Pathological dieting and alcohol use in college women--a continuum of behaviors

A longitudinal test of problematic alcohol use and binge eating among college women: The moderating role of shame

Problematic alcohol use and binge eating frequently co-occur. High levels of negative affect, negative urgency, and/or shame may increase the likelihood that problematic alcohol use and binge eating co-occur over time.

OBJECTIVE

Examine 1) the temporal relationship between problematic alcohol use and binge eating among college women, who are at high risk for both, and 2) the additive and moderating effects of shared, emotion-based risk factors in models involving both problematic alcohol use and binge eating.

METHOD

In n = 302 college women assessed at two time points across 8 months, we used hierarchical linear regression to invstigate our objectives.

RESULTS

Baseline problematic alcohol use and baseline shame independently predicted increases in follow-up binge eating, controlling for baseline binge eating. In addition, the interaction between problematic alcohol use and shame accounted for further variance in subsequent binge eating (the influence of baseline problematic alcohol use on follow-up binge eating was stronger at higher levels of baseline shame). The reciprocal relationship was not significant: baseline binge eating did not predict follow-up problematic alcohol use independently or in conjunction with risk factors. Neither negative affect nor negative urgency showed predictive effects beyond prior behavior and shame. Results support 1) problematic alcohol use as a prospective risk factor for binge eating, 2) shame as an additive predictor of binge eating, and 3) shame as a positive moderator of binge eating prediction from problem drinking.

CONCLUSION

Addressing shame and problematic alcohol use may be warranted in binge eating interventions for college women.

The relation between questionnaire-measured self-reported emotional eating and disordered eating behaviors: A meta-analysis of nearly three decades of research

Extensive research exists on the association between self-reported emotional eating (EE) and disordered eating (DE) behaviors. Heterogeneity exists by type (e.g., unidimensional vs. multidimensional) and valence (e.g., negative vs. positive) of self-reported EE, and no previous meta-analyses have examined the association between self-reported EE and DE behaviors. A total of 67 studies (N = 26,289; 43 reporting relations in one model, and 24 reporting relations in more than one model) met inclusion criteria; ranges for age and publication date were 18.0-61.8 years old and 1995 to 2022. Five models quantified relations between DE behaviors and 1) broad negative EE, 2) EE in response to depression, 3) EE in response to anger and anxiety, 4) EE in response to boredom, and 5) EE in response to positive emotions. Using random-effects models, pooled Cohen's d effect sizes suggested small, positive relations between DE behaviors and self-reported broad negative EE (d = 0.40, p < 0.001), EE-depression (d = 0.41, p < 0.001), EE-anger/anxiety (d = 0.35, p < 0.001), and EE-boredom (d = 0.38, p < 0.001). A significant, but very small, positive relation was observed between DE behaviors and self-reported EE-positive (d = 0.08, p = 0.01). Subgroup analyses suggested a medium, positive relation between self-reported broad negative EE and binge eating (d = 0.53, p < 0.001) and a small, positive relation between self-reported broad negative EE and dietary restraint (d = 0.20, p < 0.001). Significant heterogeneity was identified across all models except for the EE-boredom and DE behaviors model. Higher BMI, but not age, clinical status, or type of DE behavior strengthened the positive relation between self-reported broad negative EE and DE behaviors. Findings support previous research suggesting that negative and positive EE are distinct constructs, with negatively valenced EE being more closely associated with DE behaviors, especially binge eating.

Drunkorexia and trait mindfulness among college students

Objective: Combined alcohol and disordered eating (drunkorexia) are alcohol fueled weight management behaviors. Mindfulness negatively relates to both disordered eating and alcohol use. Participants: Participants (n = 344, average age 20) were primarily female (85.2%, n = 293), and Caucasian (82.6%, n = 284). Methods: Students reported drunkorexia and mindfulness. Results: Drunkorexia behaviors were negatively correlated with Acting with Awareness (AA; full attention to a present moment; r = -.21, p < .001) and Nonjudgment (NJ; understanding and leniency toward oneself; r = -.22, p < .001). Drunkorexia motivations are significantly correlated with AA (r = -.13, p = .01) and NJ (r = -.18, p = .001). Structural equation modeling revealed higher levels of NJ related to higher levels of drunkorexia. Conclusion: The objective was to determine a potential relationship between drunkorexia behaviors and motivations, and trait mindfulness. Findings suggest a nonjudgmental disposition relates to lower levels of drunkorexia.

A Complex Interplay between Nutrition and Alcohol use Disorder: Implications for Breaking the Vicious Cycle

Approximately 16.5% of the United States population met the diagnostic criteria for substance use disorder (SUD) in 2021, including 29.5 million individuals with alcohol use disorder (AUD). Individuals with AUD are at increased risk for malnutrition, and impairments in nutritional status in chronic alcohol users can be detrimental to physical and emotional well-being. Furthermore, these nutritional deficiencies could contribute to the never-ending cycle of alcoholism and related pathologies, thereby jeopardizing the prospects of recovery and treatment outcomes. Improving nutritional status in AUD patients may not only compensate for general malnutrition but could also reduce adverse symptoms during recovery, thereby promoting abstinence and successful treatment of AUD. In this review, we briefly summarize alterations in the nutritional status of people with addictive disorders, in addition to the underlying neurobiological mechanisms and clinical implications regarding the role of nutritional intervention in recovery from alcohol use disorder.

Development and psychometric evaluation of an empirically-derived daily checklist of weight control: Consumption-reduction strategies and health-focused strategies in college students

Objective: Many college women report engaging in weight control strategies, yet little is known about which strategies are used and how often. The current study's goal was to evaluate the factor structure of a comprehensive list of weight control behaviors used in the previous 24-hours. Participants: Undergraduate women (N = 286) were recruited from a southwestern university. Methods: Participants reported their weight control strategies for the previous 24 hours on a checklist compiled from previous studies. Results: Exploratory and confirmatory factor analyses indicated that a 14-item, 2-factor ("Consumption-reduction", "Health-focused" Strategies) structure was a good fit of the data. Tests of longitudinal measurement invariance found support for using the checklist to make meaningful comparisons across time. Conclusions: This study developed a checklist of past 24-hour weight-control strategy usage, thereby providing a step toward developing an instrument that may be used for weight control or early intervention for disordered eating.

The impact of snapchat usage on drunkorexia behaviors in college women

ObjectiveResearch has shown the deleterious effects of drunkorexia behaviors. The goal of this project was to examine the impact of college women's Snapchat usage on drunkorexia behavior frequencies and motives, through comparing one's body to others and internal drives for thinness.Participants636 college women (Study 1 N = 109, Study 2 N = 527) were recruited from a large research institution in the Southwestern U.S.MethodsParticipants completed an online survey regarding Snapchat usage, body comparison indices, drive for thinness, and drunkorexia behaviors and motives.ResultsFindings support the hypotheses that Snapchat usage impacts drunkorexia behaviors in general (Study 1), and specific drunkorexia motives (Study 2). These effects were mediated by an index of body comparisons and drive for thinness.ConclusionsCollege women may be at risk for drunkorexia due to their experiences on social media. Aspects of the platform may be pushing women toward disturbed eating habits.

Binge Drinking and Obesity-Related Eating: The Moderating Roles of the Eating Broadcast Viewing Experience among Korean Adults

Recently, there has been a notable rise in binge drinking and in the popularity of eating broadcasts via TV and online platforms, especially in Korea. This study analyzed the moderating effect of the eating broadcast viewing experience on the relationship between binge drinking and obesity-related eating behaviors. Cross-sectional self-reported online survey data were collected from 1125 Korean adults. Moderation models for restrained, emotional, and external eating behaviors were tested using moderation analyses with Hayes’s PROCESS version 3.5 compatible with SPSS. As a result, the eating broadcast viewing experience moderated the relationship between binge drinking frequency and external eating (F_change = 2.686, p = 0.045). More frequent binge drinking was associated with a higher level of external eating in participants who only watched online eating broadcasts, especially among women. Participants in their twenties showed the same above association; additionally, those who only watched TV eating broadcasts showed an inverse association, indicating that more frequent binge drinking was associated with a lower level of external eating. Consequently, an eating broadcast viewing experience was one of the environmental factors associated with binge drinking that influences obesity-related eating behaviors.

A network analysis of eating disorder symptoms and co-occurring alcohol misuse among heterosexual and sexual minority college women

Eating disorders and alcohol misuse are common problems among college women. Individually, both have high prevalence rates and are associated with a significant economic burden. Yet eating disorders and alcohol misuse also frequently present simultaneously, which may increase symptom severity and related impairment. These associations are especially important to test in sexual minority populations, as symptoms may present differently, and the prevalence and personal cost of these disorders may be even higher for this group. The present study (N = 1072 undergraduate college women) used network analysis to identify pathways, central symptoms, and bridge symptoms across alcohol misuse and eating disorder symptoms. A network comparison test was used to determine if the network structure differed between heterosexual women (n = 923) and sexual minority women (n = 149). For the overall network, cognitive restraint, excessive exercise, and frequency of binge drinking, were the most central symptoms. Bridge symptoms included drinking in the morning, purging, alcohol-related guilt, and muscle building. Heterosexual and sexual minority women did not differ significantly in network structure or global strength. Regardless of sexual orientation, prevention efforts for eating disorders and alcohol misuse among college women should target central and bridge symptoms.

Emotion dysregulation moderates the relationship between alcohol use and eating pathology among heavy-drinking college men

OBJECTIVES

There is limited research examining the relationship between alcohol use and eating pathology in men or factors that may moderate this association. The current study investigated the relationship between alcohol use and eating pathology, and examined emotion dysregulation as a moderator of this association, among heavy-drinking college men.

METHOD

Men mandated to receive an alcohol intervention (N = 88; average age = 19 years) completed questionnaires related to alcohol use, emotion dysregulation, and eating pathology.

RESULTS

Results demonstrated positive relationships between alcohol use and some eating pathology, and a significant interaction between alcohol use and emotion dysregulation. However, results were contrary to hypotheses, such that there was a positive relationship between alcohol use and eating pathology at low levels of emotion dysregulation.

CONCLUSION

Future studies should continue to examine the overall presentation of eating pathology in men and investigate factors that may impact the relationship between alcohol use and eating pathology.

Shared and non-shared risk and protective factors of binge eating and binge drinking from adolescence to young adulthood

This study aimed to elucidate the shared and non-shared behavioral, sociocultural, and personal risk factors underlying binge eating and binge drinking among a sample (n = 1764) of participants from Project EAT at baseline and 10-year follow-up. Longitudinal and cross-sectional analyses revealed a range of risk factors associated with binge eating and binge drinking at 10 years, which varied by gender. The results revealed that risks associated with binge eating and binge drinking often differed, and thus full-scale dual preventive interventions for concurrent binge eating and binge drinking may be less effective. However, general prevention and intervention programs may emphasize shared risk factors.

Does physical appearance perfectionism predict disordered dieting?

Despite that disordered eating has been repeatedly associated with perfectionism, the results are inconsistent as to which exact dimensions of perfectionism it is related to. Moreover, the increasing evidence that perfectionism is best conceptualized as a domain-specific, as opposed to a global, trait contribute to the lack of clarity. Therefore, the aim of this study was to examine which dimensions of global and physical appearance perfectionism statistically predict disordered dieting in a non-clinical adult female sample. In total 437 participants completed the Short Almost Perfect Scale, which distinguishes between adaptive and maladaptive perfectionism, the Physical Appearance Perfectionism Scale, which distinguishes between hope for perfection and worry about imperfection, and the Dieting subscale of the Eating Attitudes Test-26. A hierarchical regression analysis revealed that only maladaptive, as opposed to adaptive, global perfectionism statistically predicted disordered dieting. Furthermore, both dimensions of physical appearance perfectionism statistically predicted disordered dieting, although worry about imperfection, its maladaptive dimension, was the strongest statistical predictor. The present results demonstrate that worry about imperfection is an effective statistical predictor of disordered dieting among women, possibly serving as a starting point for further research investigating the utility of its incorporation in prevention and treatment protocols for disordered eating.

Cognitive Behavioral Training Using a Mobile Application Reduces Body Image-Related Symptoms in High-Risk Female University Students: A Randomized Controlled Study

Body dissatisfaction is prevalent in young women, and is associated with symptoms of body dysmorphic disorder (BDD) and eating disorders (EDs). The aim of the study was to assess the efficacy of a mobile application, based on cognitive behavioral principles, in reducing body dissatisfaction and BDD/ED symptoms in female university students considered at high-risk of developing body image disorders (BIDs). Fifty university students at high-risk of developing BIDs (using self-report questionnaires assessing BIDs and the Structured Clinical Interview for DSM-5 Clinical Version) were randomized in two groups: immediate-use App group (iApp group; n = 25) and delayed-use App group (dApp group; n = 25). The iApp group started using the app at baseline for 16 days (T0 to T1). The dApp group waited for 16 days before starting to use the app (T1 to T2). Participants completed questionnaires at baseline (T0), 16 days from baseline (T1), and 32 days from baseline (T2). Repeated measure Analyses of Variance (ANOVAs) showed a Group (iApp vs. dApp) × Time (T0 vs. T1) interaction on BDD symptoms indicating medium effect size (partial eta squared) reductions in the iApp group compared to dApp group at T1; post-intervention means for BDD symptoms were under the cut-off for extreme body dissatisfaction/BDD symptoms in both groups. Pertaining to ED symptoms, no significant Group × Time interaction was detected. Training 3 minutes a day for 16 days with a CBT-based mobile application may lead to reductions in some forms of body dissatisfaction, including BDD symptoms in female university students at high-risk of developing BIDs. On the other hand, effects of the intervention on ED symptoms seem more limited.

Emotion regulation difficulties interact with negative, not positive, emotional eating to strengthen relationships with disordered eating: An exploratory study

Disordered eating includes core eating disorder symptoms present in diverse populations. The extant literature has focused on associations between negative emotional eating and disordered eating to the exclusion of positive emotional eating. Emotion regulation may help explain relationships between emotional eating and disordered eating. Emotion regulation difficulties was examined as a moderator of relationships between negative and positive emotional eating and disordered eating including dietary restraint, eating, weight, and shape concerns, and global scores of disordered eating, a general index of disordered eating. A cross-sectional study was employed using a university student population in the United States. Participants completed surveys assessing negative (Dutch Eating Behavior Questionnaire; Emotional Appetite Questionnaire) and positive (Emotional Appetite Questionnaire) emotional eating, emotion regulation (Difficulties in Emotion Regulation Scale), and disordered eating (Eating Disorder Examination Questionnaire). Moderation analyses were calculated with emotion regulation difficulties as the moderator of relationships between negative and positive emotional eating and disordered eating. Across two separate measures of negative emotional eating, higher negative emotional eating was associated with higher weight concerns and global scores of disordered eating when emotion regulation difficulties was average and increased (+1 SD above average). Higher positive emotional eating was associated with lower dietary restraint and global scores of disordered eating when emotion regulation difficulties was decreased (-1 SD below average). Emotion regulation difficulties strengthened relationships between negative, not positive, emotional eating and disordered eating. Research and clinical implications for the contribution of emotional eating and emotion regulation on disordered eating were discussed.

Prevalence of disordered eating behaviors and associated factors in Brazilian university students

BACKGROUND

University students may be a vulnerable group to adopt unhealthy behaviors, including changes in eating behavior. Assessment of factors associated with the prevalence of disordered eating behaviors in this population may facilitate the early identification of their predictors, thus allowing fast interventions.

AIM

To analyze the prevalence of disordered eating behaviors (DEB) and associated factors in Brazilian university students.

METHODS

Cross-sectional study of male and female students aged 16-25 years, enrolled in full-time degree program at a public university in the mid-west of Brazil. Disordered eating behaviors in the last three months (binge eating, purging, and food restriction), through an adapted version of the instrument developed by Hay, was evaluated and the association with demographic and socioeconomic characteristics, including lifestyle, body image, perceived stress, depressive symptoms, and excess weight, was analyzed. A hierarchical analysis model was performed to determine the relative importance of factors on the prevalence of DEB.

RESULTS

A total of 1608 university students were evaluated (50.7% male). Prevalence of DEB was 4.4% for binge eating, 2.5% for purging and 9.1% for food restriction, all of which were higher among women (7.0%, 4.4%, and 13.5%) compared with men (1.8%, 0,6%, and 4.9%, respectively). The factors that remained significantly associated with these behaviors were female sex, smoking, consumption of alcoholic beverages, dissatisfaction with body image, excess weight, high perceived stress, and presence of self-reported depressive symptoms.

CONCLUSION

Factors associated with DEB signal that intervention is required to create synergy between individual and population-level interventions in lifestyle behaviors.

College alcohol beliefs and negative alcohol-related consequences: A moderated mediation model of enhancement drinking motives and restricted eating

College alcohol beliefs (CABs; i.e., beliefs that alcohol use is an integral feature of college life) have been shown to be positively associated with negative alcohol-related consequences among college students. Given this information, the present study examined restricted eating before consuming alcohol to increase intoxication as one drinking behavior mechanism through which CABs relate to negative alcohol-related consequences. Additionally, we examined whether the indirect association of CABs and negative alcohol-related consequences through restricted eating differed as a function of enhancement drinking motives, specifically the CABs-restricted eating association (i.e., first-stage moderated mediation). Participants included college students (n = 1347) across 10 states/universities who consumed alcohol in the last month. The majority of participants identified as being White, non-Hispanic (69.0%), female (70.1%), and reported a mean age of 20.92 (Median = 20.00; SD = 4.60) years. As hypothesized, restricted eating mediated the association between CABs and negative alcohol-related consequences. Further, the indirect effect of CABs on negative alcohol-related consequences through restricted eating was stronger in students who endorsed high levels of enhancement motives, compared to students with low or average levels. Our findings suggest that college students with high levels of enhancement motives are at a relatively higher risk of experiencing negative alcohol-related consequences related to CABs via restricted eating, compared to those with average or low levels. Future research is needed to examine additional drinking-related factors that may influence the pathways between CABs and negative alcohol-related consequences among college students.

Gender differences in relations between alcohol-related compensatory behavior and eating pathology

PURPOSE

Concerns about caloric intake associated with alcohol use (e.g., fear of weight gain) are positively associated with compensatory eating behaviors (e.g., caloric restriction, self-induced vomiting), a phenomenon that has been identified across gender. Specific motivations for compensatory behaviors differ; some relate to eating disorder (ED) pathology (e.g., shape and weight concerns), and others to alcohol (e.g., enhancing effects). Research examining motivations for alcohol-related compensatory behaviors in men is limited to date. The current study sought to assess how specific types of alcohol-related compensatory behaviors and their association with ED pathology present differently by gender.

METHODS

Undergraduates (N = 530, 48% female) completed the Compensatory Eating Behaviors in Response to Alcohol Consumption Scale (CEBRACS), Eating Disorders Diagnostic Scale (EDDS), and reported height, weight, and frequency and quantity of alcohol consumption. Data were examined using linear regression, and relations between CEBRACS behaviors and eating pathology were compared across gender.

RESULTS

Factors that were positively associated with EDDS scores for both men and women included alcohol-related dietary restraint, and exercise. For women, but not men, alcohol-related bulimic behavior also contributed to elevations in EDDS scores.

CONCLUSIONS

Findings indicate that specific types of alcohol-related compensatory eating behaviors (i.e., dietary restraint and exercise) are positively related to ED pathology for both male and female participants. In contrast, bulimic behaviors' association with ED pathology is gender specific. Understanding gender differences in alcohol-related compensatory behaviors and ED risk may inform gender-specific intervention targets.

LEVEL OF EVIDENCE

Cross-sectional descriptive study, Level V.

Barriers in addressing body image and eating issues in primary care: an overview of women's narratives

Disordered eating and body image concerns continue to be rising problems for young women that come with significant mental and physical health risks. Primary care may be a potential avenue for early identification and intervention of eating and body image issues. However, few studies have explored this area in depth. Preliminary studies show that few women discuss these issues with their primary care providers (PCPs), and the barriers to these conversations remain unknown. This study used an open-ended survey to explore women's narratives concerning their experiences and barriers to discussing eating and body image issues with their PCPs. A total sample of 102 female college students (aged 18-35 years) in the Boston area completed self-report questionnaires online (February 2015 through January 2016). Themes in both communication and relationship domain emerged. Communication themes for participants included: health information, prompting by the PCP, and other barriers. Relationship themes included: patient and provider characteristics, negative and positive emotions, and trust. According to these participants, many women experience negative interactions with their providers when discussing these sensitive topics. Strategies for improving these outcomes in primary care are discussed.

Examination of the relationships between dietary restraint, alcohol, and adverse problems among women

OBJECTIVE

Women who report greater chronic dieting consume more alcohol, drink more frequently, and experience greater problems than women who report less chronic dieting. Alcohol may also temporarily disrupt a woman's dietary rules, leading to increased caloric intake and subsequent restriction. This study examined whether alcohol use mediated the relationship between dietary restraint and alcohol problems in a woman's daily life.

PARTICIPANTS

Women (N = 59) completed the study by the fall of 2013.

METHODS

Participants completed up to six assessments for 10 days, including intended dietary restraint, alcohol use, and problems.

RESULTS

Drinking quantity partially mediated the relationship between dietary restraint and alcohol problems. For each drink consumed, there was a 1.4 times greater likelihood of eating after drinking, which was associated with greater intention to subsequently restrict calories.

CONCLUSIONS

The types of drinks consumed and reasons for restricting one's caloric intake may inform the relationship between these behaviors.

Disordered eating in college sorority women: A social network analysis of a subset of members from a single sorority chapter

OBJECTIVE

Disordered eating attitudes and behaviors are prevalent among college women, and peers appear to influence current and future eating pathology. Social network analysis (SNA) is an innovative quantitative method to examine relationships (i.e., ties) among people based on their various attributes. In this study, the social network of one sorority was modeled using exponential random graph model (ERGM) to explore if homophily, or the tendency for relationship ties to exist based on shared attributes, was present according to sorority members' disordered eating behaviors/attitudes and their body mass index (BMI).

METHOD

Participants included members of one sorority at a large Southeastern university. All members were included on a roster unless they elected to opt out during the consent process, and 41 (19%) of the members completed the study measures. Participants completed the Social Network Questionnaire developed for this study (degree of "liking" of every member on the roster), the Eating Disorder Examination-Questionnaire (EDE-Q), and a demographics questionnaire in exchange for one hour of community service credit.

RESULTS

The final sample consisted of mostly White women with an average age of 20. Homophily across liking ties was examined based on the EDE-Q Global scale, episodes of binge eating, and BMI. The greater the difference in EDE-Q Global scores, the more likely the participants were to like one another. The greater the difference in BMI, the less likely the participants were to like one another. Binge eating was unrelated to homophily.

DISCUSSION

College sorority women appear to prefer other women with dissimilar levels of disordered eating attitudes, suggesting complex interactions between stigmatized or valued disordered eating attributes. Women with similar BMI were more likely to like one another, confirming past findings.

A cross-sectional analysis examining the association between dieting behaviours and alcohol use among secondary school students in the COMPASS study

Background

Unhealthy weight-control methods and problematic alcohol use appear linked, with individuals engaging in both behaviours at greater risk of adverse consequences. Most studies have been conducted among females and young adults, yet both dieting and binge drinking emerge at earlier stages of development. Moreover, gender differences are likely due to contrasting body ideals. This study investigated the co-occurrence of dieting and alcohol use among youth, focusing on varying weight goals in males and females, and meal skipping, as a form of food restriction.

Methods

Cross-sectional analyses were conducted in sample of 44 861 Grade 9-12 students from Year 2 (2013-14) of the COMPASS study.

Results and conclusions

The majority of females were trying to lose weight, while males tended to report efforts to gain and these two groups demonstrated the highest odds of alcohol use and binge drinking. Breakfast and lunch skipping predicted binge drinking and alcohol use in females, but only the former was related to drinking behaviour in males. Breakfast skipping rarely occurred for weight loss purposes, although more females reported this reason for missing meals than males. Results support hypothesized gender variations in weight goals and meal skipping, and differing associations with drinking behaviour.

Fat or fiction? Effects of body size, eating pathology, and sex upon the body schema of an undergraduate population

Although there is a growing consensus that women with anorexia nervosa have a distorted body schema, the origins of this disturbance remain uncertain. The present investigation examined the effects of body size, eating pathology, and sex upon the body schema of an at-risk, undergraduate population. In Study 1, 98 participants mentally simulated their passage through apertures. When aperture width was manipulated, narrow and broad women over- and under-estimated their spatial requirements for passage, respectively. This relationship was exacerbated by dietary restraint. When aperture height was manipulated, short and tall men over- and under-estimated their spatial requirements for passage, respectively. Study 2 (N=32) replicated the association between women's veridical and internally-represented widths, although no significant effects of eating pathology were observed. Our findings suggest that body schema enlargement is not necessarily pathological, and may be driven by normal perceptual biases and internalised sociocultural body ideals.

Global/local processing style: Explaining the relationship between trait anxiety and binge eating

OBJECTIVE

Anxiety is a risk factor for disordered eating, but the mechanisms by which anxiety promotes disordered eating are poorly understood. One possibility is local versus global cognitive processing style, defined as a relative tendency to attend to details at the expense of the "big picture." Anxiety may narrow attention, in turn, enhancing local and/or compromising global processing. We examined relationships between global/local processing style, anxiety, and disordered eating behaviors in a transdiagnostic outpatient clinical sample. We hypothesized that local (vs. global) processing bias would mediate the relationship between anxiety and disordered eating behaviors.

METHOD

Ninety-three participants completed the eating disorder examination-questionnaire (EDE-Q), State-Trait Anxiety Inventory (STAI)-trait subscale, and the Navon task (a test of processing style in which large letters are composed of smaller letters both congruent and incongruent with the large letter). The sample was predominantly female (95%) with a mean age of 27.4 years (SD = 12.1 years).

RESULTS

Binge eating, but not fasting, purging, or excessive exercise, was correlated with lower levels of global processing style. There was a significant indirect effect between anxiety and binge eating via reduced global level global/local processing.

DISCUSSION

In individuals with disordered eating, being more generally anxious may encourage a detailed-oriented bias, preventing individuals from maintaining the bigger picture and making them more likely to engage in maladaptive behaviors (e.g., binge eating).

"Safe Foods" or "Fear Foods": the implications of food avoidance in college students from low- and middle-income countries

PURPOSE

The primary objective of this study was to explore if self-reported food avoidance (fats, carbohydrates and protein) exists among college students in low- and middle-income countries (LMICs) and its relationship with body mass index (BMI), dieting, mood/anxiety symptoms, physical activities and general health knowledge.

METHODS

This study is a subset (N = 6096) of a larger 26 LMICs cross-sectional survey, which consisted of 21,007 college students. We ascertained socio-demographic information, food avoidance, physical activities, dieting behaviours, depressive and PTSD symptoms, and recorded anthropometric measurements. Chi-square analyses assessed the relationship between predictor variables and food categories eliminated from participants' diet. Multiple logistic regression assessed if food avoidance predicts outcome variables such as binge drinking, high physical activity, being underweight, exhibiting significant depressive and PTSD symptoms.

RESULTS

Food avoidance exists in as many as one-third of college students in low- and middle-income countries, with this being more likely in persons who are trying to lose weight whether by dieting or otherwise. Food avoidance was associated with higher BMI, depressive symptoms, and high intensity exercises, as well as the level of health knowledge influencing the types of food avoided. A significant difference was noted between lower middle-income and upper middle-income countries with respect to the foods they avoided.

CONCLUSION

Despite being knowledgeable about health-related behaviours, we found that college students in our sample were not that different from those in developed countries and may be influenced by a similar advice given by non-experts about macronutrients. These results hold implications for intervention programmes and policy makers.

LEVEL OF EVIDENCE

Level V, descriptive cross-sectional survey.

The influence of childhood polyvictimization on disordered eating symptoms in emerging adulthood

Children who endure multiple victimization experiences, or "polyvictims," are vulnerable to maladaptive outcomes. Yet, little research exists evaluating the relationship between childhood polyvictimization and disordered eating symptoms (DES) in emerging adulthood. The current study examines the relationship between childhood polyvictimization and DES in emerging adults. Data were collected from 288 participants across two universities using online self-report measures. Hierarchical regression analyses revealed a significant positive relationship between number of childhood victimization experiences and DES in young adulthood (ß=0.14; p=0.016). Female participants were more likely to demonstrate DES (ß=0.14; p=0.008). Further, high levels of emotion dysregulation during young adulthood were associated with more DES (ß=0.33; p<0.001). Findings suggest that exposure to victimization experiences in childhood increases individuals' risk for exhibiting DES in young adulthood. Results also highlight the strong relationship between individuals' emotion regulation abilities and the presence of DES. Findings align with the theory that children who have endured high levels of victimization often feel overwhelmed by their emotions and circumstances, demonstrate emotion regulation difficulties, and may rely on maladaptive coping strategies, including disordered eating, to manage adversities. Study results emphasize the importance of considering victimization history when working with emerging adults displaying disordered eating symptomatology.

Is "drunkorexia" an eating disorder, substance use disorder, or both?

Researchers have identified a specific behavior pattern labeled "drunkorexia" to describe recurrent inappropriate compensatory behaviors (e.g., fasting and self-induced vomiting) to avoid weight gain from consuming alcohol (referred to as ICB-WGA). Several studies have investigated the prevalence of these behaviors among college students, but few have tested whether this behavior pattern is more strongly related to substance use or disordered eating, which may have future implications for eating disorder and substance abuse research fields. The aim of this project was to test: (1) whether disordered eating or alcohol use adds incremental validity to the prediction of ICB-WGA when controlling for the other variable and (2) the effect of sex on ICB-WGA. College participants (N=579; 53% female) completed the Eating Pathology Symptoms Inventory (EPSI), the Alcohol Use Disorders Identification Test (AUDIT), and several questions designed to measure ICB-WGA. Results indicated that EPSI Restricting and Body Dissatisfaction scales were not significant predictors of ICB-WGA, whereas the AUDIT and EPSI Cognitive Restraint, Excessive Exercise, Purging, and Binge Eating scales significantly predicted ICB-WGAs. Results indicated that disordered eating and alcohol use both added incremental validity to the prediction of ICB-WGA; however, ICB-WGA was more strongly related to disordered eating, and this was particularly true for women. Our findings suggest that individuals engaging in ICB-WGA may be at-risk for future development of both eating and substance disorders. Notably, our findings highlight the need for future research to focus on trans-diagnostic prevention programs that target mechanisms that underlie both disordered eating and substance misuse.

Alcohol expectancies and drinking behaviors among college students with disordered eating

OBJECTIVE

The authors investigated binge drinking, alcohol expectancies, and risky and protective drinking behaviors in relation to disordered eating behaviors in male and female college students.

PARTICIPANTS

The full sample consisted of 7,720 undergraduate students, 18 to 22 years of age. Drinking behaviors were analyzed in 4,592 recent drinkers.

METHODS

Participants anonymously completed a survey as part of a universal alcohol abuse prevention program between September 2007 and April 2008.

RESULTS

Co-occurring disordered eating behaviors and binge drinking characterized 17.1% of males and 19.0% of females. Rates of binge drinking were higher in those with disordered eating behaviors. Students with disordered eating behaviors also had more positive and negative alcohol expectancies and engaged in more risky and fewer protective drinking behaviors than their counterparts.

CONCLUSIONS

Students with disordered eating behaviors have outcome expectancies and behavior patterns associated with problematic drinking. These findings may enhance prevention and intervention programs.

Validation of the Italian version of the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS)

The aim of the study was to evaluate, in a representative sample of high school students, the psychometric characteristics of the Italian version of the CEBRACS scale (Rahal et al., 2011), a questionnaire investigating compensatory eating behaviors correlated with alcohol consumption. These behaviors are adopted to make up for calories consumed through the drinking of alcohol and/or to enhance the intoxicative effects of alcohol. Study participants were selected from an initial sample of 965 students. Out of the 965 youths originally recruited, 640 (376 males and 264 females) reported drinking alcohol over the previous 3 months, and were considered eligible for the purpose of the study. The following questionnaires were administered: CEBRACS, Alcohol Use Disorders Identification Test (AUDIT) (Saunders, 1993), and the Eating Disorder Inventory-3 (EDI-3) (Garner, 2004). Test/retest reproducibility was evaluated on a subgroup of 189 youths. The factorial structure, internal consistency, test–retest reliability and concurrent validity of CEBRACS were evaluated. Factor analysis of inter-item correlation indicated 5 factors as being better suited to describe data, with an estimated 68.85% variance: "Alcohol Effect, "Laxative Use", "Dietary Restraint and Exercise", "Diuretic Use", "Restriction and Vomiting". A high degree of reproducibility and homogeneity (ICC = 0.806; Cronbach's Alpha = 0.886) of the scale was detected. A significant correlation was revealed between CEBRACS, the three eating disorder risk scales comprised in EDI-3 and scores and clinical risk yielded by AUDIT. The overall reliability and validity of the CEBRACS scale was confirmed in an extensive sample of Italian students, highlighting a satisfactory construct validity, good internal consistency and good degree of reproducibility. In view of the relevance of the problem, associated with serious health risks, a more widespread investigation of the phenomenon should be conducted using evaluation tools of proven validity and reliability on both representative samples of the general population and clinical samples.

Gender differences in the relationship between impulsivity and disordered eating behaviors and attitudes

OBJECTIVE

We investigated relationships among gender, impulsivity and disordered eating in healthy college students.

METHOD

Participants (N=1223) were healthy, undergraduate men (28.5%) and women (71.5%), who completed the Barratt Impulsiveness Scale - Version 11 (BIS-11) and a four-factor version of the Eating Attitudes Test (EAT-16).

RESULTS

As predicted, mean scores on all four EAT-16 factors were significantly higher for women than for men. Attentional impulsivity was related to poorer self-perception of body shape, more dieting, and a greater preoccupation with food for the sample as a whole. Moreover, motor impulsivity was related to poorer self-perceptions of body shape and a greater preoccupation with food. However, no gender differences emerged in the relationship between impulsivity and disordered eating attitudes.

DISCUSSION

This study elucidates the role of impulsivity in disordered eating behaviors among non-clinical college students. For both women and men, attentional and motor impulsivity were related to disordered eating attitudes and behaviors. Overall, these findings suggest that different facets of impulsivity are related to disordered eating attitudes and behaviors in a non-clinical college population.

Comparison of disordered eating symptoms and emotion regulation difficulties between female college athletes and non-athletes

The purpose of the study was to compare the prevalence of disordered eating between female college athletes and non-athletes and explore emotion regulation as a potential mediator of the link between participation in athletics and disordered eating symptoms. Data for this cross-sectional study came from 527 college students in a mid-western state of the USA in fall of 2013 (376 non-athletes and 151 athletes). Disordered eating symptoms and emotion regulation were assessed utilizing the Eating Attitudes Test and the Difficulties with Emotion Regulation Scale in a survey-based format. The prevalence of disordered eating was higher in non-athletes (16.5%, vs. 6.6%; X(2)=62.8; p<.05). Non-athletes reported more signs and symptoms of disordered eating than athletes (p<.01). A linear regression approach indicated a statistically significant indirect effect (0.63, CI95=0.18, 1.20) of athletic-status on disordered eating via emotion regulation; however, this effect did not reach practical significance. Our findings show that female athletes in our sample were somewhat protected from disordered eating compared to non-athletes, but the mechanism of this relationship is unclear. A further in-depth examination of other factors, such as self-esteem and body satisfaction, that may have contributed to this finding is warranted utilizing a large sample of female college students and athletes representing a variety of sports.

Exploring the motives and mental health correlates of intentional food restriction prior to alcohol use in university students

This study explored the prevalence of and motivations behind ‘drunkorexia’ – restricting food intake prior to drinking alcohol. For both male and female university students ( N = 3409), intentionally changing eating behaviour prior to drinking alcohol was common practice (46%). Analyses performed on a targeted sample of women ( n = 226) revealed that food restriction prior to alcohol use was associated with greater symptomology than eating more food. Those who restrict eating prior to drinking to avoid weight gain scored higher on measures of disordered eating, whereas those who restrict to get intoxicated faster scored higher on measures of alcohol abuse.

Alcohol, Appetite and Loss of Restraint

Alcoholic beverages have long been associated with feasts, celebration and marking special events. Today, it is commonplace to consume alcoholic beverages before, with and/or after a meal. Alcohol provides additional pleasure to the meal and enhances appetite. However, consuming an alcoholic beverage with or before a meal is associated with poor short-term energy compensation; energy from alcohol is additive to total energy intake with the added property of stimulating further eating. Limiting alcohol intake is an obvious means to reduce total energy intake for those who wish to lose weight. However, dieters and restrained eaters drink more and report greater binge drinking than unrestrained eaters despite employing cognitive strategies to reduce their intake. Increased intake may be attributable to greater attentional bias to alcohol related cues as well as to food cues, since these are more salient to those limiting intake. Alcohol increases energy intake in dieters, in part due to abandonment of restraint (disinhibition) and consumption of forbidden items including alcohol exacerbates attempts to resist temptation. Paradoxically, links between binge drinking or increased drinking frequency to overweight and obesity may be mediated by dietary restraint. Efforts to limit food and alcohol intake for weight control appear to be unsuccessful and have the net effect of promoting overconsumption. The potential role of restrained eating in the association between alcohol, appetite and obesity has been overlooked by much of the current research and further investigation of this is therefore warranted.

Protective Behavioral Strategies and Alcohol Use Outcomes Among College Women Drinkers: Does Disordered Eating and Race Moderate This Association?

The current study examined the degree to which associations that protective behavioral strategy use had with alcohol consumption and alcohol-related negative consequences were moderated by disordered eating and race. Participants were 382 female undergraduates (ages 18-25) who had consumed alcohol at least once within the previous month. Participants completed online self-report measures concerning their use of protective behavioral strategies, disordered eating, weekly alcohol consumption, harmful drinking patterns, and alcohol-related negative consequences. White non-Hispanic women who used the fewest protective behavioral strategies reported the highest levels of alcohol consumption and harmful drinking patterns. Protective behavioral strategy use was associated with lower levels of alcohol-related negative consequences except for African American women with low levels of disordered eating behaviors. For interventions targeting drinking among college women, disordered eating behaviors may increase risky behaviors and qualify relationships between protective behavioral strategies and alcohol-related negative consequences. Thus, assessment of disordered eating behavior as part of drinking interventions may be helpful.

Psychiatric co-morbidity in women presenting across the continuum of disordered eating

OBJECTIVE

To compare the prevalence and correlates of psychiatric co-morbidity across a large sample of college women without an eating disorder, those at high risk for an eating disorder and women diagnosed using DSM-5 criteria for an eating disorder.

PARTICIPANTS

549 college women aged 18-25.

METHODS

Data from the Eating Disorder Examination, the Structured Clinical Interview for DSM-IV Axis I disorders and self-report questionnaires were analyzed using logistic regression for categorical data and ANCOVA for continuous measures.

RESULTS

Eating disordered symptomatology was strongly associated with anxiety disorders, mood disorders and insomnia. These co-morbidities (type and severity) tend to increase with eating disorder symptom severity.

CONCLUSIONS

Prevention and treatment programs for eating disorders need to address the high levels of mood, anxiety and sleep problems in this population. The findings on insomnia are novel and suggest that sleep disturbance may play an integral role in eating-related difficulties.

Evaluating eating behavior treatments by FDA standards

Behavioral treatments for obesity are not evaluated by the same criteria as pharmaceutical drugs, even though treatments such as low-calorie dieting are widely prescribed, require patients' time and investment, and may have risks. The Food and Drug Administration (FDA) has a procedure for evaluating drugs, in which drugmakers must answer the following questions: (1) Is the treatment safe? (2) How dangerous is the condition the intervention is treating? (3) Is the treatment effective? (4) Is the treatment safe and effective for large numbers of people? We argue that using this framework to evaluate behavioral interventions could help identify unanswered research questions on their efficacy and effectiveness, and we use the example of low-calorie dieting to illustrate how FDA criteria might be applied in the context of behavioral medicine.

Characteristics and behaviors of non-overweight college students who are trying to lose weight

The purpose of the current study was to examine characteristics and behaviors of college students who perceive themselves as underweight or about the right weight, yet report trying to lose weight, as compared to their counterparts. Participants included 944 students (M = 20.4 years, 61.1 % White; 64.7 % female) at a southwestern university. A composite of perceived weight and weight-related behavior was created. Participants who reported they were under- or about the right weight and trying to lose weight were included in this composite group. Cross-sectional logistic regression analyses were run to assess characteristics and behaviors of the composite group. Individuals in this group were significantly more likely to be women, in a fraternity/sorority, have a lower body mass index, engage in regular vigorous physical activity, exercise and/or diet to lose weight, and engage in unhealthy weight-control behaviors. These individuals were not more likely than their counterparts to consume 5 or more servings of fruits/vegetables daily, to engage in moderate physical activity, or to report smoking cigarettes in the past month. Further research is needed to understand why individuals who perceive themselves as under- or about the right weight engage in certain weight-loss behaviors. Interventions to target weight-related perceptions and behaviors among college-age individuals may need to address unhealthy weight-control measures.

Effects of motivational interviewing intervention on blackouts among college freshmen

PURPOSE

Alcohol and illicit drug abuse is a serious public health issue facing college students. This study examined the impact of motivational interviewing (MI) as an intervention on the rate of blackouts among freshmen who engaged in high-risk drinking and illicit drug use.

DESIGN

A sample of 188 volunteer freshmen from a university were administered the Daily Drinking Questionnaire, the Rutgers Alcohol Problem Index, and the Government Performance and Results Act at baseline and again at 6 months postintervention. MI was applied at baseline and then again at 2 weeks, 3 months, and 6 months.

METHODS

Generalized estimated equations and logistic regression models were used to determine associations between the rate of blackouts and time, ethnicity, gender, illicit drug use, and alcohol consumption.

FINDINGS

At 6 months, the rate of blackouts decreased from 40% at baseline to 16% (p < .0001). The average number, time, and days of drinking and frequency of drug use also decreased significantly (p < .0001). An association between rate of blackouts and gender was observed, but not with ethnicity.

CONCLUSIONS

MI had an impact on reducing alcohol consumption and the rate of blackouts among college freshmen who were engaging in high-risk drinking and illicit drug use.

CLINICAL RELEVANCE

The findings support the importance of using MI with freshmen college students to decrease drinking and the associated negative consequences, including blackouts, which has particular relevance for advanced practice registered nurses, physicians, and community health nurses who conduct MI as an intervention with college students.

Sweetened-fat intake sensitizes gamma-aminobutyric acid-mediated feeding responses elicited from the nucleus accumbens shell

BACKGROUND

There is much interest in exploring whether reward-driven feeding can produce druglike plasticity in the brain. The gamma-aminobutyric acid (GABA) system in the nucleus accumbens (Acb) shell, which modulates hypothalamic feeding systems, is well placed to "usurp" homeostatic control of feeding. Nevertheless, it is unknown whether feeding-induced neuroadaptations occur in this system.

METHODS

Separate groups of ad libitum-maintained rats were exposed to daily bouts of sweetened-fat intake, predator stress, or intra-Acb shell infusions of either d-amphetamine (2 or 10 μg) or the μ-opioid agonist D-[Ala2, N-MePhe4, Gly-ol]-enkephalin (DAMGO, 2.5 μg), then challenged with intra-Acb shell infusion of the GABAA agonist, muscimol (10 ng).

RESULTS

Exposure to sweetened fat robustly sensitized muscimol-induced feeding. Sensitization was present 1 week after cessation of the palatable feeding regimen but had abated by 2 weeks. Rats exposed to sweetened fat did not show an altered feeding response to food deprivation. Repeated intra-Acb shell infusions of DAMGO (2.5 μg) also sensitized intra-Acb shell muscimol-driven feeding. However, neither repeated intra-Acb shell d-amphetamine infusions (2 or 10 μg) nor intermittent exposure to an aversive stimulus (predator stress) altered sensitivity to muscimol.

CONCLUSIONS

Palatable feeding engenders hypersensitivity of Acb shell GABA responses; this effect may involve feeding-induced release of opioid peptides. Heightened arousal, aversive experiences, or increased catecholamine transmission alone are insufficient to produce the effect, and a hunger-induced feeding drive is insufficient to reveal the effect. These findings reveal a novel type of food-induced neuroadaptation within the Acb; possible implications for understanding crossover effects between food reward and drug reward are discussed.

Are restrained eaters accurate monitors of their intoxication? Results from a field experiment

Brief interventions encourage college students to eat more before drinking to prevent harm (Dimeff et al., 1999), although many women decrease their caloric intake (Giles et al., 2009) and the number of eating episodes (Luce et al., 2012) prior to drinking alcohol. Participants were 37 undergraduate women (24.3% Caucasian) who were recruited from a local bar district in the Midwest. This study examined whether changes in eating after intending to drink interacted with dietary restraint to predict accuracy of one's intoxication. Results indicated that changes in eating significantly moderated the relationship between dietary restraint and accuracy of one's intoxication level. After eating more food before intending to drink, women higher in restraint were more likely to overestimate their intoxication than women lower in restraint. There were no differences between women with high levels and low levels of dietary restraint in the accuracy of their intoxication after eating less food before intending to drink. Future research would benefit from examining interoceptive awareness as a possible mechanism involved in this relationship.

Eating Disorders Examination Questionnaire (EDE-Q): norms for US college students

PURPOSE

To present normative data for the Eating Disorders Examination Questionnaire, 6th edition (EDE-Q) from a large (n = 2,448), diverse (56 % White) sample of college students.

METHODS

Participants completed the EDE-Q online. Mean scores and percentile ranks for global and subscale (restraint and eating, weight, and shape concerns) scores and binge eating and inappropriate compensatory behavior (dietary restraint, self-induced vomiting, medicine misuse, excessive exercise) frequencies were computed.

RESULTS

Women had higher global and subscale scores and tended to engage in inappropriate compensatory behaviors more often than men. Women with clinically significant restraint, and eating, shape, and weight concerns scores equaled 5.4, 2.0, 18.6, and 13.0 %, respectively, and, for men, equaled 3.0, 0.3, 6.0, and 2.0 %. Compared with less diverse samples, women in this study had significantly higher shape concern and lower restraint and eating concern scores and men had lower shape and weight concern scores.

CONCLUSIONS

Normative data from this diverse sample can help healthcare professionals and researchers better interpret EDE-Q scores.

Gender differences in the associations among body mass index, weight loss, exercise, and drinking among college students

OBJECTIVE

To explore gender differences regarding weight management behaviors of college drinkers.

PARTICIPANTS

Nationally representative sample of college students from the fall 2008 American College Health Association's National College Health Assessment II (N = 26,062 students).

METHODS

Structural equation modeling was used to examine potential gender differences in associations among exercise, weight loss behaviors, and alcohol use.

RESULTS

Critical ratio tests revealed that associations between exercise and weight loss behaviors were more strongly correlated among females as compared with males. For females, there was a small negative association between exercise and drinking behaviors; in contrast, for males, there was a positive relationship between exercise and alcohol use. Weight loss behaviors were positively associated with drinking for both female and male students; however, the association was significantly stronger for females.

CONCLUSIONS

This investigation furthers previous research on drunkorexia and also sheds additional light on the gender-based differences in weight management behaviors of drinkers.

Alcohol consumption as a function of dietary restraint and the menstrual cycle in moderate/heavy ("at-risk") female drinkers

Previous research suggests that women who report dietary restraint tend to consume alcohol in greater quantities, however most studies use retrospective data collection, which is often unreliable, and no studies have accounted for this relationship with respect to potential changes in alcohol consumption across the menstrual cycle. Therefore, the present study investigated the relationship between prospectively monitored drinking patterns and dietary restraint across the menstrual cycle among females from the general population whose drinking level (7-20 drinks/week) places them at-risk for developing alcohol use disorders. Restrained eaters (RES; N=51) and unrestrained eaters (UN-RES; N=55), per the cognitive restraint scale scores from the Three-Factor Eating Questionnaire, provided prospective ratings measuring mood, alcohol consumption, and consequences of alcohol use across one full menstrual cycle. Dysphoric mood increased during the late luteal and menstrual phases in both groups. Although overall the RES group did not drink more than the UN-RES group, the RES group drank less than the UN-RES group during the follicular phase, suggesting that among RES women alcohol consumption may be modulated by hormonal fluctuations across the menstrual cycle. The differences between the present findings and previous research may be due to the cohorts sampled; the majority of previous studies sampled college students, where binge drinking and dietary restraint are more common, whereas this study sampled the general population. Future research should replicate prior studies in a college-aged population using the current design of prospective data collection for greater accuracy of self-reported alcohol consumption.

From disordered eating to addiction: the "food drug" in bulimia nervosa

The high prevalence of substance abuse in individuals with bulimia nervosa (BN) and the pervasive symptom substitution in many types of drug addiction suggest that a number of substances--including food--can impair an individual's self-control, even in the presence of negative consequences. Nonetheless, the neurobiological similarities between BN and drug addiction are not clearly established. This review explores how the specific eating patterns seen in BN (binge eating and purging, with intermittent dietary restriction) are particularly addictive and differentiate BN from other eating disorders and obesity. A number of peripheral and central biological aberrations seen in BN may result in altered reward sensitivity in these individuals, particularly through effects on the dopaminergic system. Neurobiological findings support the notion that BN is an addictive disorder, which has treatment implications for therapy and pharmacological manipulations.

Development and validation of the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS)

The goal of the current investigation was to develop and validate a measure to assess an individual's eating-related behaviors related to alcohol consumption, specifically behaviors intended to compensate for calories so that more alcohol could be consumed or restrict calories to enhance the psychoactive effects of alcohol consumption. Two hundred and seventy four undergraduate students (n=51 males; 75.2% Caucasian) completed a newly developed scale, the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS), along with measures of eating restriction, bulimia, and body dissatisfaction. An exploratory factor analysis on the CEBRACS revealed the existence of 4 clear-cut factors: alcohol effects, bulimia, dieting and exercise, and restriction. Internal consistency statistics for all subscales ranged from .79 to .95. Pearson product-moment correlations between the CEBRACS and measures of bulimia, restriction, and body dissatisfaction ranged from .04 to .44. T-tests revealed no gender differences in compensatory eating behaviors. Future research directions and limitations of the current study are discussed.