What is Purging?

**Content warning: This post includes discussion of purging behaviors. Please use your discretion when reading and speak with your support system as needed.

A characteristic of certain kinds of eating disorders is a behavior called purging. The act of purging is often used as a way of compensating for food intake in order to influence body weight or shape. Purging is not specific to one kind of eating disorder and can occur in those experiencing bulimia, anorexia, and OSFED (Other Specified Feeding or Eating Disorder). This behavior is very serious and requires professional help.

In this blog, we will discuss different types of purging, warning signs, physical effects, and treatment options.

Types of Purging

When people think of purging, they often think of self-induced vomiting. In actuality, purging also includes abusing laxatives and diuretics, misusing insulin, and overexercising. Learn about the common kinds of purging below:

• Self-induced vomiting: Most commonly associated with purging, self-induced vomiting is when a person forces themself to expel the food they consumed.
• Laxative/diuretics abuse: Self-induced diarrhea is another kind of purging, typically achieved by abusing laxatives. Diuretics, which cause water loss in the body, are sometimes abused for weight loss as well. 
• Insulin misuse/mismanagement: People experiencing type 1 diabetes may restrict insulin or use extra insulin as a way of purging. Adolescent females with type 1 diabetes are twice as likely to be diagnosed with an eating disorder as their non-diabetic peers (Jones, 2000).
• Excessive exercise: Exercising may be used as a way to “make up” for calories consumed.

Warning Signs of Purging

Because purging is a symptom of multiple kinds of eating disorders, there are varying behaviors that can come with it. For example, if an individual is experiencing bulimia, they may eat a large amount of food and then disappear for a long while in the bathroom afterward. In contrast, purging disorder does not involve binge eating but does involve purging, as suggested by the condition’s name.

Here are examples of warning signs and symptoms of purging:

• Binge eating and then going to the bathroom for an extended time period 
• Use of laxatives, diuretics, ipecac syrup, or enemas as compensatory behaviors after eating
• Inflexible adherence to exercise schedules
• Shame and guilt surrounding eating
• Fear of gaining weight or becoming “fat”
• A self-worth based solely on appearance
• Broken blood vessels in the eyes and swollen cheeks (from self-induced vomiting)
• Receding gum lines, yellowed teeth, painful teeth, and tooth decay (from self-induced vomiting)
• Russell’s sign, or calluses on the back of the hands and knuckles (from self-induced vomiting)
• Feeling depressed or anxious

Physical Effects of Purging

As with many other eating disorder behaviors, purging can have a significant negative effect on the body. Learn how different areas of the body can be affected by purging below:

Hair and Eyes

When the body is malnourished due to purging or other reasons, it directs all its energy toward essential functions. This can lead to the body taking nutrients from hair and cause that hair to become brittle or even fall out. 

Forced vomiting causes pressure on a person’s eyes. This pressure can make their eyes become red and irritated, even causing blood vessels to break. Dark circles under the eyes and sunken eye sockets can also appear. 

Teeth and Mouth

When someone forces themselves to vomit what their stomach has started to partially digest, stomach acid enters the throat and mouth. The esophagus and oral cavity, including teeth and gums, can become damaged. Specifically, self-induced vomiting can erode the enamel surface of teeth, causing tooth decay and cavities over time. 

Teeth may become yellow, brittle, or even painful. Stomach acid can also cause the swelling of cheeks and salivary glands, as well as painful mouth sores on the roof of the mouth, inner cheeks, inner lips, throat, and tongue.

Heart and Kidneys

Purging can result in imbalanced electrolytes, dehydration, and strain on the heart. Electrolyte imbalances can lead to a heart attack or a seizure. Kidney stones, urinary tract infections, and even kidney failure—which could be fatal—can all result from prolonged dehydration caused by purging. 

Brain

Eating disorders commonly co-occur with illnesses such as depression, anxiety, bipolar disorder, substance use disorder, and post-traumatic stress disorder (PTSD). The malnourishment caused by purging can affect brain chemistry and cause stress and mood swings. In addition, purging can contribute to feelings of shame, guilt, isolation, irritability, and more. 

Treatment Options

Eating disorder behaviors like purging often come with shame and stigma, making those experiencing them more hesitant to reach out for help. For anyone experiencing purging—or any eating disorder thought or behavior—it is recommended to seek help from a specialty treatment center as soon as possible. The result of earlier treatment is often a shorter and more lasting recovery. With the appropriate care, those who experienced adverse physical effects of purging may be able to reverse most of the bodily symptoms and lead a life free from their eating disorder.

If you would like to learn more about purging or eating disorders in general, check out the About Eating Disorders page of our website.