In the context of eating disorders, purging typically goes hand-in-hand with bingeing. However, the latter is not necessary for compensatory behaviors to occur. Purging, which can include self-induced vomiting, laxative or diuretic abuse, enemas, and compulsive exercise, can also follow a small or relatively normal-sized meal. This is referred to as purging disorder.
Bulimia nervosa is characterized by both bingeing and purging. Compensatory behaviors without bingeing can also be found in those with anorexia nervosa. However, if an individual’s symptoms do not fit the other diagnostic criteria for these disorders, then purging disorder might be present.
Many people mistakenly believe that eating disorders are only present if there is a dramatic weight loss. This is not true, and is often not representative of individuals with purging disorder, though weight fluctuations are common. There are other specific behaviors that can serve as red flags for purging disorder.
What is purging disorder?
Purging disorder is included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) under the classification of Other Specified Feeding and Eating Disorder (OSFED). Though there are no current statistics on how many individuals are affected by this condition, the signs and dangers of purging on both the mind and body are well understood within the eating disorder community.
Compensatory behaviors are typically done in secret. As with other eating disorders, purging disorder is closely associated with shame and self-loathing.
Individuals struggling with purging disorder often isolate during and after mealtimes, avoiding meals with friends or big parties where they might be unable to purge following food consumption of any kind.
Engaging in compensatory behaviors can become addictive. Self-induced vomiting can actually change an individual’s brain chemistry, affecting serotonin levels and releasing endorphins.
This can result in a high that those with purging disorder might strive to recreate following a meal. Similarly, it can be difficult to cease laxative use if an individual’s body has become reliant on them to produce bowel movements.
If you notice a loved one regularly going to the restroom directly following every meal, this can be indicative of purging behaviors. Likewise, if someone does not have gastrointestinal problems but consistently has diarrhea, this can be a sign of laxative abuse.
Physical and psychological impact
Different forms of purging can have similar physical side effects. These include dehydration, electrolyte imbalance, and vital organ damage. Additionally, self-induced vomiting can lead to dental problems, swelling of the throat, and broken blood vessels in the face and neck. Laxative abuse can result in rectal bleeding, chronic diarrhea, or constipation without the aid of laxatives.
There are serious psychological side effects of purging, as these behaviors are addictive and can become a compulsion. Purging in any form is often implemented to cope with feeling out of control and/or to relieve anxiety, but it undoubtedly exacerbates both in the long run.
These effects are similar to those of other eating disorders, including irritability, mood swings, and increased anxiety, particularly when the individual is unable to engage in behaviors.
Eating disorders typically trick those who are struggling into believing their behaviors are the one thing keeping them above water. In reality, disordered eating and compensatory behaviors can force an individual into isolation and increase co-occurring mental health conditions. The chemical changes that self-induced vomiting causes in the brain can also directly contribute to depression and anxiety.
Barriers from seeking help
Awareness and observing behaviors can be helpful for family members to recognize that a loved one is struggling, but it is vital that confrontation is done in a sensitive way. Shaming an individual for his or her behaviors will only increase self-loathing and create distance between you and your loved one.
Many individuals are hesitant to admit to themselves and others that their disordered behaviors are a problem. As previously mentioned, they believe their eating disorders are helping them.
No one can be forced into recovery, as this will not have lasting success. However, loved ones can help an individual see the damage purging disorder has had on their lives and relationships, encouraging them to seek help.
If your loved one is grappling with purging disorder, immediate professional attention is recommended. Early intervention is the most effective treatment for eating disorders.
Community Discussion – Share your thoughts here!
Have you or your loved one struggled with purging disorder? What types of medical treatment have you incurred to assist healing from the physical side effects of purging?
About the Author: Courtney Howard is the Administrative Assistant for Eating Disorder Hope and Addiction Hope. She graduated summa cum laude with a B.A. from San Diego State University, holds a paralegal certificate in Family Law and is a Certified Domestic Violence Advocate. After obtaining her certification as a life coach, Courtney launched Lionheart Eating Disorder Recovery Coaching in 2015 and continues to be a passionate advocate for awareness and recovery.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on February 12, 2018
Published on EatingDisorderHope.com