Drinking and Eating

4 September 2019

Researchers:

Dr Jacinta Tan and Ms Gemma Johns, Swansea University

Key findings

  • A clear correlation between GP diagnoses of eating disorders and alcohol dependency using routine clinical data.
  • Themes demonstrating a relationship between eating behaviours and drinking among people dependent or misusing alcohol.
  • A clear correlation between alcohol use and eating disorders from the perspective of people with eating disorders and clinicians.
  • More research is needed to explore these issues further and gain a better understanding of the interaction between the two.
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Introduction

This report provides an overview of the findings from a recent research project exploring the relationship between drinking and eating behaviours. Methods of data collection and analysis included the use of routine clinical data; focus group discussions and online surveys. The findings demonstrate that there is a clear correlation between alcohol use and eating disorders from the perspective of people with alcohol dependency or misuse, people with eating disorders and members of staff working in these services. It is recommended that more research is needed in this subject area to gain deeper understanding of the interaction and links between alcohol use and disordered eating behaviours.

Background

Alcohol dependency and misuse are characterised as ‘drinking excessively’ beyond recommendations based on alcohol consumption as measured in units and an eating disorder is defined as ‘abnormal eating behaviours’ which can involve eating too much or too little. Both disorders can threaten a person’s health, wellbeing and even life. A co-occurring relationship between the two can increase a person’s risk for significant complications. Research demonstrates a significantly high co-occurrence of alcohol misuse and eating disordered behaviours with co-occurring interactions of the two reported at nearly 50 per cent – a rate of nine times greater than the general population.

Methods

This research sought to capture a range of experiences from people with alcohol dependency or misuse, or people with an eating disorder, to explore possible links and relationships between the two. A mixed methods approach using both quantitative and qualitative data collection and analysis was taken for this research using three separate methods including a small exploratory study using a clinical database, focus group discussions, and two online surveys.

Findings

  • Findings demonstrate a clear correlation between GP diagnoses of eating disorders and alcohol dependency, showing a high odds ratio.
  • Three themes emerged from discussions with people with alcohol dependency or misuse:
    • Theme 1: No matter the level of severity or stage of a person’s alcohol misuse, the importance of food and nutrition was relegated to a ‘secondary’ priority for a variety of reasons
    • Theme 2: A good relationship with food was embodied with the concept of ‘love, care and pleasure’ associated with good and caring relationships as opposed to the solitary and isolated relationship with alcohol.
    • Theme 3: Concern about the ‘alcohol wheel’ as triggering those more susceptible to an eating disorder in alcohol services.
  • In the two online surveys, it was widely accepted amongst both clinicians and people with eating disorders that there is a clear correlation between alcohol use and eating disorders.

Implications

Although the numbers were too small in this research to be sure, it identifies that there are many potential associations between alcohol use and eating behaviours for people who are seen in either eating disorder and alcohol services. Both groups of people appear to be at risk of developing problems in both areas of drinking and eating. Where this comorbidity occurs, there is a raised risk of a range of both physical and psychological health concerns.

Conclusion

This research identified some intriguing patterns and associations between eating and drinking behaviours. We suggest that larger-scale, in-depth research is needed to advance understanding in this area, to tease out and develop a deeper understanding of the interaction between eating behaviours, eating disorders, and alcohol misuse and dependency.