Identifying Laxative Abuse: Signs, Symptoms, and Treatment
What you will learn
- Laxative abuse involves the excessive or inappropriate use of laxatives, which can be for various reasons, including weight control.
- This method of purging can result in electrolyte imbalances, damage to the digestive system, and other issues.
- It can often be difficult to see signs of laxative abuse due to the highly secretive nature of eating disorders.
- Treatment for laxative abuse may involve therapy, nutrition counseling, and sometimes medical interventions.
Purging isn’t limited to self-induced vomiting. Many individuals who develop eating disorders–particularly bulimia nervosa–begin abusing laxatives as a manner of weight control.
Although laxatives do not work for fat loss and the weight lost due to laxatives is only water weight, many people become stuck in cycles of laxative abuse.[1]
What is Laxative Abuse?
Laxative abuse involves the excessive use of laxatives to induce bowel movements. In the context of eating disorders, laxatives are often taken as a means of weight control, often after a binge.
Those abusing laxatives may use various types, including stimulant, osmotic, and bulk-forming laxatives. However, it’s important to note that the primary effect of laxatives is to evacuate the contents of the bowel, not to promote fat loss.
Why Do People Abuse Laxatives?
People who abuse laxatives may do so for a range of reasons. Aside from believing that laxatives will help the individual lose weight, laxatives are also sometimes used as a method of self-punishment or self-harm.
Some people who abuse laxatives do so out of a necessity to relieve constipation or gas but then become overly dependent on laxatives.
No matter the reason, laxative abuse may result in both physical and psychological consequences.
What are the Risks of Abusing Laxatives?
The risks of laxative abuse range can be severe. Side effects of overconsuming laxatives include:
Digestive System Damage
Laxatives can be harsh on the digestive system, especially those with stimulant properties such as senna. Laxative abuse can lead to irritation of the colon which can cause blood in stools and result in anemia.
Excessive laxative use may also result in impaired intestinal function in which normal tone is lost, and nerve response is inhibited, and it may become difficult to pass stool normally.[2] In some cases, laxative abuse may even lead to rectal prolapse, a condition in which the inside of the intestines protrudes through the anus.
In more severe cases, long-term laxative abuse can lead to intestinal paralysis, pancreatitis, cathartic colon, and irritable bowel syndrome(IBS).
Dehydration
Diarrhea associated with laxative use can lead to urinary tract infections and kidney damage and can even be fatal. Signs of dehydration include extreme thirst, decreased urination, headaches, light-headedness, dry mouth, weakness, and confusion.
Dehydration can also cause constipation, further exacerbating laxative dependence.
Electrolyte Imbalance
Excessive laxative use can lead to abnormally rapid loss of sodium, potassium, and chloride, which can lead to heart damage and even death.
Nutrient Deficiencies
Abusing laxatives can result in nutrient deficiencies, as they can interfere with the body’s ability to absorb nutrients from food. Nutrient deficiencies can cause conditions in the organs and tissues. Damage can be permanent.
Psychological Effects
Those who abuse laxatives for the purpose of losing weight–such as those with bulimia nervosa–may experience intensified eating disorder symptoms. Depression, anxiety, low self-worth, shame, isolation, and cycles of restriction, binging, and purging are common among eating-disordered individuals who also abuse laxatives.
Can Laxative Abuse Be Fatal?
Laxative abuse can be fatal. Electrolyte imbalances, dehydration, and organ damage caused by laxative abuse can lead to severe health complications and even death.
Signs of Laxative Abuse
If you suspect that you or someone you know is struggling with laxative abuse, there are signs to look for.
Signs of laxative abuse include:
- Frequent use of laxatives or using laxatives in large quantities
- Frequent trips to the bathroom
- Chronic constipation or diarrhea
- Abdominal pain or cramping
- Signs and symptoms of electrolyte imbalances and dehydration
- Obsessive thoughts about weight or body shape
Can Laxative Abuse Be Hidden?
Eating disorders are associated with feelings of guilt, low self-worth, and shame, and those struggling with abusing laxatives may attempt to conceal their behaviors.
Someone trying to hide laxative use will often isolate themselves, avoid social interactions where food plays a central role, hoard food, or refuse to go anywhere where there isn’t easy access to a bathroom.
Note that in many cases, people with laxative bulimia will have publicly normal eating or bathroom habits and binge and purge in private.
How is Laxative Abuse Diagnosed?
Laxative abuse can be diagnosed through a combination of physical exams, blood tests to measure electrolyte levels and organ function, and psychological evaluations. A doctor or mental health professional can help determine if someone is abusing laxatives.
Recovering From Laxative Abuse
Recovery from an eating disorder is possible, although the recovery time may be long, and some effects of excessive laxative use may be irreversible.
Treatment for laxative abuse typically involves a combination of medical, psychological, and nutritional interventions. This may include medical monitoring to address any physical complications, individual and group therapy to address underlying psychological issues, support groups, and nutritional counseling to address any nutrient deficiencies. Some individuals with eating disorders require inpatient or outpatient treatment.
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Frequently Asked Questions About Laxative Abuse
What is Laxative Bulimia?
Laxative bulimia is a type of eating disorder that involves the use of laxatives to purge after eating. This subtype of bulimia can have serious health consequences, including electrolyte imbalances, dehydration, and irreversible digestive system damage.
Those with bulimia nervosa may engage in other purging behaviors, such as self-induced vomiting or compulsive exercising, as well as laxative abuse.
Can Laxative Abuse Lead To Other Eating Disorders?
Disordered eating often falls on a spectrum. Bulimia-related laxative abuse is often associated with other eating disorders, such as anorexia nervosa and binge eating disorder.
Many individuals with eating disorders will experience cycles of behaviors that are characteristic of multiple eating disorders. For example, someone with laxative bulimia may use extreme restrictions to punish themselves after binging and abusing laxatives.
Can You Get Addicted to Laxatives?
Some individuals may become dependent on them to induce bowel movements. With eating disorders, this often occurs when there is no physical need for laxatives on a therapeutic level.
Many individuals with eating disorders resort to taking laxatives every time they eat, which can become a psychological addiction.
What is the Recovery Timeline for Laxative Abuse?
Everyone experiences recovery differently, and recovery is rarely linear. How long it takes to recover from laxative abuse can vary depending on the severity of the abuse, overall health, and how well the underlying mental health conditions are treated.
It may take weeks, months, or even years to fully recover from the physical effects of bulimia and laxative abuse. However, recovery is a lifelong commitment. It is important for those with a history of disordered eating to consciously follow their treatment plan and use healthy coping skills to avoid relapsing.
Why Do Laxatives Not Help With Weight Loss?
Laxative abuse may cause temporary weight loss by reducing water weight and stool weight, but it does not affect fat loss, which is a common misconception perpetuated among those in pro-eating disorder groups. Calories from food are absorbed in the intestines, meaning that laxatives have no effect on true weight loss.[3]
Laxative Abuse vs. Laxative Dependence: What’s the Difference?
Laxative abuse is characterized by excessive and prolonged use of laxatives when not required to have a regular bowel movement. Laxative dependence refers to the body’s reliance on laxatives to regulate bowel movements.
Due to the damage that overusing laxatives can cause, laxative abuse may lead to laxative dependence. Both conditions can lead to dangerous health consequences and require professional treatment.
[1] MediLexicon International. (n.d.). Laxatives for weight loss: Why they are not safe or effective. Medical News Today. Retrieved April 9, 2023, from https://www.medicalnewstoday.com/articles/325892
[2] – Cornell University. Cornell health laxative use: What to know. (n.d.). Retrieved April 9, 2023, from https://health.cornell.edu/sites/health/files/pdf-library/LaxativeUse.pdf
[3] WebMD. Medically reviewed by Dan Brennan, MD. (n.d.). Taking laxatives for weight loss: Is it safe? WebMD. Retrieved April 9, 2023, from https://www.webmd.com/diet/taking-laxatives-to-lose-weight
