Why Do Alcoholics Eat So Little?

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Alcoholics eat so little due to gastritis, liver disease and alcoholic ketoacidosis [1] [2].

Alcoholics will eat little whilst having an alcohol use disorder to either:

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Why Don't Alcoholics Eat?

Alcoholics become more focused on drinking and neglect the rest of their needs, including eating a balanced diet [5].

Alcoholism may be caused by, or co-occurring with, depression and anxiety, causing sufferers to eat less [6].

Why Does Alcohol Suppress My Appetite?

Consuming alcohol causes a temporary drop in blood sugar levels and hormones that suppress the appetite [7].

The sugary and carbonated liquids in alcohol cause feelings of fullness [8].

Alcohol As A Hunger Suppressant

Alcohol contains empty calories, filling the stomach without providing the nutritional value usually obtained from food [9].

An alcoholic's sense of taste and smell is dulled due to loss of zinc through excessive urination, further suppressing hunger [10].

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Focus On Drinking And Not Eating

Alcoholics prioritise alcohol financially, both by choosing to buy alcohol instead of food, and buying cheaper foods with lower nutritional value [11].

Some drinkers choose to replace food with alcohol, to offset the calories in alcohol, with consistent food replacement being described as 'drunkorexia' [12].

Alcoholic ketoacidosis occurs after a prolonged drinking binge when the body is in a malnourished state [13].

Alcoholic ketoacidosis may begin when the alcoholic has not eaten food for a day, meaning that the longer an alcoholic is not eating, the more they risk developing alcoholic ketoacidosis [14].

Anion Gap

Anion gap blood test results below 4 mEq/L indicate alkalosis, whereas results above 12 mEq/L indicate alcoholic ketoacidosis [15] [16].

Alkalosis is caused by alcohol abuse, and loss of electrolytes from eating little food [17].

What Does It Mean When An Alcoholic Stops Eating?

An alcoholic stops eating when they have become focussed exclusively on drinking.

Alcoholics obsess exclusively about access to the next drink, and how and when the next drink will occur [18].

Co-occurring issues trigger eating less as a form of attention seeking, including:

  • Low self esteem
  • Anti-social behaviour
  • Insecurity in relationships
  • Depression
  • Anxiety [21]

How Eating Less Develops Over Time

79.1% of university students have been reported to suffer from drunkorexia, with these behaviours being shown to continue into later life, as users rely on alcohol to stay thin [23].

Alcohol use affects digestion, storage and utilisation of nutrients, meaning that even if alcoholics are not consciously consuming less food at first, they are still becoming malnourished, leading to alcohol ketoacidosis [24].

Drinking Alcohol And Not Eating For Days

The pattern of binge drinking means the effects of alcohol are experienced quicker and therefore the brain is unable to prioritise eating over drinking [25].

Alcoholics may give the impression that they are eating well as alcohol's calories are quickly available in the body and boost energy, allowing the alcoholic to keep up drinking and not eating [26].

How Alcoholics Eat So Little

Valencia Martin et al found patterns in how alcoholics consume food including:

  • Not eating enough fruit and vegetables, 3 servings less than non drinkers
  • Skipping meals, particularly breakfast
  • Excessive consumption of meat, fish, eggs and fatty food, 2 servings more than non drinkers [29]

These patterns are linked to alcoholics not prioritising eating [30].

Triggers that cause alcoholics to eat little include a history of trauma and societal or family expectations about physical appearance [31].

Drinking and eating little are rationalised by alcoholics by:

  • Denial - the alcoholic believes that they are able to control cravings and stop drinking whenever they wish
  • Believing that their actions are not hurting anyone - even if there is evidence that it is affecting others
  • Comparing drinking to other drinkers' behaviour, especially those who also drink excessively

These behaviours allow the alcoholic to continue eating little and drinking excessively without changing their actions [32].

Alcoholics mask eating little by:

  • Avoiding eating in public
  • Drinking excessive amounts of water as a food replacement
  • Using mints or mouthwash [33]

Those closest to the alcohol use disorder sufferer may begin to enable the destructive behaviours around drinking, including avoidance, denial and making excuses [34].

Eating Less Due To Alcoholism vs Eating Less Due To Eating Disorder



Eating Disorders

Eats less to drink more

Eats less as a coping mechanism

Eats less due to peer pressure

Eats less due to perceived societal pressure

Eats less during binge drinking

Avoids social occasions with food

When Do Alcoholics Eat So Little

Alcoholics begin to eat less as a result of chasing the original feeling that alcohol gave them before the addiction became chronic, as well as ensuring the feeling of being drunk as tolerance increases.

The cycle that occurs is:

  • Drinking to cope - with either life or work stress
  • Drinking causing job loss, divorce, domestic abuse or homelessness
  • Further alcohol abuse, eating less and other destructive behaviours [39]

Although alcohol gives temporary relief from emotional distress, it later enhances negative emotions such as stress, guilt, anger and trauma [40].

This leads to further heavy drinking, and disordered eating, as the negative emotional cycle continues [41].

When An Alcoholic Eating Less Isn't Obvious

Subtle signs of an alcoholic eating less are:

  • Dry, scaly skin, brittle nails and coarse hair - from hypocalcaemia [42]
  • Nausea and vomiting, headaches and drowsiness and fatigue - from hyponatremia [43]
  • Passing water more often - since alcohol is a diuretic [44]

An alcoholic may be eating less, upon sudden onset of:

  • Acne [45]
  • Alcoholic myopathy [46]
  • High blood pressure
  • Lack of cognitive function [47]
  • Hives
  • Cellulitis
  • Psoriasis
  • Runny or red nose
  • Sun sensitivity [48]

These symptoms indicate not eating food whilst drinking alcohol, even if the alcoholic is still appearing to eat food in front of loved ones.

Additional Risks As A Result Of Not Eating While Drinking

Female drinkers run a 5-fold increased risk of developing eating disorders compared to female non-drinkers [49].

The risk of developing an eating disorder increases by 64% when drinkers believe that their reduced food intake does not offset calories provided by alcohol [50].


Alcoholics Who Do Eat Well

Family and friends provide food for an alcoholic to eat well, thinking that it will help minimise alcohol causing long term damage [51].

High functioning alcoholics do eat well because they use meal times as an excuse to start drinking [52].

Alcohol abuse sufferers who eat well have a more structured support system, for example, a partner who maintains a regular household environment and provides a balanced diet [53].

Alcoholics on higher incomes manage to eat better because they do not have to make the choice between alcohol and food [54].

How To Improve Eating Habits When Drinking

Alcoholics may improve their eating habits when drinking by:

  • Avoiding enablers where possible, and if not possible, taking steps to set boundaries and limit time spent with the enabler [55]
  • Eat before drinking- to allow space for food in the stomach and to lessen the intoxicating effects of alcohol [56]
  • Choose healthy food options- instead of removing food altogether to offset alcohol's calories [57]
  • Identify and begin to resolve emotional triggers causing alcoholism and eating less [58]

When Eating Less Is Not A Result Of Alcoholism

Alcoholism increases the chance of suffering from GERT by 95%, therefore those who suffer with GERT are likely to avoid eating due to its symptoms [59].

Alcoholics with co-occurring disorders which may involve food include:

  • Obsessive compulsive disorder- 24-40% of those who have OCD also suffer with alcoholism [60]
  • Borderline personality disorder- 50% of those diagnosed with BPD have an alcohol use disorder [61]

Reduced eating may be indicative of OCD instead of alcoholism when:

  • Obsessively eating only certain types of food
  • Limiting food that they believe will be difficult to swallow- developing a fear of choking
  • A fear of contaminated food stopping eating
  • Rituals around eating- eating certain amounts and in certain locations [62]

Reduced eating may be indicative of BPD instead of alcoholism when there is:

  • Binge eating followed by vomiting
  • Extreme restriction of food
  • Mood swings
  • Fear of abandonment
  • Controlling behaviour in relationships [63]
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About the author

Harriet Garfoot

Harriet Garfoot BA, MA has an Undergraduate degree in Education Studies and English, and a Master's degree in English Literature, from Bishop Grosseteste University. Harriet writes on stress & mental health, and is a member of the Burney Society. Content reviewed by Laura Morris (Clinical Lead).

Last Updated: December 4, 2023