Purging disorder can be as dangerous as anorexia and bulimia nervosa. Learn more about the symptoms of purging disorder and effective treatments for it.

What Are the Symptoms of Purging Disorder?

People with purging disorder vomit or abuse laxatives to control their weight. They don’t eat large amounts of food like bulimics and people with binge eating disorder. Instead, they purge after eating normal amounts of food. People with purging disorder may also abuse diuretics or engage in excessive exercise. They struggle with poor body image and low self-esteem.

The DSM 5 lists purging disorder under Other Specified Feeding or Eating Disorders (OSFED). OSFED is a diagnosis given to people who don’t meet the criteria for:

  • Bulimia nervosa
  • Anorexia nervosa
  • Binge-eating disorder

Signs and symptoms of purging disorder may include:

  • Laxative abuse
  • Diuretic abuse 
  • Fasting
  • Vomiting
  • Excessive exercise
  • Preoccupation with weight, food and appearance
  • Secretive behavior around food
  • Skipping meals in social settings
  • Distorted body image
  • Frequent feelings of shame and self-hate 
  • Irritability and mood swings

Research on purging disorder is in its infancy. One review of purging disorder studies shows people with this condition often have:

  • High levels of emotional distress
  • Personality disorders
  • Mood disorders
  • Anxiety disorders
  • Low self-esteem
  • Body dissatisfaction
  • Substance abuse
  • Functional impairment

Purging disorder is more common in women than men. In one study, 77% of participants with purging disorder were women.

Purging Disorder and Bulimia

Bulimia and purging disorder both involve self-induced vomiting to lose weight. Many people confuse bulimia and purging disorder. Symptoms of bulimia include binging and purging. Purging disorder also involves self-induced vomiting or laxative abuse. The difference is that people with purging disorder eat normal amounts of food. Bulimics take in thousands of calories during a binge. 

What Are the Risks of Purging Disorder?

Purging disorder can cause serious health issues. Repeated self-induced vomiting or laxative abuse may contribute to:

  • Dehydration
  • Electrolyte imbalances
  • Kidney damage
  • Acid reflux
  • Stomach ulcers
  • Tearing or rupturing of esophagus
  • Irregular heart rate
  • Congestive heart failure
  • Laxative dependence
  • Irritable bowel syndrome
  • Dental problems 
  • Popped blood vessels in eyes
  • Swollen cheeks 
  • Muscle weakness

Complications from some of these symptoms can be fatal. One study found 11 out of 219 people with purging disorder died within nine years.

How Do You Treat Purging Disorder?

Effective treatment for purging disorder addresses underlying issues. Like other eating disorders, purging disorder is about more than food and weight. Eating disorder symptoms are often a way to cope with emotional pain. People with purging disorder may try to self-medicate issues tied to:

  • Trauma
  • Co-occurring mental health disorders
  • Poor self-esteem
  • Relationship problems
  • Societal pressures
  • Attachment issues

Time in a residential treatment center may be necessary to break the purging cycle. Effective eating disorder treatments often include approaches like:

Cognitive Behavioral Therapy (CBT)

Counselors use cognitive behavioral therapy to treat all types of maladaptive behaviors. CBT helps you identify inaccurate or unhealthy beliefs and thoughts. It teaches you how they influence behaviors and emotions. You learn to replace negative thoughts with healthier ones. This can be especially useful for people with eating disorders. They often think in extremes. They have unhealthy perceptions of themselves and their environment.

Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy helps you tolerate distress and manage emotions. It blends CBT principles with mindfulness practices. Several studies show DBT’s effectiveness in treating eating disorders. DBT is especially useful in cases of co-occurring personality disorders. People with eating disorders often struggle with personality disorders.

Dual Diagnosis Treatment

Treatment for eating disorders should include dual diagnosis treatment. People with eating disorders often struggle with co-occurring disorders like:

  • Anxiety
  • Depression
  • Personality disorders

Dual diagnosis treatment addresses disordered eating and mental illness at the same time.

Family Therapy

Challenging relationships can contribute to eating disorders. Studies show people with eating disorders often come from families with:

  • Low cohesion
  • Poor flexibility
  • Disengagement
  • Enmeshment
  • Unpredictability
  • Rigidity

Family therapy helps you work through unhealthy relationship patterns. You and your loved ones learn to communicate better and have healthy boundaries.

Acceptance and Commitment Therapy (ACT)

This therapeutic approach teaches you to manage emotions and difficult situations. ACT helps you resist the urge to push away distressing feelings. You learn to accept difficulties as a part of life. You adopt better coping strategies. ACT helps you reassess your values and identify areas of your life that don’t align with them. 

A troubling environment can contribute to eating disorders. Focusing on food and weight can give people a false sense of security and control. Research shows that ACT can help people with eating disorders. It helps them manage control issues and black-and-white thinking.

Mindfulness

Mindfulness is a promising approach in eating disorder treatment. You’ll observe difficult thoughts and emotions without acting on them. Emotional pain can trigger disordered eating behaviors. Mindfulness is a healthy coping skill.

Nutrition Counseling

People with eating disorders should also work with a nutritionist. They’ll help you change your relationship with food. You’ll learn about well-balanced meals that support physical and mental health.

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