Food and Alcohol Disturbance (FAD) in the US and France: Nationality and gender effects and relations to drive for thinness and alcohol use

Objective: Food and Alcohol Disturbance (FAD), colloquially coined "drunkorexia," is a set of behaviors that encompasses restriction of calories, over-exercise, and other compensatory behaviors before, during, or after alcohol use to offset caloric intake or maximize intoxication. To date, this phenomenon has not been compared in a cross-cultural sample. Method: The Compensatory Eating and Behaviors Related to Alcohol Consumption Scale (CEBRACS), Eating Disorder Inventory - Drive for Thinness Subscale (EDI-DT) and Alcohol Use Disorders Identification Test of Consumption (AUDIT-C) were completed by 502 American (73% female) and 365 French (68% female) college students. Results: Just over half (56.70%) of French and American (55.83%) participants engaged in FAD. Nationality was found to be a significant moderator of the relationship between alcohol use and FAD for both compensatory (p =. 013) and intoxication (p =. 01) purposes, such that Americans who drank more engaged in more FAD. Further, nationality moderated the relationship between drive for thinness and FAD for compensatory purposes (p =. 005), but not for intoxication purposes (p =. 10). At higher levels of drive for thinness French participants were more likely to engage in FAD for compenatory purposes. Discussion: There is growing concern around how maladaptive eating and drinking behaviors intersect within the college population. These findings suggest that FAD is present cross-culturally, but that the relationships between predictors vary across culture. Thus, culture should be taken into consideration in the development of interventions for FAD.