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Podcast Episode · The Addiction Psychologist · 07/14/2025 · 1h 17m

Objective: Food and alcohol disturbance (FAD) is the use of any compensatory behavior (e.g., skipping meals) within the context of a drinking episode. FAD has two underlying motives: to enhance the effects of alcohol (FAD-AE) and/or compensate for calories consumed from alcohol (FAD-CC). Prior work finds that FAD is positively associated with alcohol-related outcomes; however, it is unclear whether FAD confers increased risk above alcohol use alone and whether there are differences in alcohol outcomes by FAD-motive. Thus, the present study evaluated alcohol use patterns (i.e., past-month quantity/frequency, binge use, consequences, and drinking motives) by FAD status and FAD-motives. Method: Data were from the Stimulant Norms and Prevalence 2 (SNAP2) study, which included 5,809 undergraduates from six U.S. universities. Participants were grouped into four categories: Alcohol-Only, FAD-AE, FAD-CC, and FAD-both (i.e., both FAD-AE and FAD-CC motives). Ordinary least squares regression was used for drinking motives, and quasi-Poisson regressions were used for other outcomes. Results: Alcohol use quantity, frequency, binge use, and consequences were all greatest in the FAD-both group and lowest in the alcohol-only group, with the FAD-AE and FAD-CC groups intermediate and not significantly different from each other. To illustrate, the FAD-both group had 47%, 33%, and 25% greater alcohol-related consequences than the alcohol-only, FAD-CC, and FAD-AE groups, respectively. This stepwise pattern held for drinking motives, with fewer significant differences. Conclusions: Engagement in FAD is linked to an increased likelihood of poor alcohol outcomes versus alcohol use alone, and FAD for both motives represents the highest risk group.

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