Let's Talk About Purging
Purging are actions undertaken with the intention of ridding the body of any food, liquid or weight. The act of purging is associated with the following eating disorders:
- Anorexia Nervosa (AN)
- Bulimia Nervosa (BN)
- Binge Eating Disorder (BED)
- Other Specified Feeding or Eating Disorder (OSFED)
- Unspecified Feeding or Eating Disorder (UFED)
There are a range of reasons that drive purging behaviour in eating disorders – each unique to the individual. The most recognised reasons are:
Compensatory: Purging after a binge episode to account for the additional energy consumed. Purging may also act as a way to reclaim a lost sense of control over the mind and body.
Control of weight and shape: This might be the case regardless of what was consumed, how much of it was consumed, or how much control was exercised during eating.
Management of feelings: Purging can help in the short term to soothe intense negative feelings including anxiety, guilt and shame.
Control of physical sensations: Purging can be used as a way to feel ’empty’ and rid the feeling of fullness from within the stomach. Some individuals may mistake their anxiety symptoms with a sense of fullness.
Purging is complex to understand as it may take many forms – the most common being:
Spitting and chewing: Repeatedly chewing and spitting out food before it is swallowed. This is usually to be able to enjoy the taste of food, without taking in the carlories.
Examples of physical complications:
- Cavities
- Gum disease
Vomiting: Self-initiated vomiting is a result of an individual tries to prevent weight gain by ‘undoing’ the impact of eating. Regular self-induced vomiting to offset a binge can contribute to a dangerous cycle of binge eating followed by vomiting.
Examples of physical complications:
- Dental complications
- Oesophagus and throat damage
- Damage to eyes (red patches) and nose (frequent bleeding)
- Electrolyte imbalance
- Gastrointestinal complications
- Swollen face and/or jaw.
Laxative use: People may over-use laxatives to cause bowel movements for various reasons, such as wanting to feel thinner or emptier, directly compensating for binge eating, or aiming to lose a large amount of weight in a short time frame.
Examples of physical complications:
- Impaired intestinal function
- Infections
- Rectal prolapse. Surgical treatment is typically required to treat associated symptoms.
Excessive exercise: Engaging in a series of obsessive, impulsive, and intense physical activities. The primary goal of excessive exercise is to burn calories with the intent to offset food intake.
Examples of short-term physical complications:
- Dehydration
- Strains and sprains
- Chronic pain in the knee or back
- Elbow, hip, and stress fractures.
Examples of long-term physical complications:
- Osteoporosis
- Degenerative arthritis
- Period loss
- Heart issues.
It can be difficult to know how to support your loved one who is purging. The underlying factors that contribute to purging are complex and related to emotional distress, stress, anxiety and other negative emotions.
As a carer, the most valuable role that you can play is one of support, non judgement and acceptance of where your loved one is at, whilst educating yourself about the illness and seeking to gain skills and strategies for you and your loved one through:
Professional support for you and your loved one:
- Short-term (hotlines such as Lifeline Australia on 13 11 14 and the, Butterfly Foundation on 1800 33 4673)
- Long-term – setting up an eating disorder care team (your general practitioner can provide you with a Medicare subsidised referral to allied health practitioners, such as a psychologist, psychiatrist or dietitian etc).
Being there for yourself too, through acts of self-care:
- EDFA’s free “Fill The Gap” one-on-one counselling service for carers who support a loved one with an eating disorder.
- Spending time around people that make you feel safe and supported in your feelings, such as family, friends, and other trusted people.
- Taking care of yourself by engaging in activities that you enjoy and help you to feel grounded and more equipped to manage feelings of overwhelm and distress.
Educating yourself, and connecting with the knowledge of other carers and experts in the eating disorder field:
- EDFA’s twice monthly online webinars and a library of 160+ hours of webinar recordings covering a wide range of eating disorder topics presented by lived experience and professional experts from all over the world. Find out more here.
- One of four EDFA’s Carer Support Groups: general support, coffee catchup, diagnosis-specific, or carer-specific.
- EDFA’s private Facebook daily support and information sharing forum for carers supporting a loved one with an eating disorder.