Background: Limited research exists on mental health correlates of behaviors of weight-conscious drinking (BWCD) and students' perceptions of how BWCD should be addressed. Purpose: The objectives were to (1) examine BWCD and different aspects of mental health and (2) gain insight into students' perceptions of such behaviors and potential strategies to address them. Methods: Four-hundred-twelve students completed a survey consisting of validated measures for: BWCD, eating disorders, exercise addiction, alcohol use, and psychological distress. Eight focus groups explored students' understanding of BWCD, its presence on campus, and potential intervention strategies. Results: Majority (62%) of participants indicated they engaged in at least one behavior associated with BWCD "very often" or "all the time." Hierarchical linear regression analysis indicated that disordered eating and exercise addiction were significant predictors of BWCD. Focus groups indicated participants struggled with awareness and ability to identify concerning BWCD. Taken together, the results indicated high prevalence of behaviors, but limited awareness of associated health consequences, and identification of BWCD. Discussion: BWCD are pervasive in this college sample, but students do not perceive them as harmful or problematic. Translation to Health Education Practice: There is a need for comprehensive education to address the intersection between alcohol use, exercise, and disordered eating.