The weekend is synonymous with sleeping in, cheat meals, and drinking alcohol — sometimes in excess. So, you may find yourself trying to curb some of the damage by even counting calories on your alcohol of choice. In some case, this leads drinkers to calorie-swap food for a glass of wine to control dietary intake and maximize the effects of alcohol — also known as “drunkorexia.”

Counting Calories: The Food Swap

It is recommended for a healthy man or woman to consume 2,000 calories per day, according to the Food and Drug Administration. This helps consumers easily calculate the Daily Values needed for their own diets. Daily calorie intake is also one of the largest determinants of overweight and obesity, which is why counting calories is essential for weight management.

Living off a 2,000-calorie diet means you have to pick and choose where you get your sources of nutrition. A drunkorexic will limit their food/calories during the day, says Dr. Vanessa Pawlowski, a psychologist with a private practice in Beverly Hills, Calif., so that when they drink at night they do not have to worry about gaining weight from the extra calories of alcohol. “Sometimes people will also eat excessively while drinking and may throw up to compensate the calorie intake. Or people may also exercise excessively to burn calories associated with drinking,” Pawlowski told Medical Daily in an email.

These alcoholic drinks oftentimes contain little or no nutritional value, which leaves consumers malnourished and intoxicated. Alcohol contains about 7 calories per gram, which is almost as much as its fat, which contains 9 calories per gram. This adds up if you drink a 12-ounce of five-percent alcohol beer that has about 150 calories. Meanwhile, a 4-ounce glass of dry wine comes in at 100 calories.

A night of drinking adds up and encourages drinkorexics to not eat and “save” themselves for a few glasses of wine instead. This introduces the concept of binge drinking, especially on the weekend. A recent study by the Centers for Disease Control and Prevention found it’s not college students or teenagers, but rather middle-aged Americans, between the ages of 35 and 64, who are most likely to die from drinking too much alcohol too quickly. This counters the popular perception that young people are more likely than their elders to die from alcohol poisoning.

However, it is undeniably apparent drinkorexia is more likely to take place in college where women are very sensitive to weight gain, according to Pawlowski. As many as 10 percent of college women suffer from a clinical or nearly clinical eating disorder, including 5.1 percent who suffer from bulimia nervosa.  The social dialogue on weight issues tend to affect women more so than men. This makes women more susceptible to the effects of drinkorexia than men due to the pressures of being thin while they still go out and drink heavily.

Health Effects Of Drunkorexia: An Eating Disorder?

Drunkorexia is not considered an eating disorder, but seen as a disordered approach toward eating that can easily trap people. However, it does have the underpinnings of anorexia because of the unhealthy behaviors attached to it, such as starvation. Drinking on an empty stomach can become a lethal combination and lead to faster drunkenness.

Drunkorexic behaviors, such as the belief that calories skipped in food can be replaced by alcohol, can produce destructive outcomes. These include alcohol poisoning, susceptibility to violence or unwanted sexual encounters, and alcohol-related brain damage, among many others. Although anyone can struggle with drunkorexic behaviors, a 2010 study published in the Journal of Alcohol and Drug Education found there is a strong connection between people with a history of eating disorders and alcohol dependency, and having a predisposition to an eating disorder increases likelihood of alcohol abuse.

Dr. Lauren Ampolos, a program director of Ai Pono Maui, a residential treatment facility for eating disorders in Maui, Hawaii told Medical Daily in an email: “Someone who regularly engages in [drunkorexia] will typically meet criteria for "Other Specified Eating or Feeding Disorder" (OSFED).” This is especially true if the person is unable to maintain normal body weight or if they’re engaging in compensatory behaviors, like vomiting or over exercising to get rid of the calories. Ampolos warned this should be assessed by a professional as soon as possible.

Drunkorexia can also take more of a physical toll on women than men. Women tend to have more body fat than men, and since alcohol is not stored by fat, it passes in great amounts into the bloodstream. In addition, women have less dehydrogenase — an enzyme that metabolizes alcohol — which causes the alcohol to remain in the blood for longer.

This pathological fear of fatness can also lead to a malnourishment not just in calories, but also in nutrients such as vitamins, minerals, and amino acids. Kevin Meehan, a holistic practioner and founder of Meehan Formulations in Jackson, Wyo., explained to Medical Daily in an email ethanol ingestion leads to the loss of components that are essential for staying healthy. These include B vitamins, particularly thiamin, riboflavin and niacin. “When this occurs, long-term effects such as “heart problems, muscle wasting, and pre-diabetes are more likely to develop,” he said.

Counting Calories: The Healthy Way To Drink Alcohol

One of the most commonly asked questions is “how can you drink alcohol and have a flat stomach too?” The truth is even the healthiest ways to drink alcohol aren’t really that healthy, but the key is in moderation.

Ampolos advises: “Don't restrict calories in order to consume alcohol. It is critical to continue eating a healthy and balanced diet regardless of what we do in life. Having a drink is no different. If you want to enjoy a glass of wine or beer, do so knowing that your body is resilient and is unlikely to change based on that choice. Also, know your limits and avoid binge drinking, which is often detrimental to one's health.”