Differences in alcohol-related variables between individuals who engage in food and alcohol disturbance (FAD) behaviors and those who only use alcohol: The role of FAD motives.

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. Data were from the Stimulant Norms and Prevalence 2 (SNAP2) study, which included 5,809 undergraduates from six US 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. 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. Engagement in FAD is linked to increased likelihood of poor alcohol outcomes versus alcohol use alone, and FAD for both motives represents the highest risk group.