Eating Disorders & Laxative Abuse
Laxative abuse occurs when an individual attempts to eliminate or ‘rid’ their body of calories via repeated, frequent use of laxatives. Laxative abuse is dangerous and may often result in health complications, such as dehydration, weakness, tremors, fainting, kidney damage, and it can even be life-threatening.¹
By: Krizia Crooke
The term laxative refers to a substance that produces evacuation of the bowel.² Laxatives can relieve constipation and prevent fluid retention, but often are misused when individuals mistakenly believe that laxatives will prevent caloric absorption and weight gain. Laxatives work by acting on the large intestine, whereas most nutritional absorption occurs in the small intestine. By the time laxatives artificially stimulate the emptying of the large intestine, absorption of calories has occurred. Therefore, ‘weight loss’ induced by laxative use is primarily due to water, minerals, electrolytes, and indigestible fiber losses.¹ Often, individuals will begin to use laxatives in a non-eating disordered way to relieve constipation. This ‘clearance’ of the colon can leave one feeling ‘empty’ or ‘cleaner’ because their GI system feels emptier. These induced bouts of diarrheal losses can lead to hyper-focus around bowel movements and scheduling one’s day around bathroom breaks, ultimately leading to other disordered habits.³
Significant complications of laxative abuse include electrolyte and fluid losses, and gastrointestinal bleeding. Electrolytes and minerals lost through laxative abuse include sodium, potassium, chloride, calcium, magnesium, and phosphorus. These losses can manifest as dizziness, lightheadedness, cardiac arrhythmias, and edema or fluid retention.² Over time, the colon may begin to react abnormally and rely on larger doses or amounts of laxatives to produce a bowel movement. This overdependency on laxatives can result in loss of muscle tone in the digestive tract and can impact nerve responses, which affects contraction of the intestines, preventing adequate evacuation of stool. Recovery from laxative abuse is, more often than not, possible, but it can be a slow and grueling process.⁴ Seeking support from a medical professional on how to best stop laxative abuse is recommended, considering some individuals may experience laxative withdrawals, such as fluid retention, constipation, and bloating.⁴
There are other ways to relieve symptoms of constipation other than through the use of stimulant laxatives, which can do more harm than good. There is a wide range of variability in how often one has a bowel movement. It can be anywhere from 2 to 3 times per day to once a week. Therefore, determining what is normal for you is the first step in deciding how to best regulate your schedule.⁴
At BALANCE eating disorder treatment center™, our compassionate, highly skilled team of clinicians is trained in diagnosing and treating the spectrum of eating disorders, including anorexia, bulimia, binge eating disorder, compulsive overeating, and other disordered eating and body image issues. In addition to our full-time Day Treatment Program and Weeknight Intensive Outpatient Program, we offer nutrition counseling with a licensed dietitian, meal support, and a variety of other groups and resources to assist those seeking help for food concerns. Click the button below to learn more about our programs and services.
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This post was written by BALANCE Dietetic Intern, Krizia Crooke (she/her).
Krizia is a Dietetic Intern and graduate student at New York University where she is pursuing her Master’s Degree in Clinical Nutrition. She completed her undergraduate education at Texas Woman’s University, majoring in Nutrition and minoring in Criminal Justice. After completing her dietetic internship, Krizia plans to work in the realm of eating disorders and is passionate about incorporating the HAES approach into her practice.
References
1. Laxative abuse. National Eating Disorders Association Web site. https://www.nationaleatingdisorders.org/learn/general-information/laxative-abuse. Updated 2017. Accessed Dec 4, 2021.
2. Vanin JR( 1 ), Saylor KE( 2 ). Laxative abuse: A hazardous habit for weight control. Journal of the American College Health Association. 37(5):227-230. doi:10.1080/07448481.1989.9939064
3. Gaudiani JL. Sick Enough: A Guide to the Medical Complications of Eating Disorders. New York, NY: Routledge; 2019.
4. Cornell health laxative use: What to know. https://health.cornell.edu/sites/health/files/pdf-library/LaxativeUse.pdf. Accessed December 3, 2021.