Drunkorexia: When Eating Disorders and Alcohol Abuse Collide

College is an exciting time for many young adults. It’s often their first chance to establish an identity entirely separate from their parents or caregivers. But, with that freedom comes a lot of social pressures. Legends of crazy parties, wild binge drinking, casual sex gets passed down from generation to generation. The idea that irresponsible drinking and sex are rights of passage for college students is also a staple of American popular culture as evidenced through popular movies like “Animal House,” “Old School,” and “Neighbors.” Many students feel pressure to both participate in party culture and to maintain a certain level of “sex appeal” in order to be socially accepted. 

 

These pressures are leading many students to make dangerous trade-offs when it comes to alcohol and food. In a recent study, more than 80 percent of college students reported that they skipped meals, binged on food and purged, or used a laxative, so that they could “save calories” and binge drink without gaining weight and/or increase the effects of alcohol. These behaviors are associated with a trend called “drunkorexia.” Drunkorexia is not a medical diagnosis, but it describes the growing trend of college students sacrificing nutrition for alcohol.

The Surprising Relationship Between Eating Disorders and Alcohol Abuse

Though not everyone who engages in food restricting and binge drinking will go on to develop an eating disorder or an alcohol addiction, they may be at higher risk. Research has shown that 50 percent of women who reported eating disorder behaviors also struggled with drug and substance use disorders. That is a rate of risk five times higher than that those without eating disorders.

Alcohol use disorders tend to be particularly common among people with eating disorders, because of the way they interact with one another. Alcohol can be used to help induce vomiting—especially when consumed in excess on an empty stomach—and to facilitate dehydration. Alcohol can also be used to help numb the feelings of fear and anxiety that women with eating disorders carry with them. They tend to fear both weight gain, and someone finding out about their unhealthy behaviors.

Even if the person exhibiting signs of drunkorexia doesn’t end up with long-term, co-occuring disorders, the behaviors in and of themselves can be dangerous. Drinking on an empty stomach allows alcohol to be absorbed into the blood stream more quickly, which increases the likelihood of alcohol poisoning, blackouts, memory loss, and alcohol-related violence. Severe cases can even lead to permanent brain damage.

Overcoming Drunkorexia Requires Dual Diagnosis Treatment

Treating someone who struggles with both an eating disorder and an addiction can be complex. Often patients end up in a treatment center that specializes in either the eating disorder, or the substance abuse, but not both. Since the two disorders do interact and, in some ways, depend upon one another, it’s important to find a program that can treat both disorders at the same time. If a person enters into recovery from their eating disorder but not from their alcoholism, they are much more likely to relapse. The use of the alcohol will likely trigger the impulse to purge or restrict again and interfere with their judgment when it comes to making healthy choices about food.

If you or a loved one needs help for both an eating disorder and substance use disorder, you’ll want a treatment center like Remuda Ranch at The Meadows that offers an integrated, multidisciplinary approach to treatment. Remuda Ranch offers medical supervision 24 hours a day, seven days a week, along with talk therapies, experiential therapies (like equine therapy and challenge courses), family programming, nutritional and culinary training, and the latest neurobehavioral techniques for treating emotional trauma.

For more information about Remuda Ranch at The Meadows’ inpatient, partial hospitalization, and residential treatment for women and adolescent girls, please call 866-390-6100. Our Intake Specialists are happy to answer any questions you may have and help you decide if Remuda Ranch at The Meadows is right for you.

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Breaking Misconceptions and Myths of Eating Disorders

By James D. “Buck” Runyan, Remuda Ranch at the Meadows Executive Director

When a person is found to have a problem such as diabetes, there are quick reactions from family and professionals to treat the affected person with a sense of urgency. Diet, exercise, proper sleep, stress reduction and medications are all implemented within a short period of time with the hope of limiting the consequences of a poorly functioning or non-functioning pancreas.

Though the general populace, in general, knows little about diabetes, the disorder tends to acquire quick attention because people are aware it is a dangerous disorder needing immediate attention. Eating Disorders are similarly dangerous — yet the recognition of these disorders and the lack of urgency to find adequate treatment leaves those affected vulnerable to highly life altering and possibly life-threatening consequences.

A Star Athlete’s Struggle

Sara represents a common example of someone who struggles with an eating disorder. Sara was 20 years of age, a star athlete on a university scholarship, and an academic scholar with a 4.0 GPA. She had reported struggling with bulimia for more than five years. Though she did mention several of the struggles she experienced over the years, her parents dismissed the topic as being a “teenage thing.” Based upon her parents’ prior responses she went silent on the progression of the disorder as well as the severity of her symptoms; until one day a college roommate found her having fainted during a purging episode in their dorm room. This scene facilitated Sara’s entry into her first treatment.

Secrets and Shame

During the assessment phase, she revealed to the medical team she had intentionally hidden the eating disorder behavior from her family. She revealed keeping them in the dark because of their previous disbelief, her potentially having to leave college as well as possibly losing her scholarships and ultimately having to address the shame she experienced on a daily basis for her behavior. She went on to provide in great detail the secretiveness, the planning, the physical and emotional struggles of having bulimia which culminated in a deep sense of shame, episodes of self-directed anger, and times of unstoppable sobbing.

What became her solace also became her captor. Though she admittedly is a person with physical talent, keen intellect, and high potential, her emotional maturity was lacking in an age appropriate development. The lack of emotional maturity caused her severe anxiety when experiencing new social events and even kept her from developing any depth in personal relationships because she feared the rejection of others if they discovered her secret life with bulimia.

The Double Life

All eating disorders have a similar dynamic in that the sufferer not only maintains a personal secret; they protect it with an unyielding fierceness. They lead a double-life. Family and friends will often notice their loved one’s life patterns frequently exhibit dichotomies.

In one sense they present as having a focused effort to self-control or are controlling of others; having a sense of self-directedness and an unusual knack for self-destruction.

When the eating disorder becomes family and/ or public knowledge, the members often speak about having noticed a variety of odd behaviors and inconsistencies within the sufferer’s life but were neither comfortable nor free to openly hold conversations about them their observations.

The primary eating disorders that affect both men and women of all ages include Anorexia, Bulimia, and Binge Eating Disorder.

Anorexia identified most often by significant weight loss due to restrictive eating behavior. Bulimia is identified by eating a large volume of food in a short period of time and making oneself vomit to remove the consumed food products. Binge Eating is identified by eating a large volume of food in a short period of time and does not include any compensating behavior such as food restriction or self-induced vomiting.

Eating Disorders are Non-Discriminatory

Eating disorders affect both men and women of all ages. Most but, not all eating disorder behavior begins in the younger age population.The general age of onset for Anorexia is 15, Bulimia is 16 and Binge Eating is 25. Frequently there are children as young as 8 and adults in their 60’s seeking treatment services for Anorexia. The same holds true for Binge Eating Disorder. Bulimia is a bit different in that it tends to affect middle teenager up through middle-aged adults.
Common traits of those affected by eating disorders include oversensitivity to change or chaos in their environments. They tend to react with extreme behavior and emotional expression when overwhelmed. Often their first reaction is out of impulse which can be presented from an odd nonreaction, excessive tearfulness, anger, yelling, or aggressive tones. Behaviorally they may withdraw from situations that are uncomfortable or attempt to “control” the circumstances in a “bullying” kind of manner. The important takeaway in observing the person is that they behave and react in extremes that are not necessarily congruent with the events at hand.

Those who struggle with eating disorders will develop some distinct medical complications and unique consequences related to the type of eating disorder, but they all but they share some similar features as well.

Those with Anorexia will often have a lower than reasonable body weight, rapid weight loss, complain of dizziness, move or exercise continuously, maintain a slow metabolism, suffer stress fractures, lose menses (for women,) have lower testosterone levels (for men) and appear somewhat fearful of various types of food.

Those with Bulimia will often complain of intestinal discomfort, experience frequent headaches and experience heart palpitations. They may also experience dental problems, experience irregular menses, and experience constipation.
Binge Eating is often but not always associated with obesity. For those individuals who are not obese, they will experience many of the same symptoms of Bulimia with a higher focus on the intestinal track discomfort. For those who are higher in weight due to the Binge Eating, they may experience, diabetic symptoms, knee and back problems, sleep apnea, Reflux, intestinal discomfort, thyroid problems and vast weight fluctuations due to attempting various “diet” plans.

How The Family Can Help

A common misconception that family members have is that their loved one need only “make a decision” to correct their relationship with food. They put pressure on their loved one by way of allowing a “special” meal plan that deviates from the family’s standard meal plans.

The family often attempts to use a form of logical conversations to encourage the person struggling to recognize their behavior is unusual. They may even attempt to use coercion and manipulation to force change. Though well intentioned, these tactics backfire more times than not. The best way to help is to seek support from a trained eating disorder specialist who can provide education on how best to approach the family member struggling with an eating disorder. But the family can provide valuable information on signs, symptoms, medical complications and they can help develop a comprehensive team of professionals to help. It will be important for a Primary Care Physician, Counselor, Psychiatrist and Registered Dietitian be involved so that each area of the sufferer’s life is assessed and supported by a subject matter expert.

Hope through Eating Disorder Recovery

Eating disorders are the most complicated psychological disorders to treat. Sadly, when untreated they also carry the highest mortality rate of any other disorder. Much like diabetes, when a person is struggling with any one of these eating disorders, it is imperative for their health, quality of life and in some cases their life’s longevity that they receive appropriate treatment as soon as possible. The benefits to comprehensive quality care will potentially create a life of purpose and hope once the psychological, behavioral and medical concerns are resolved.

At Remuda Ranch at The Meadows, we believe wholeheartedly that people can heal from these disorders with proper care, training, and support. We encourage anyone who may be struggling with one of these disorders to take a very important step of courage to reach out for support from a treatment expert and begin a path of improving their quality of life and relationships.
Note: This article originally appeared in Together Arizona.

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How You And Your Teen Can Cope With Adolescent Anxiety

By Noah Smith Anxiety affects millions of Americans, and adults aren’t the only ones who live with it; children and teens struggle to cope with nervous conditions and mood disorders such as depression, too. For teenagers, anxiety can be difficult to cope with because it affects their performance at school, their relationships, and their social lives.

It’s important to talk to your teen about anxiety and how to handle it, because everyone reacts differently to its effects. Some may have a hard time being in public places, while others may worry about something that hasn’t happened yet. Talk to your child about how some worry and anxiety is normal, and how to train their brain to navigate the anxious thoughts when they come. It’s also important to talk to them about avoiding drugs and alcohol, which can make anxiety worse.

Here are some of the best tips on how to do so.

Encourage talk Some parents fear that talking about their child’s anxieties will make them worse. It’s almost always better to engage in helpful conversation about their fears, so ask your teen to talk about what worries them the most. The important thing here is not to judge; no matter what their concerns are, let your teen know that it’s okay to have worries sometimes and talk about your own fears, especially ones you might have had when you were their age. If your teen doesn’t feel comfortable having a conversation about it, encourage him to write down what makes her the most anxious. Keeping a journal is a great way to navigate anxiety and may help your child understand what she’s feeling.  

Comfort your child

Sometimes, when trying to understand another person’s fears, it’s hard to comprehend or sympathize with. But no matter how you view your child’s worries, it’s important to let her know that you love her and that everything will be okay. Let her know that no matter how strongly she may feel sometimes, the anxiety will pass.  

Do some research

If your child is battling anxiety, she may also be facing some physical effects and not even realize they are tied to her feelings. Some forms of anxiety can cause an individual to break out into a cold sweat, feel nauseous, or become jittery, and these can be mistaken for a physical ailment. If your child reports feeling these symptoms, it might be a good idea to set up a doctor’s appointment just to set both your minds at ease.  

Learn about mindfulness

  It may be helpful for your child to learn mindfulness, which can be achieved through a variety of activities including meditation, yoga, or art therapy. These things can all reduce stress and can help your child learn methods of positive thinking, which can help her circumvent anxious thoughts when they rear their ugly heads.

Sunflower at The Meadows

Sunflower at The Meadows in Wickenburg, Arizona, is an inpatient program designed specifically for teen girls who are struggling with eating disorders and co-occurring conditions like depression, anxiety, and addiction. In a safe and nurturing environment, we provide individualized treatment to a small and intimate group of young women, helping them to change their self-destructive behaviors, heal their emotional trauma, improve their self-esteem, and build better relationships with family and friends. To learn more call 866-390-1500 or visit Sunflower.

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Meet our Eating Disorder Experts at the iaedp Symposium

The practice of treating eating disorders has become more complicated in the last few years. Recent research has shown that a variety of factors can influence an individual’s development of an eating disorder. 

 

We now know that there is a strong genetic component to eating disorders that makes individuals more vulnerable to the disease based on different temperaments and brain functions. We also know that there are many neurobiological factors that greatly influence the development of eating disorder behaviors and traits.

Co-occurring conditions such as trauma, mood disorders, substance misuse, and personality disorders are often present in many eating disorder patients. This complicates diagnosis, treatment, and treatment outcomes.

Eating disorder treatment teams are continually faced with the challenge of working with a more acute patient population, making a basic understanding of the diagnostics and functions of all types of eating disorders vital for the best possible treatment outcomes.

The annual International Association of Eating Disorder Professionals (iaedp) Symposium, which kicks off this week (March 23 – 26) in Las Vegas, Nevada, gathers health experts from many different disciplines together to share the latest knowledge and research on eating disorder and treatment. Medical and behavioral health professionals discuss ways to broaden their understanding and get ideas for integrating new knowledge into better treatment experiences for eating disorder patients.

We consider it a tremendous honor and privilege to have two of our eating disorder experts from Remuda Ranch serve as presenters at the symposium and as leaders of the iaedp organization.

As an organization, iaedp develops educational opportunities and helps to establish a high level of competency for eating disorder professionals. It is the only organization that serves as the standard bearer for eating disorder professional certification.

The work of iaedp’s leaders and chapter members across the country helps to ensure that those struggling with eating disorders can receive the highest level of care and that therapists, dieticians, doctors, and nurses are trained to recognize the signs of eating disorders and help guide their patients to right treatment programs.

Our Remuda Ranch and iaedp Leaders

Buck Runyan, MS, LMFT, LPC, CEDS
James “Buck” Runyan has a long history with iaedp. He started the first iaedp chapter in Orange County, California in 2004 and went on to establish several more chapters from there. He has also served as President of iaedp and as a member of their board of directors. He currently sits on the iaedp advisory board.

For this year’s symposium, Buck rewrote spearheaded the redevelopment of the core certification courses offered to those who want to begin the process of becoming a Certified Eating Disorder Specialist (CEDS.)
He will be co-presenting the first certification workshop, Pre-certification Core Course 1 – Overview of Eating Disorders alongside Dr. Craig Johnson on Wednesday, March 22.

This workshop is designed as an introductory course in eating disorders. Participants will learn how to identify and diagnose eating disorders, gain an understanding of social and culture features of populations affected by eating disorders, and understand how neurobiological influences may factor into an individual’s likelihood of developing eating disorders.

Buck says that he’s looking forward to seeing his friend and colleagues at the symposium and to integrating some of the knowledge and ideas presented there into the Remuda Ranch program:

“This meeting is the largest gathering of thought leaders in eating disorder treatment in the world. Being able to teach alongside Dr. Craig Johnson and have conversations with other influencers like Phillip Mailer, Sondra Kronberg, and many others at the top of their fields is quite an honor. We also get to access some of the best clinical eating disorder education available anywhere in just one week’s time. I’m looking forward to using what I learn to help our Remuda Ranch team members continue to rise above the highest levels of professionalism and industry standards.”

Vicki Berkus, MD, Ph.D., CEDS

Dr. Berkus is currently the medical director for Brighthearthealth.com, a telemedicine IOP, and a Senior Fellow at Remuda Ranch at The Meadows. She has also served in many capacities within the iaedp organization and currently serves on the advisory board. She is a regularly featured speaker at iaedp events and conferences.

On Thursday, March 23 she’ll take part in a roundtable discussion at the iaedp Symposium titled "An Integrative Approach to the Psychological, Medical, and Nutritional Treatment of Eating Disorders in Special Populations."
Dr. Berkus will be stationed at Table 8, where participants will get a chance to talk with her about the physiology of eating disorders and integrative treatment.
The roundtable discussions aim to help reinforce the fact that, more than any other disorder, the treatment of eating disorders requires a multidisciplinary approach. Medical providers, psychotherapists, dieticians, nutritionists, body workers, practitioners of eastern medicines, coaches and trainers, sufferers, family members and more will benefit from will benefit from understanding the varied approaches of their multidisciplinary team members. At the same time, the eating disorder patient is a multifaceted, biopsychosocially developed human being with key aspects that are essential for providers to understand.

Visit us at Booth 51

Stop by our booth to learn more about treatment options available at Remuda Ranch at The Meadows and our exciting, newly enhanced programming for adolescent girls - Sunflower at The Meadows. Or, contact us today to learn why Remuda Ranch at The Meadows is the treatment choice for adolescent girls and women with eating disorders and co-occurring conditions. 866-331-5926.

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Recovering from My Eating Disorder Through Faith

By Kelly Biese, 2007 Remuda Ranch Alumna
I will never forget October 11, 2007, as I stood in front of the security gates at the Dayton airport. I was so angry with God. Part of me wanted to turn and run back, afraid that I'd never return to see my friends, and another part of me still believed I didn't have a problem and would be sent back home when I got to Remuda Ranch. I was just so tired of fighting and tired of being tired.

Remuda Ranch proved to be just the right place for me, and by the second day God began to change my heart and fill me with hope as I put my trust in HIM. There were challenges while I was there, but the caring staff and especially the music and messages I experienced in Chapel continued to fill me with strength and hope. 

 

When I returned home on Nov. 25th, 2007, I felt great and believed everything was going to be okay. However, even though I was using the skills I learned at Remuda Ranch and following my treatment plan, I took my focus off of God and started looking to those around me to provide my strength and hope. I made them my foundation, and I began to sink again.

Fortunately, I had a strong support person that asked me one evening if I had ever asked God to be healed. After thinking for a moment, I realized that I had prayed for years but had never asked God to heal me. That night, I wrote the following in my journal:

"Lord, it is time. I want to be healed. I want to be well enough to let your light shine through me and touch others. Please Lord, send the Holy Spirit to fill me. Empower me to rise above this. If there is something deep inside me holding me back from fully accepting recovery, from embracing the new life you have for me, from letting go of the past, please open my eyes to it and help me to move beyond it. Help me to move beyond this, Lord. You said ask and ye shall receive, knock and the door shall be opened. I've been afraid to ask because I didn't feel I deserved it. It is your will, Lord, but I don't believe your will is for me to continue suffering with no gain. Lift this burden, Lord. I'm willing to take the steps I need, but I need your help to guide me, Lord. I'm willing to take the step, but I need your guidance. I trust you. Open my eyes. Open my ears. Open my mind. Open my heart—to you, Lord. Fill me with your Holy Spirit, that I may grow strong and serve You." - April 28, 2008

The next morning I awoke with a sense of peace I can never describe, and I have not been the same since. I have continued on my path of recovery and each year gets a little easier. I may not love every part of my body, but I can finally say I like my body, for the first time in my life. I can enjoy food - ALL food - when and where I want, without guilt. The scale has no place in my life, because I refuse to let three digits consume my mind and define my life.

In August, I returned to graduate school to pursue my Masters in Social Work degree, and I hope to specialize in trauma and substance abuse. I will forever by grateful to Remuda Ranch for bringing me back to life and giving me hope for healing.

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