Purging (e.g., self-induced vomiting, laxative abuse, or compulsive exercise) often follows an episode of binging in which a person eats an excessive amount of food. However, some may purge after small or normal-sized meals. When a person does this compulsively, this is referred to as purging disorder.
Bulimia nervosa is a condition that is hallmarked by both binging and purging. Purging behaviors without binging are also sometimes found among those with anorexia nervosa. Anorexia is a condition that is also characterized by a refusal to eat for fear of gaining weight.
While many eating disorders that include purging fall into one of these two categories, they don’t always—for example, if a person does not typically binge, or if they haven’t incurred the extreme weight loss seen among people with anorexia. Moreover, if a person’s symptoms do not fit the diagnostic criteria for these disorders, engaging in repeated purging behaviors may be diagnosed as a purging disorder.
Purging disorder can result in weight fluctuations or dramatic weight loss, but it may not. Purging disorder may be less obvious in those who are maintaining their weight. However, there are other warning signs that may be more evident, such as spending considerable time in the bathroom after eating.
Many people with an eating disorder such as purging also abuse drugs or alcohol. They may do so to self-medicate negative thoughts and feelings associated with the disorder, and they will frequently have underlying emotional issues that contribute to both problems.
Effects of Purging Disorder
Many compulsive behaviors, such as purging, are done in secret, and they are done for a few different reasons. One reason is to keep up the appearance that nothing is wrong and to avoid receiving outside intervention. Another reason is because of the guilt and shame associated with having an eating disorder and engaging in the unsavory habits that sustain it.
People who struggle with purging disorder tend to isolate themselves around mealtime and avoid eating with others. They may also steer clear of events, such as parties or gatherings, in which a copious amount of food is available, or they will not have a safe place to purge.
If you notice a loved one routinely going to the restroom right after each meal, this may be a sign they have an active purging disorder. Similarly, if a person appears to have chronic diarrhea for no apparent reason, this could be a sign of laxative abuse.
The Relationship Between Eating Disorders and Addiction
Substance abuse often begins before or during an active eating disorder, but it can also start after recovery. The same emotional issues that contribute to eating disorders can also drive a person to use substances. Also, some people are genetically predisposed to addiction, and, as noted below, purging can be an addictive behavior.
A recent study found that as many as 50% of people who suffer from an eating disorder have also abused alcohol or drugs—five times the rate of the general population. What’s more, over one-third of individuals who abuse substances have eating disorders—11 times the rate of the general population.
The most common substances of abuse by those with eating disorders include alcohol, amphetamines, cocaine, laxatives, diuretics, and heroin. It is no coincidence that many of these substances may be used by a person trying to lose or control weight, which is a common reason for purging in the first place.
Substance abuse and eating disorders share many common risk factors, including biology, family history, depression, anxiety, and low self-esteem. Other shared factors include a tendency toward compulsive or addictive behavior, social isolation, and suicidal thoughts.
Purging as an Addiction
As noted, compulsive behaviors can become addictive. Believe it or not, self-induced vomiting can change an individual’s brain chemistry, not unlike substances, affecting levels of serotonin and endorphins. This can result in feelings of euphoria or reward, which then serve to perpetuate a person’s desire to vomit. A person who purges through excessive exercising will experience similar feelings.
Moreover, resisting the temptation to purge when you have an eating disorder is much like resisting the urge to use substances for an addict or alcoholic. It can feel profoundly unpleasant and even painful, despite knowing that resisting would be in this person’s best interests.
Research has identified similarities between the behavioral experience of drug addiction and bulimia. For one, both food and drugs can cause cravings that often become associated with certain people, places, or situations. People experience feelings of reward and pleasure when eating and using drugs, which encourages them to repeat these behaviors.
But there are also biological similarities between drug addiction and bulimia. Other research has suggested that people who have bulimia have dopamine abnormalities comparable to those who have an addiction to alcohol or cocaine. Also, similar regions of the brain are activated in those who have either condition, in association with cravings for food or drugs.
Getting Help for Substance Abuse and an Eating Disorder
Persons struggling with addiction and an eating disorder should speak with trained medical professionals who can understand, diagnose, and address both disorders simultaneously. Failure to properly treat either condition will increase the risk of relapsing into the other.
Harmony Treatment and Wellness offers comprehensive addiction treatment programs designed to address all aspects of a person’s emotional and physical well-being. We give patients the tools they need to recover from addiction, eating disorders, and other mental health conditions.
If you are ready to begin your recovery journey, contact us today! We help those who need it most to reclaim their lives by freeing themselves from the chains of addiction for life!