The National Eating Disorders Association (NEDA) defines purging disorder as “recurrent purging behavior to influence weight or shape in the absence of binge eating.” People with purging disorder use self-induced vomiting, laxatives, or diuretics after eating in order to prevent weight gain and relieve anxiety.
Purging disorder is classified as an Other Specified Feeding or Eating Disorder (OSFED) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Although it is not an official diagnosis, purging disorder can be serious and life threatening. But, with the right treatment and support, you can overcome purging disorder.
Purging disorder vs. bulimia
People may think of purging disorder as falling somewhere between anorexia and bulimia. This can make it difficult to distinguish the different eating disorders from each other.
The main difference between purging disorder and bulimia is binge eating. People with bulimia tend to feel out of control when bingeing on large amounts of food. They then purge, or eliminate, the food in an effort to remove the calories they have consumed. As with purging disorder, they may do this through:
- self-induced vomiting
- use of laxatives or diuretics
- excessive exercise
People with purging disorder do not binge on large amounts of food before purging.
In bulimia, bingeing and purging become a repeating cycle that has a negative effect, emotionally and physically, on your quality of life.
Purging disorder vs. anorexia
While purging disorder involves the removal of food to influence weight, people with anorexia instead deny themselves food in order to lose weight. They may:
- restrict food to the point of self-starvation
- refuse to eat
- have an intense fear of weight gain
- purge food
- exercise to the point of exhaustion
Because purging disorder can have serious consequences for health and quality of life, it’s important to recognize the signs and symptoms.
Signs to look for include:
- self-induced vomiting
- misuse of laxatives, diuretics, or enemas
- frequent trips to the bathroom after eating
- signs or smells of vomiting
- fear of gaining weight or obsession with losing weight
- misconceptions about weight or shape
- fasting
- excessive exercise
- issues with self-esteem
- significant emotional distress
- difficulties in work or personal life
Getting early treatment for purging disorder can improve your chance of recovery. Your doctor will tailor your treatment plan to your individual needs. It may include a combination of treatments.
Psychotherapy
To reduce or eliminate purging behaviors, you may undergo cognitive behavioral therapy (CBT). CBT is a type of talk therapy that helps you recognize distorted or unhelpful thinking patterns and change them so you can respond to challenges more effectively.
You may engage in therapy individually, with family, or in a group setting. Family-based treatment is especially important for families with children and adolescents. It can help families learn how to ensure healthy eating patterns and provide support for their loved one.
Medications
Your doctor may prescribe medication to help treat purging disorder. There are no FDA-approved medications for purging disorder specifically, but healthcare professionals do use some medications to treat eating disorders, including:
- antidepressants
- antipsychotics
- mood stabilizers
Medications may also be helpful for treating other conditions that occur at the same time as purging disorder, such as anxiety and depression.
Medical care and monitoring
Some people may need treatment in an inpatient or residential eating disorder treatment center or a partial hospital setting.
For serious health concerns resulting from poor nutrition or very low body weight, you may need treatment in a hospital.
Nutrition counseling
Nutrition counseling may be helpful for some people. A nutrition professional can help you learn how to establish healthy eating behaviors and maintain a moderate weight.
Learn more about what to expect with eating disorder treatment.
If you are experiencing signs and symptoms of purging, reach out to a trusted health professional. It may be difficult to talk about your experience, but the sooner you seek treatment, the greater your chance for recovery will be.
Recovery from an eating disorder takes time, so be patient with yourself. Your doctor or mental health professional can support you in the process.
You can also contact NEDA, which operates a helpline and offers numerous other services and resources.
To diagnose purging disorder, your doctor may carry out a physical examination and ask you questions about your symptoms or experience with purging.
Your doctor may also recommend a psychological evaluation by a mental health professional. During this evaluation, you will provide information about your eating habits and behaviors and your history of dieting, purging, and exercise.
According to the National Institute of Mental Health (NIMH), eating disorders can affect people of any:
- age
- racial/ethnic background
- body weight
- gender
Eating disorders often appear during the teen years or young adulthood. However, they may also develop during childhood or later in life.
Purging disorder affects approximately 2.5% of adolescents each year. It is more likely to affect people assigned female at birth.
Those who may be at risk for purging disorder include people with:
- body dissatisfaction
- a history of dieting to lose weight
- a higher BMI
- a family history of eating disorders
According to the NIMH, people with eating disorders have an increased risk of suicide and medical concerns. They may experience other mental health conditions, such as depression or anxiety, or have difficulties with substance use.
A 2022 study of more than 200 women with purging disorder or bulimia nervosa suggests that people who experience purging disorder have comparable negative long-term outcomes to those with bulimia nervosa.
Purging by vomiting or using laxatives depletes your body of important substances called electrolytes, including potassium, sodium, and chloride. Electrolyte imbalances can lead to irregular heartbeat and possibly to heart failure and death.
Other possible complications of purging include:
- slowed digestion
- stomach pain and bloating
- nausea and vomiting
- dehydration
- constipation
- intestinal obstruction or infection
- sore throat or a hoarse voice
- difficulty sleeping
- dizziness or fainting
- muscle cramps
- neurological or hormonal problems
- anemia
In severe cases, purging can lead to:
- malnutrition
- ruptured esophagus
- pancreatitis
- seizures
- kidney failure
Learn more about the complications of eating disorders.
Purging typically involves the same physical sensations you experience when vomiting. Since purging is often a way to cope with difficult feelings, it may make you feel better temporarily, but those same feelings may return afterward.
Recovery time for purging disorder is different for everyone. In a 2018 study that included 57 people with purging disorder, the average length of treatment was 4 months.
Among the people in the study, 37% dropped out of treatment, 21% continued to have purging disorder, 25% had partial remission, and 18% no longer had the disorder after treatment.
Purging disorder is an eating disorder in which you purge food in an effort to lose weight or change your body shape.
Purging disorder can affect anyone but often occurs in teens and young adults. Symptoms include self-induced vomiting, misuse of laxatives or diuretics, and frequent trips to the bathroom after eating.
Purging disorder may cause digestive, neurological, and hormonal complications. In severe cases, it can lead to medical problems, including heart failure, and death.
Treatments for purging disorder include psychotherapy, medication, and nutrition counseling. Some people may need medical care and monitoring in a hospital setting.
Contact your doctor if you have concerns about purging or purging disorder.
