Ecco una traduzione completa in inglese, mantenendo il taglio medico-divulgativo e professionale degli articoli precedenti. Ho reso drunkorexia il termine principale, spiegandolo alla prima occorrenza.Scrittura“Drunkorexia” or Alcohol-Related AnorexiaWhenever new names are coined, a new “condition” can suddenly become newsworthy, as happened with “drunkorexia,” sometimes referred to as alcohol-related anorexia. This is not actually a new form of eating disorder: it is a pattern of disordered eating behaviour that has long been known and simply re-emerges as an apparent novelty under a new name.People who are concerned about controlling their weight can broadly be divided into two categories. There are those who—dangerously—succeed in losing weight and continue moving towards an increasingly low ideal weight; and there are those who manage to control their weight successfully at certain times, find it more difficult at others, and at other times simply “let themselves go,” and so on.Someone who loses weight through particularly effective self-control may eventually run the risk of developing anorexic psychosis, in which they perceive themselves as fat and strive by any means possible to reach levels of thinness that are incompatible with life. A characteristic feature is that the fear of gaining weight becomes greater the thinner the person becomes, rather than the opposite.When people with anorexia lose contact with reality in this way, they may also tend to regard “weight” as an abstract concept more closely related to control and, more generally, to mass, rather than to body fat or physical shape.Those who are unable to control their weight and therefore remain heavier than they would like, or who maintain their desired weight only with considerable effort, are usually looking for ways to reduce that effort.In the past, for example, amphetamines—which are now almost entirely prohibited for this purpose—were used to remain thin, energetic, and awake for long periods, with toxic consequences both for behaviour and for intellectual performance.Alcohol can become another such tool, and this is not particularly surprising. Normally, alcohol does not interfere with eating. On the contrary, it commonly accompanies a meal, precedes it as an aperitif, is traditionally thought to “open the appetite,” and facilitates enjoyment of the meal as a social occasion.Some individuals, however, may use alcohol—even without enjoying its taste or its effects—to suppress their appetite, driven by the intention of avoiding food.A certain degree of intoxication can reduce the urge to eat and may instead cause nausea, a feeling of fullness or satiety, and relief from the discomfort associated with hunger.Using alcohol in this way over time is dangerous for three main reasons.First, it facilitates the continuation of the eating disorder by reinforcing the person's preoccupation with food and weight.Second, it may develop into an independent problematic relationship with alcohol, particularly in individuals who are genetically predisposed to alcohol dependence.Third, obtaining one's nutritional intake from alcohol, even if the caloric intake appears equivalent, constitutes malnutrition. Alcoholic beverages are not nutritionally complete foods: they do not provide all the essential nutrients required for metabolism, and alcohol itself is toxic to many tissues, including the gastrointestinal mucosa.Some people who use alcohol to suppress their appetite may even rely on its toxic effects—for example, its irritating effect on the gastric mucosa—in an attempt to end the “alcoholic meal” by vomiting and thereby eliminate some of the calories consumed from alcohol as well.Internal intoxication and outward nausea are therefore two sides of the strategy that a person engaging in “drunkorexia” may attempt to control.In some cases, the sedative or narcotic effect of excessive alcohol consumption is used to fall asleep and effectively “skip” the usual mealtime, thereby avoiding eating altogether.It is worth emphasizing that it has long been recognized that some people with anorexia drink alcohol in order not to eat or in order to induce vomiting, while people attempting to avoid binge-eating may instead binge on alcohol, redirecting the drive to consume and attempting to limit their effective caloric intake, sometimes subsequently vomiting part of the alcohol.A further complication may arise when weight control becomes increasingly unsuccessful. In an attempt to relieve the anxiety and shame associated with weight gain or with the perceived loss of control, the person may become intoxicated. This can in turn worsen weight gain and also aggravate associated depression or agitation, including suicidal impulses.Another aspect of “drunkorexia,” particularly in eating-disorder patterns with bulimic features, is the emergence of disinhibited or aggressive behaviour. The person may initially find such behaviour amusing, or may have little or no precise memory of it after becoming intoxicated, while instead feeling satisfied that they have managed not to eat.For all these reasons, anyone who becomes persistently preoccupied with controlling their weight or physical appearance should understand that this apparently effective solution—as with many other such strategies—is not a way out of the problem. Instead, it may reinforce and perpetuate the problem, while often introducing additional risks.Because the temptation can be particularly strong, and because adolescence and young adulthood are periods in which controlling weight and physical appearance may become central and seemingly non-negotiable goals, it is advisable to seek guidance from a doctor or psychologist. This can help prevent the adoption of destructive strategies under the mistaken belief that an effective new way of controlling weight has been discovered.
