Understanding body image in adolescents with drunkorexia behaviors: The roles of body image disturbance, coping strategies and gender

Drunkorexia consists of any calorie compensation or eating restrictive conduct enacted before, during, or immediately after alcohol intake. These behaviors raise many health concerns, but studies on adolescents are still limited. Specifically, understanding how body image impacts adolescent drunkorexia might be crucial for prevention and treatment. Following the multidimensional body image framework, this study investigated the role of various body image features (i.e., body image disturbance, adaptive and maladaptive body image coping) in explaining two types of drunkorexia behaviors in teenage girls and boys: (1) eating-related restrictive and compensative conducts; and (2) overexercising. The participants were 832 alcohol-drinking adolescents aged 15 to 20 years (48.6 % girls), who completed an online anonymous survey administered at school. A multigroup mediation model was estimated in line with the aims of the study. Body image disturbance symptoms were positively related to eating drunkorexia behaviors via the mediating effects of increasing maladaptive coping (avoidance and appearance fixing). However, the same relation was negative when the mediating effect of increasing adaptive coping (positive rational acceptance) was considered. Moreover, body image disturbance was positively associated with exercise-related drunkorexia behaviors via increasing appearance fixing coping. Finally, the indirect effect of body image disturbance on eating-related drunkorexia via appearance fixing was positive and significant only in girls (not in boys). These findings provide indications for implementing prevention and educational programs for schools, and for identifying core themes to address in clinical treatment and public health policies.