The inverse association between BMI and past-year alcohol use disorders among women is consistent with previous studies showing negative associations between quantity of alcohol consumed and BMI in women in the general population. Prior research also suggests that women who consume alcohol substitute alcohol calories for other sources of energy (Colditz et al., 1991). If decreased caloric intake explains lower body weight among women with alcohol use disorders, effects of reduced food intake on body weight could be temporary. This could explain why the category of women with lifetime alcohol use disorders, most of whom do not currently meet criteria, do not differ from women without a history of problem alcohol use. The failure to find an association between BMI and alcohol dependence may indicate that women who drink most heavily are consuming excessive calories from alcohol, thereby replacing calories avoided through reduction in food intake. Removing nicotine dependence and drug use disorder covariates resulted in a significant negative association between obesity and past-year alcohol dependence, suggesting that the alcohol dependent women who smoke or use illicit drugs may consume fewer calories than those who do not.
