Young women with eating disorders are overdoing it with energy drinks

Overconsumption of low-cal, highly caffeinated energy drinks is on the rise among young women with unhealthy eating and exercise habits, say doctors at more than a dozen of the nation’s top hospitals and eating-disorder treatment centers. Taking in too much caffeine can cause serious health problems, especially for people who aren’t eating enough, doctors say.

Brands like Celsius and Alani Nu pitch themselves as fitness aids, and, in the case of Celsius, claim to boost metabolism and burn fat. Attaining a toned body, the brands’ social-media posts suggest, looks as easy as sipping a can of the sparkling sugar-free beverages before a sweat sesh.

At Cleveland Clinic Children’s, about a third of the hospital’s eating-disorder patients consume energy drinks, estimates Ellen Rome, head of adolescent medicine. Teen and young-adult patients frequently arrive for appointments with Celsius cans in hand, she says.

“Social media and peer exposure make these caffeinated drinks look like the next great thing," Rome says.

Anne Arthurs was in treatment for anorexia when she began noticing her classmates at the University of Utah, as well as fitness influencers and TikTok creators, consuming Celsius. Campus vending machines were stocked with energy drinks.

Drinking them seemed normal and healthy, Arthurs thought at the time. And they made her feel full. “I wasn’t getting energy from food so I had to get it from something," says Arthurs, now 22.

Celsius declined to comment. Alani Nu didn’t respond to several requests for comment.

‘I knew I needed to change’

Arthurs had always been weight-conscious, and during the pandemic shutdown in her senior year of high school, the Michigan native’s eating behavior became a problem. She was diagnosed with anorexia as a college freshman and underwent intensive outpatient treatment for a year.

At that time, Arthurs began drinking one, then two cans of Celsius a day, attracted to fruity flavors like Sparkling Orange. Or she’d drink Alani Nu, a rival brand started by fitness influencer Katy Hearn. Both energy drinks contain 200 mg of caffeine per 12-ounce can, equivalent to more than four same-size Diet Cokes. Supplementing her energy drinks with diet soda regularly brought Arthurs’s daily caffeine intake to 500 mg.

Arthurs says her heart raced after a Celsius or Alani Nu and believes they contributed to her anxiety. Other women interviewed for this story described drinking up to 800 mg of caffeine a day—double the amount the Food and Drug Administration considers safe for healthy adults.

Caffeine tends to have stronger effects on women, whose bodies metabolize it more slowly than men, doctors say. While caffeine has been shown to boost athletic performance, high doses can cause heart problems, anxiousness, restlessness and sleep disturbances.

For young women who aren’t eating enough, those effects can be more severe, says Jessica Barth Nesbitt, nutrition director for the Eating Recovery Center’s West and Mountain regions.

Patients also use energy drinks to temporarily boost their vital signs and gain water weight to pass medical exams and avoid hospitalization for eating disorders, doctors say.

Eating problems spiked during the pandemic, and doctors say they’ve noticed a change in patient behavior since. Tom Hildebrandt, chief of the eating- and weight-disorders program at the Icahn School of Medicine at Mount Sinai Hospital in New York, rarely saw patients consuming energy drinks before the pandemic. Now, almost all his patients drink them.

While living at home with her parents in the summer of 2021, Arthurs drank Celsius on the drive to and from work and tossed the empty cans in back. Her dad discovered the trash and her parents confronted her, worried she was relapsing. It was then that she realized how unhealthy her habit had become.

“After scaring my family this much, I knew I needed to change," Arthurs says.

A fit lifestyle

Celsius holds the No. 3 spot in the crowded $21 billion U.S. energy drinks market behind Monster and Red Bull, according to Goldman Sachs. It represents about 10% of energy drink sales in U.S. stores tracked by Nielsen.

Part of that success is due to female customers, marketing experts say. Celsius, Alani Nu and other brands position themselves as part of a fit lifestyle, and Celsius claims to have health benefits.

“Celsius was the first energy brand to really attract women," says Michael Bellas, chairman and chief executive of Beverage Marketing Corp., an industry research firm. Celsius has publicly stated that it has an equal mix of male and female customers. The broader energy drinks market is closer to 60% male, according to Bellas.

Where Red Bull, Monster and Rockstar Energy sponsor motocross racers and skateboarders, female-focused brands espouse wellness and good vibes.

Alani Nu, founded in 2018 and part of a holding company that also sells Prime Hydration energy drinks, has had endorsement deals with Kim Kardashian, Brittany Mahomes and Paris Hilton. Celsius partners with personal trainers, athletes and college brand ambassadors to spread its “Live Fit" motto across campuses and social media.

Celsius and Alani Nu cans typically contain 10 to 15 calories and ingredients such as green-tea extract and B vitamins.

Celsius describes itself as “your partner in an active lifestyle" and lists six studies on its website—all of which it funded—that claim its drinks have calorie- and fat-burning properties and help people increase lean muscle when consumed before exercising.

Alani Nu doesn’t make specific health claims, but states on its website: “Whether you want to hit your last rep, hold your next handstand or balance your hormones, we want to be beside you."

Medical experts say Celsius’s fat-burning and metabolism-boosting messages are misleading. “The studies they use to justify their claims have substantial design flaws with small sample sizes and were conducted over short periods of time," says Aviva Musicus, science director at the Center for Science in the Public Interest, a nonprofit consumer advocacy group.

Elaine Rosen, a doctor who runs UCLA Health’s eating-disorder treatment programs, says the claims are “a match near dry kindling on a hot day" for people susceptible to eating disorders. “It’s promising all your dreams will come true, and it’s being endorsed in the name of health by gorgeous-looking people."

‘I couldn’t get through my day without it’

Kace Boland began trying to lose weight at age 12. At 16 she started drinking coffee to curb her hunger. At 18 she was diagnosed with anorexia.

During her freshman year at Georgetown University in 2019, where she played volleyball, Boland turned to energy drinks to boost her workouts. “What got to me was gymfluencer culture on Instagram," she says.

She started drinking one to two cans of Celsius a day, plus espresso—usually consuming between 400 and 600 mg of caffeine daily, and as much as 800 mg. She found the caffeine suppressed her appetite, but came at a cost to her sleep. Boland often awoke in the middle of the night, heart racing; the insomnia convinced her to wean herself off caffeine.

Now 23 and a pre-med student, Boland considers herself in remission from anorexia and avoids energy drinks.

Arthurs, the former Utah student, transferred to Montana State University and continued treatment for anorexia. As she began to eat more, she slowly gave up energy drinks.

“Now I hate them," she says.

Nicole Earl, who was treated for an eating disorder for nearly a decade, began consuming energy drinks when she was in college and increased her intake during grad school to 600 to 800 mg of caffeine a day.

Starting off with a can in the morning, she says, let her push lunch to 2 or 3 p.m. “I was just pounding them down," she says. After graduation, she tried to cut back.

Earl, now 26 and working as an adolescent therapist near Bowling Green, Ohio, says her eating habits have improved—but she’s still drinking at least one Alani Nu or similar brand a day. Her current therapist now monitors her energy drink consumption to make sure she’s not relying on them.

“I tried to go cold turkey and I made it less than 24 hours," Earl says. “I just can’t separate myself from it."