Behaviors
The Silent Suffering
Main Menu
Navigation
[Purging]
COMMON METHODS
Self-Induced Vomiting
Laxatives
Diuretics - Also known as "water pills"
Diet Pills
Fasting
Ipecac - A powerful substance, Ipecac is intended to cause vomiting in individuals who have ingested harmful substances, such as poison.
Exercise
CONSEQUENCES
Self-induced vomiting is heavily linked to heart issues such as cardiac arrest and heart attack.
Diuretics are extremely harmful to the body. They dehydrate you and deplete your body of necessary vitamins and minerals required to keep you alive. They also cause an abundance of cardiac issues, including heart attack and cardiac arrest.
Laxatives also upset your body and its fluid and electrolyte balance. your body can become dependent on laxatives and you may lose control over your intestines and bowel movements. They will wreck your digestive system. You may lose the ability to have a bowel movement without the use of them if your body becomes dependent on them.
Most diet pills are EXTREMElY dangerous and can result in death.
Ipecac and self induced vomiting can quickly and suddenly upset your body and it's fluid and electrolyte balance and can lead to cardiac issues and death.
Over-exercising can result in dehydration and injury.
"Frequent vomiting and abuse of laxatives and diuretics leads to loss of potassium, sodium, chloride, hydrogen, and fluid. Additional potassium is lost through renal excretion as the body tries to adjust to the metabolic changes caused by purging. Loss of electrolytes can lead to muscle weakness, cardiac arrythmias, cardiomyopathy, seizures, acute renal failure, convulsions, and coma. Deaths of eating diordered patients have been traced to low blood potassium levels. It is impossible to predict when complications of low electrolytes might occur since patients are usually asymptomatic. In patients who have chronically low potassium levels, minor dips can be fatal." (Herrin, p 168)
Herrin, Marcia. Nutrition Counseling in the Treatment of Eating Disorders. New York: Brunner-Routledge, 2003. Print.
___________________
TYPES OF LAXATIVES
Stimulant-type - Stimulate the intestines to have a bowel movement; it acts on the intestinal wall muscles and increases muscle contractions by being an irritant. This type is the most harmful regarding long-term effects. [Examples: Ex-Lax, Correctol, Ducolax]
Hyperosmotic - Encourages bowel movement by drawing water into intestines from surrounding body tissues. With a low intake of dietary fiber these may cause diarrhea. [Examples: Lactulose, Golytely]
Bulk-Formers - Indigestible fiber that absorbs fluids in the intestines and swell to form a soft stool. Bulky masses in the intestine naturally stimulate the intestines. Adequate amounts of water must be consumed to promote stool. [Examples: Metamucil, Citrucel]
Lubricants - Coat the stool, keeping moisture in for easier bowel movement. [Example: Mineral oil]
Stool Softener - Helps liquid mix into the stool allowing for an easier bowel movement. [Example: Colace]
_______________________________
EFFECTS OF LAXATIVE ABUSE
Constipation
Intestines may become dependent on laxatives making it hard for them to function.
Dehydration
Laxatives cause fluid loss through the intestines. Excessive fluid loss = dehydration = impaired body functioning.
Electrolyte Abnormalities
Electrolytes [sodium, chloride, potassium for example] are removed from the body through stool.
Fluid Retention
Laxatives cause fluid loss, which alters the body's fluid balance. This confuses the body's self-regulation mechanism, causing it to retain more fluid to offset the fluid loss.
Bleeding
Abusing stimulant types of laxatives can cause blood in the stool. Chronic blood loss can result in anemia.
Impaired bowel function
Abuse of stimulant laxatives may permanently damage bowel function. No stimulus = no movement = muscle atrophy.
Rectal prolapse
Long-term/extreme laxative abuse can cause damage to the bowels to the point that they begin to "slip out" [prolapse]. This typically requires surgical intervention.
__________________________
WITHDRAWAL SYMPTOMS
-Constipation
-Fluid Retention
-Feeling bloated
-Temporary weight gain [water/fluid weight]
[The duration of withdrawal varies from person to person.]
_____________________________
MYTHS CONNECTED WITH LAXATIVE USE
"Taking laxatives help in losing weight."
INDUCING DIARRHEA WITH LAXATIVES DOESN'T SIGNIFICANTLY CHANGE THE ABSORPTION OF FOOD. The weight decrease you may see is only dehydration.
Laxatives work near the end of the bowel where they affect primarily the absorption of water and electrolytes. Most of the energy nutrients have already been absorbed.
"Laxatives should be taken every time I feel constipated."
"Feeling" constipated does not mean you are constipated. A sense of constipation can be caused by
1. Not eating enough food
2. Not eating enough fat
3. Eating sporadically
4. Dehydration
5. Stress
Bowel movements do not need to occur every day. Every other day or every three days is adequate.
"Extra fiber will help my bowels wean off laxatives quicker."
Healing the bowels requres moderate amounts of fiber coupled with adequate fluids and ample time, which will allow the healing process to occur.
****This information was taken from my Remuda Ranch workbook****
Diuretics are substances that promote to body to lose fluid through urination.
Medical purpose
-Used to decrease blood volume in individuals with high blood pressure
-Used to decrease edema in individuals with congestive heart failure
-Used to decrease intra-ocular pressure in individuals with glaucoma
Abuse purpose
Weight loss. Like laxatives, diuretics can cause temporary weight loss due to fluid shifts.
Side effects
Electrolyte abnormalities
Rebound edema
____________________________
I HIGHLY DISCOURAGE THE USE OF DIURETICS. YOU WILL NOT, I REPEAT, WILL NOT LOSE WEIGHT FROM THEM. ALL THEY DO IS DEHYDRATE YOU! AND, THEY DEPLETE YOUR BODY OF VITAL NUTRIENTS LIKE POTASSIUM. I ALMOST DIED FROM TAKING DIURETICS AND HAD TO BE ADMITTED TO THE HOSPITAL BECAUSE I WAS LITERALLY MOMENT AWAY FROM HAVING A HEART ATTACK! I WAS FORTUNATE TO HAVE GON TO THE HOSPITAL WHEN I DID AND I COULD HAVE EASILY DIED IN MY SLEEP FROM TAKING THESE.
I KNOW that it is hard, I know that it is much more complicated than just eating or stopping a behavior, but if you are engaging in any of these behaviors, I encourage you to seek help. Eating disorders do kill, even if you don't believe it will happen to you. You only have one life, and it is very precious.
[Exercise Addiction]
Psychological Signs
Compulsion, duty
Loss of pleasure/enjoyment
Continued exercise when sick or injured
Increased anxiety, depression, or decreased self-worth with missed workouts
Daily activities organized around workouts
Only method of stress management
Avoiding underlying problems or issues
Addicted to endorphins, "runner's high"
Exercise used to earn food
Insufficient caloric intake for exercise expenditure
Focused on weight loss
Emphasis on weight and not body composition
Deny need for body fat
Physical symptoms
Difficulty achieving training goals
Frequent injuries, stress fractures
Insomnia, disturbed sleep
Overall fatigue
Extreme muscular fatigue and soreness
Muscle loss/deterioration
Frequent illness, colds/flu
Elevated morning blood pressure and heartrate
Amenorrhea, lack of menstrual cycle
Bone loss
Recovery behavior
Exercise for enjoyment
Exercise is a lifestyle, not a means to an end
Weight is stable within ideal range with activity
Food is the necessary fuel for effective and appropriate exercise
Learn and practice proper training techniques
Vary intensity and type of exercise
Take rest days (1-2 weekly) and blocks of time off each year
Separate self-worth from performance
Learns other coping skills for stress management
Obtain proper support for dealing with underlying issues
Flexibility, mix activities with relationships and fun
Exercise has always been a huge struggle for me and I am still working to find a balance with it. As a result of exercise abuse I have crackly joints and arthritis in my hips and knees (at the ripe age of 26). You can indeed have too much of a "good" thing.
[Self-Induced Vomiting]
Ramifications:
Erosion of enamel of teeth & other dental issues
Gastrointestinal
Gastroparesis
Abdominal pain
Injury to the esophagus, stomach
Stomach rupture
Esophagitis
Tears/holes in esophagus
Fluid & Electrolyte Imbalance
Aspiration of food into lungs
Vomiting can cause a sudden, drastic change in your body, especially with fluid and electrolyte imbalances. This can lead to heart attack or death.
"Patients assume that purging is an effective means of expunging calories consumed during binge-eating episodes. The emptiness they experience after vomiting provides the evidence that this is, indeed, true. it is not uncommon for patients to report that initially purging helped them lose weight despite significant binge-eating episodes. Over time, however, most patients who continue to purge find that body weight does increase. usually purging is part of a cycle of bingeing and purging. some patients binge and purge multiple times per occurence. other patients purge normal sized meals; some purge if they feel even slightly full or if they have eaten something they feel is fattening; and still others purge everything they eat." (Herrin, p 165)
"Self-induced vomiting leads to a variety of health problems. Esophageal and gastric irritation are painful. Esophageal scarring and narrowing make swallowing difficult; esophageal tears can be life-threatening. Most patients find swollen salivary glands, while not dangerous, disturbing in their effect on appearance. Dental damage and the hemorrhages in and around the eyes from forceful vomiting can be unsightly." (Herrin, p.59)
"Patients who continue to purge should be warned that brushing their teeth just after purging can cause permanent damage to tooth enamel, softened and made fragile by stomach acid. To protect tooth enamel, advise patients to wait several hours before brushing. Instead, immediately after a purging episode, they should rinse their mouths with a flouridated mouthwash or baking soda dissolved in water or even just plain water. These rinses neutralize stomach acid and permit at least some re-mineralization to occur." (Herrin, pp. 168-169)
source
[coming soon]
Chew & Spit (aka C&S) is exactly what it sounds like. Individuals who practice this behavior chew the food of choice, gathering the flavor and getting the taste in their mouths, and then spit it out to avoid digestion. This may sound genius to some (as I once thought) or incredibly disgusting to others, but it is actually quite common for individuals with eating disorders. It seems a harmless practices, but that in fact is not the case.
Chewing food begins the digestion process. Food starts to get broken down in the mouth. Essentially, think of it like this - you start chewing and your body starts gearing up for the nourishment it is about to receive. Of course, if you spit it out then it never makes it to your digestive tract and never fully absorbs into your system. But, just because the food doesn't pass through and out of your body as it should doesn't mean that it has no impact.
Chewing and spitting is linked to various medical issues. Dental problems. Ulcers (stomach and mouth primarily). I have personally had issues with stomach ulcers and I am certain that C&S has contributed at some point to them.
The following is a quote from Associated Content -
"Compared to the devastating physical effects of other eating disorders, such as anorexia or bulimia, chew and spit eating sounds fairly benign. Yet people with these disorders can experience swollen glands, mouth sores, cavities, cracked teeth, sore throats, and irritated or ulcerous stomachs. This is because when a person thinks about or begins to eat the salivary glands and stomach acids kick into action. The salivary glands work on the food in the mouth to break it down into simple sugars and make it easier to digest. Some argue that the breakdown allows the sugar to be absorbed through the mouth into the body, thus causing actual calorie ingestion. Others argue that this would be minimal as the food does not stay in the mouth long enough for this to happen. Some claim that it's impossible to not swallow some of the food, but again this is usually minimal. When the salivary glands and acids are frequently working it can lead to the complications mentioned. It can also cause a spike in insulin levels, which regulate blood sugar, and make it harder to lose weight."
As the article states, chewing and spitting could also be linked to weight gain. So, is this behavior really worth the trouble? I don't think so.
Associated Content - Chew and Spit: A Hidden Eating Disorder
[Bingeing]
Consequences
Continued bingeing can lead to :
weight gain
obesity
Diabetes
high blood pressure
high cholesterol
gallbladder disease
heart disease
Gastrointestinal disorders
The act of binging is also phyically harmful to the stomach, causing it to stretch beyond what it is meant to.
[REALITY]
Laxatives are not an effective way of of losing weight. Absorption is not prevented and the only "weight loss" you may experience is water weight, which will return. Therefore, there is really no benefit to taking them. If they don't prevent absorption, then obviously they won't prevent weight gain. Consistent abuse of laxatives can also cause water retention over time, which will only make you feel worse. Laxative abuse can cause PERMANENT damage to your body and digestive system.
The same goes for diuretics - you only lose water weight. That is why they are sometimes called "water pills". You will not lose fat or real weight by taking them. They are designed to rid your body of excess water due to water retention caused by certain illnesses or medications. Diuretics should be used only by advisement of a doctor for certain diseases and blood work always has to be monitored whenever someone is on them because they can deplete vitamins and nutrients that are essential for you to live.
Think about it - is it really worth harming your body - killing your body - by using something that doesn't even work?!
I know how powerful and misleading these substances can be. I have at some point in my life 'abused' both laxatives and diuretics. I always ended up at the same place - the hospital. Feeling helpless, needing them because otherwise it felt like my world was going to end. Addicted to the empty feeling they cause. Now, my digestive system is shot and I have a cardiac arrhythmia.
Laxatives, diuretics, ipecac, diet pills ... their false results aren't worth losing your life. If you are taking any of these substances, you know that you can't take them forever, so why not consider getting help before it's too late.
"Though eating-disordered patients usually believe to the contrary, they should be informed that self-induced vomiting and laxative abuse have been proven to be relatively ineffective in eliminating consumed calories. Laxatives decrease caloric absorption by only 12%. Vomiting after binging leaves about 1200 calories in the body. Diuretics have no effect, whatsoever, on caloric absorption. Another proof is that patients who binge and purge eventually gain weight." (Herrin, p. 59)
"Normally, exercise increases metabolic rate. But when caloric intake is inadequate, the body conserves energy despite regular exercise. depressed metabolic rates have been measured in anorexia nervosa and bulimia nervosa. In anorexia nervosa, this is no doubt due to the cumulative effect of loss of muscle mass and decreased caloric intake. Signs of lowered metabolic rate in anorexic patients are bradycardia, dry skin, brittle hair, constipation, cold intolerance, and fatigue. Over time, normal calorie intake and weight gain normalize metabolic rate. The low metabolism frequently found in bulimic patients is likely the result of erratic eating patterns." (Herrin, p. 62)
[JUST SAY NO!]
To Laxatives-
Who wants a colostomy?
Do you really want to lose your bowel function?
You cannot control where or when they will do their job (or for how long)
THEY DON'T MAKE YOU LOSE WEIGHT.
________________________________
To Diuretics-
You don't want to have a heart attack
THEY DON'T MAKE YOU LOSE WEIGHT!
To Diet Pills
{under construction}
To Vomiting
You will ruin your teeth.
You will ruin your digestive system.
It can kill you.
To over-exercising
You will be at a high risk for injury (then you won't be doing ANY exercise)
To C&S
Stomach ulcers are not fun
It isn't "harmless"
