What is Purging Disorder?
Purging disorder is a serious yet often misunderstood eating disorder characterized by recurrent purging behaviors without the binge eating episodes typically seen in bulimia nervosa. Despite being less widely recognized, purging disorder carries significant physical and psychological risks. Understanding the signs and symptoms of this condition is crucial for early intervention and effective treatment. This blog post aims to be educational, to bring awareness to purging disorder, and be a resource for those struggling with this eating disorder.
Purging disorder falls under the category of "Other Specified Feeding or Eating Disorders" (OSFED) in the DSM-5-TR. Unlike bulimia nervosa, individuals with purging disorder do not engage in binge eating before purging. The disorder affects people of all genders, ages, and backgrounds, though research suggests it is more common in adolescents and young adults.
Source: Verywell
The Role of Shame and Secrecy
Shame and secrecy play a significant role in purging disorder, often reinforcing the cycle of disordered behaviors. Many individuals struggling with purging disorder experience deep feelings of guilt and embarrassment, leading them to hide their behaviors from others. This secrecy can make it more difficult to seek help, as fear of judgment or stigma may prevent individuals from opening up about their struggles. The isolation that results from this secrecy can worsen mental health symptoms and make recovery more challenging. Addressing these feelings of shame in a therapeutic setting is an important step toward healing.
The Normalization of Eating Disorders in Our Culture
Disordered eating behaviors, including purging, are often normalized in a society that glorifies thinness. Fatphobia permeates cultural narratives, reinforcing the idea that smaller bodies are inherently better, healthier, and more desirable. This harmful messaging encourages restrictive eating, excessive exercise, and purging behaviors as acceptable, or even necessary, means of achieving and maintaining an idealized body size. The normalization of weight loss at any expense makes it harder for individuals to recognize the dangers of disordered eating and seek help, as these behaviors are frequently praised rather than challenged. Challenging fatphobia and embracing body diversity are essential steps in reducing the prevalence of eating disorders and promoting true well-being.
Symptoms of Purging Disorder
Now that we have an idea of why purging disorder is lesser known, let’s explore the symptoms of this condition:
Physical Symptoms:
Dental issues such as discolored teeth, cavities, and enamel erosion
Stomach cramps, constipation, and acid reflux
Weight fluctuations
Dizziness or fainting
Dehydration
Electrolyte imbalances
Organ damage
Broken blood vessels
Rectal bleeding
Chronic diarrhea
Mental and Behavioral Symptoms:
Self-induced vomiting
Laxative or diuretic misuse
Excessive exercise
Fasting
Frequent trips to the restroom after meals
Avoidance of social eating situations
Anxiety about body image
Secretive purging habits
Fear of weight gain or obsessive focus on weight loss
Low self-esteem linked to body image
Risk Factors
A variety of factors can contribute to the development of purging disorder, including:
Family history of eating disorders
Mental health conditions such as anxiety and OCD
History of trauma or abuse
Societal pressures and weight stigma
Participation in appearance or weight-focused activities or sports
Higher prevalence in males than previously recognized
Co-occurring mood disorders, including depression and impulse control issues
Causes of Purging Disorder
The exact causes of purging disorder remain complex, but several contributing factors have been identified:
Genetic predisposition
Neurotransmitter imbalances
High stress levels in the home environment
History of sexual abuse or other traumatic experiences
Complications
Unfortunately, purging disorder can lead to severe physical and mental health complications.
Physical Complications:
Damage to teeth, esophagus, and digestive system
Swelling of the throat and face
Cardiovascular issues, including irregular heart rhythms
Scarring on hands from induced vomiting
Kidney failure due to dehydration
Nutrient deficiencies and digestive complications
Severe electrolyte imbalances, which can be life-threatening
Mental Health Complications:
Mood swings; Irritability
Difficulty focusing
Depression and anxiety
Emotional distress that disrupts daily life and relationships
Treatment for Purging Disorder
The DSM-5-TR does not have specific guidelines for purging disorder, making diagnosis complex. Clinicians evaluate the frequency and impact of purging behaviors, ruling out bulimia or other eating disorders. Early treatment is essential for recovery. A comprehensive approach often involves:
Support Team:
Mental health professionals
Physicians and dietitians
Family and friends
Therapy Options:
Cognitive Behavioral Therapy (CBT): Helps identify and change thoughts related to purging behaviors and body image concerns.
Internal Family Systems (IFS): Supports individuals in understanding their eating disorder from a trauma-informed and compassionate lens; encourages clients to get to the root of the issue.
Family-Based Therapy: Encourages family support and involvement in recovery.
Intuitive Eating: A framework to guide individuals to reconnecting with their inherent intuition and awareness of bodily cues, like hunger and fullness.
Medical Interventions:
Medication: May be used to address neurotransmitter imbalances and co-occurring conditions like anxiety and depression.
Nutritional Counseling: Guides individuals in developing a healthy relationship with food.
Hospitalization: Necessary in severe cases with life-threatening physical complications.
Recovery and Support
Recovery from purging disorder is a gradual process requiring patience and consistent effort. Strategies include:
Continued therapy
Mindfulness or journaling
Participation in support groups
Awareness of relapse triggers and strategies to maintain progress
Utilizing local and national support resources, such as:
National Eating Disorders Association (NEDA) Helpline
Suicide and Crisis Lifeline (dial 988) for emergency assistance
Conclusion
Purging disorder is a serious mental health condition that requires professional intervention. With proper treatment, individuals can achieve a healthier relationship with food and body image. If you or someone you love is struggling, reaching out for help is the first step toward recovery; here at Balanced Awakening, we have therapists who may be able to help. Feel free to reach out today.
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