The Silent Suffering
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Purging
Laxatives
Diuretics
Exercise Addiction
Self-Induced Vomiting
Fasting
Chew & Spit
Bingeing
Reality
Reasons to Resist
Purging
[Purging]COMMON METHODSSelf-Induced VomitingLaxatives Diuretics - Also known as "water pills"Diet Pills FastingIpecac - A powerful substance, Ipecac is intended to cause vomiting in individuals who have ingested harmful substances, such as poison. Exercise CONSEQUENCESSelf-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.
Laxatives
___________________TYPES OF LAXATIVESStimulant-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 ABUSEConstipationIntestines may become dependent on laxatives making it hard for them to function.DehydrationLaxatives cause fluid loss through the intestines. Excessive fluid loss = dehydration = impaired body functioning.Electrolyte AbnormalitiesElectrolytes [sodium, chloride, potassium for example] are removed from the body through stool.Fluid RetentionLaxatives 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.BleedingAbusing stimulant types of laxatives can cause blood in the stool. Chronic blood loss can result in anemia.Impaired bowel functionAbuse of stimulant laxatives may permanently damage bowel function. No stimulus = no movement = muscle atrophy.Rectal prolapseLong-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 by1. Not eating enough food2. Not eating enough fat3. Eating sporadically4. Dehydration5. StressBowel 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
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 glaucomaAbuse purposeWeight loss. Like laxatives, diuretics can cause temporary weight loss due to fluid shifts.Side effectsDehydrationElectrolyte abnormalitiesRebound edema____________________________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
[Exercise Addiction]Psychological SignsCompulsion, dutyLoss of pleasure/enjoymentContinued exercise when sick or injuredIncreased anxiety, depression, or decreased self-worth with missed workoutsDaily activities organized around workoutsOnly method of stress managementAvoiding underlying problems or issuesAddicted to endorphins, "runner's high"Exercise used to earn foodInsufficient caloric intake for exercise expenditureFocused on weight lossEmphasis on weight and not body compositionDeny need for body fatPhysical symptomsDifficulty achieving training goalsFrequent injuries, stress fracturesInsomnia, disturbed sleepOverall fatigueExtreme muscular fatigue and sorenessMuscle loss/deteriorationFrequent illness, colds/fluElevated morning blood pressure and heartrateAmenorrhea, lack of menstrual cycleBone lossRecovery behaviorExercise for enjoymentExercise is a lifestyle, not a means to an endWeight is stable within ideal range with activityFood is the necessary fuel for effective and appropriate exerciseLearn and practice proper training techniquesVary intensity and type of exerciseTake rest days (1-2 weekly) and blocks of time off each yearSeparate self-worth from performanceLearns other coping skills for stress managementObtain proper support for dealing with underlying issuesFlexibility, mix activities with relationships and fun__________________________
Self-Induced Vomiting
[Self-Induced Vomiting]Ramifications:Erosion of enamel of teeth & other dental issuesGastrointestinalGastroparesisConstipationAbdominal painInjury to the esophagus, stomachStomach ruptureEsophagitisTears/holes in esophagusFluid & Electrolyte ImbalanceDehydrationAspiration of food into lungsVomiting 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)sourceHerrin, Marcia. Nutrition Counseling in the Treatment of Eating Disorders. New York: Brunner-Routledge, 2003. Print.
Fasting
[coming soon]
Chew & Spit
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
[Bingeing]ConsequencesContinued bingeing can lead to : weight gain obesity Diabetes high blood pressure high cholesterol gallbladder disease heart diseaseGastrointestinal disordersThe act of binging is also phyically harmful to the stomach, causing it to stretch beyond what it is meant to.
Reality
[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?! 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)Herrin, Marcia. Nutrition Counseling in the Treatment of Eating Disorders. New York: Brunner-Routledge, 2003. Print.
Reasons to Resist
[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 attackTHEY DON'T MAKE YOU LOSE WEIGHT!________________________________To Diet Pills{under construction}________________________________To VomitingYou will ruin your teeth.You will ruin your digestive system.It can kill you.________________________________To over-exercisingYou will be at a high risk for injury (then you won't be doing ANY exercise)________________________________To C&SStomach ulcers are not funIt isn't "harmless"
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