Drunkorexia, Manorexia, Diabulimia: New Eating Disorders?

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

In recent weeks, I have read media reports that mentioned both "drunkorexia" and "manorexia." I have fielded questions about "diabulimia" from coworkers and friends. From the sound of these terms, it appears that there are a lot of new and recently discovered eating disorders. I certainly did not hear the word drunkorexia in medical school.

Actually, these new terms (which, by the way, are not official or standard medical terms) simply refer to subcategories of the well-known eating disorders anorexia nervosa and bulimia nervosa, both of which affect up to 1% of women and a lower percentage of men at some point in their lives.

The term drunkorexia has been coined to describe the condition of binge drinking combined with the typical self-imposed starvation seen with anorexia nervosa. It has also been used to refer to individuals who use purging (as seen with bulimia nervosa) or who have other eating disorders and try to reduce caloric intake to offset the calories consumed in alcohol. The typical individual described as a drunkorexic is a college-aged woman who is a binge drinker, starving all day in order to get drunk at night.

Manorexia simply refers to a male suffering from anorexia nervosa. Estimates suggest that males make up about 10% of those with anorexia nervosa. The disease is similar in males and females and is characterized by a refusal to maintain a normal body weight and distorted perspectives of appropriate body shape and size.

Diabulimia is a form of eating disorder that affects people taking insulin to treat diabetes. It refers to the practice of minimizing insulin dosages by patients with type 1 diabetes mellitus in an attempt to control body weight. Since insulin encourages fat storage, the manipulation of insulin dose is an attempt to reduce weight gain. The term does not refer to a recognized medical condition but to a practice recognized by diabetes experts. Diabulimia is most common in young girls and women with type 1 diabetes.

While the names may be new, all of these conditions refer to established and described eating disorders that are potentially life-threatening. In addition to the health consequences and risks associated with eating disorders, drunkorexics are at risk for complications related to alcohol abuse, while diabulimics, by altering their insulin dosages, are putting themselves at risk for the development of complications related to their underlying diabetes.