounters with college and community prevention efforts. In 2001, approximately 2 in 5 (44.4%) college students reported binge drinking, a rate almost identical to rates in the previous 3 surveys. Very little change in overall binge drinking occurred at the individual college level. The percentages of abstainers and frequent binge drinkers increased, a polarization of drinking behavior first noted in 1997. A sharp rise in frequent binge drinking was noted among students attending all-women's colleges. Other significant changes included increases in immoderate drinking and harm among drinkers. More students lived in substance-free housing and encountered college educational efforts and sanctions resulting from their alcohol use.     

“Drunkorexia”: Exploring the Who and Why of a Disturbing Trend in College Students’ Eating and Drinking Behaviors

Abstract. Objective: “Drunkorexia,” limiting food intake before alcohol consumption, increases college students’ risk for negative alcohol-related health consequences. The current study tested whether (1) women engage in drunkorexia more frequently than men; (2) weight control motivations explain sex differences in drunkorexia; and (3) among women, weight control motivations are a particularly strong predictor of drunkorexia for heavier drinkers. Participants: Undergraduate males and females (N = 63) recruited during fall of 2011. Methods: Participants self-reported their alcohol consumption, drunkorexia, and weight control motivations online. Results: Findings supported hypotheses: weight control motivations explained why women engage in drunkorexia more than men; and the weight control motivation → drunkorexia relation was strongest for heavier- (vs lighter-) drinking women. Conclusion: Women have more weight concerns than men, which makes them more likely to engage in drunkorexia. Heavy-drinking women with strong weight control motivations are at greatest risk for drunkorexia. Interventions should help students more safely reconcile pressures to be thin and drink alcohol.     

The moderating effect of alcohol use on protective and risky sex behaviors among college students in the Southeast United States

ABSTRACT

Objective: College students are a high-risk population for new human immunodeficiency viruses (HIV) diagnoses. Although condom use self-efficacy and HIV knowledge can protect against risky sexual behavior (RSB), these same protective factors have been shown to exacerbate RSB. The influence of alcohol use can further complicate these protective factors to influence RSB. Participants: 689 African American/Black and non-Hispanic White college students attending a public university in the Southeast United States. Method: This study sought to examine the relations between condom use self-efficacy and HIV knowledge with RSB and the moderating effect of alcohol use. Results: Findings showed positive associations between RSB and HIV knowledge and alcohol use. Unexpectedly, low frequency drinkers with high condom use self-efficacy were at increased risk for RSB compared to high frequency drinking counterparts. Conclusions: Findings point to the need to target prevention services for low-risk drinkers in college settings.     

The Role of Positive Alcohol Expectancies in Underage Binge Drinking Among College Students

Abstract

Objective: This study explored associations between positive alcohol expectancies, and demographics, as well as academic status and binge drinking among underage college students. Participants: A sample of 1,553 underage college students at 3 public universities and 1 college in the Southeast who completed the Core Alcohol and Drug Survey in the Spring 2013 semester. Methods: A series of bivariate analyses and logistic regression models were used to examine associations between demographic and academic status variables as well as positive alcohol expectancies with self-reported binge drinking. Positive alcohol expectancies were examined in multivariable models via 2 factors derived from principal component analyses. Results: Students who endorsed higher agreement of these 2 emergent factors (sociability, sexuality) were more likely to report an occurrence of binge drinking in the past 2 weeks. Conclusions: Study results document associations between positive alcohol expectancies and binge drinking among underage students; implications for prevention and treatment are discussed.     

The Culture of High-Risk Alcohol Use Among Club and Intramural Athletes

Abstract

Objective: The purpose of this study was to examine the drinking patterns of club and intramural college athletes and compare their alcohol consumption, perceived norms around the excessive use of alcohol, experience of negative consequences, and employment of protective strategies with those of campus varsity athletes. Participants: A total of 442 undergraduate students attending a private, suburban institution in the Northeast participated in the American College Health Association National College Health Assessment-II Web survey in spring 2011. Thirty-five students identified themselves as varsity athletes, 76 identified as club sport athletes, and 196 students identified themselves as intramural athletes. Methods: Survey responses were analyzed using Statistical Package for the Social Sciences. The Pearson's correlation coefficient and test for independence were applied to identify significant relationships between athlete status and identified variables related to alcohol use. Results: Results indicated that there were significant correlations between athlete status and all variables, to varying degrees. Conclusions: These findings have implications for campus health promotion professionals and athletics program coordinators seeking to address high-risk alcohol use among college athletes.     

“Drunkorexia”: Understanding eating and physical activity behaviors of weight conscious drinkers in a sample of college students

Objective: Behaviors of weight conscious drinkers (BWCD) include disordered eating, excessive physical activity (PA), and heavy episodic drinking. Considering that approximately 25% of the college students report BWCD, it is important to investigate what characteristics increase the likelihood of college students engaged in BWCD for both moderate and vigorous PAs. Participants: A total of 510 college students were recruited from a large, public southeastern university. Methods: Participants completed a cross-sectional survey during the spring 2015 semester. Results: Of 510 respondents, 11.2% reported moderate PA-based BWCD and 14.7% reported vigorous PA-based BWCD. Weight loss intention, BMI and Greek affiliation predicted both moderate and vigorous BWCD. Conclusions: Study findings suggest that Greek-affiliated students and students with weight loss intentions might be at an increased risk for BWCD. Along with promoting lower levels of alcohol consumption, college practitioners should consider discussing issues of weight and body image with college students as they relate to maladaptive drinking behavior.     

Partying Before the Party: Examining Prepartying Behavior Among College Students

Objective: The authors examined the phenomenon known to college students as prepartying, which is the consumption of alcohol prior to attending an event or activity (eg, party, bar, concert) at which more alcohol may be consumed. Participants: To explore the extent of this behavior, the authors surveyed 227 college students about each drinking event over a 1-month period. Results: Principal results revealed that 64% of participants engaged in prepartying (75% of drinkers) and that prepartying is involved in approximately 45% of all drinking events. Prepartying was predictive of more drinking throughout the day of the drinking event and alcohol-related negative consequences. Men and women engaged in this behavior at similar rates, and prepartying was most related to social reasons for drinking. Conclusion: Because prepartying is well-known among students, the authors suggest that clinicians and researchers target it to better understand college drinking and to help students understand the associated dangers.     

The personal protective behaviors of college student drinkers: evidence of indigenous protective norms

Given the prevalence of alcohol consumption and the relative infrequency of harm among college students, the authors sought to determine how most college students protect themselves from alcohol-related harm. An analysis of the aggregate National College Health Assessment data identified a cluster of personal protective behaviors that correlated with reduced risk when drinking. Further analysis revealed that nearly three-quarters of student drinkers regularly employ at least 1 protective behavior, and well over half of the students who use protective behaviors routinely employ 2 or more. In addition, the data reveal that student drinkers employ situational abstinence, with nearly 7 out of 10 students reporting that they sometimes or usually refrain from drinking alcohol when they socialize. The use of these protective behaviors is a strong predictor of safety and harm for college-student drinkers.