Understanding purging
Purging (vomiting up your food) is a behavioural problem experienced by many people with disordered eating. It’s not something to be ashamed of - it’s more common than you might think - but it does need to be dealt with. This article will give a brief overview of purging to help you better understand it.
Whilst purging is most often associated with Bulimia (which entails a pattern of binge-eating followed by purging), many people with Anorexia or even an eating disorder which does not fit either of these diagnoses will also purge. For some, purging is a compensatory behaviour, meaning it is used in an attempt to compensate for food intake the person feels unhappy about and/or to control their weight (exercise or laxatives are sometimes used in the same way).
The important thing to understand about purging is it does not work very well at all to manage weight. For one thing, when you vomit, your stomach muscles contract at both ends. This forces some food out of the oesophagus, but some down into the intestines - hence, it is thought to rid the body of a maximum of 2/3 of calories consumed. Secondly, people who purge tend to binge-eat as well, which offsets the purging. Over time, it also messes with your metabolism until your poor body is confused about what’s going on, and this often slows down as a result.
In terms of physical health, purging is very bad for your body. I find that many patients assume if they are of a normal or higher weight it’s not an issue. It most definitely is. Most obviously, it can do some pretty gnarly damage to your teeth (do not brush your teeth immediately afterwards, either - this erodes the enamel further) and can cause your cheeks and face to puff up (chipmunk face). But more significantly, it causes imbalances in electrolytes that can impact your heart functioning. Some people get to the point of purging multiple times per day, whereas others may only do it once a fortnight - either way, it will be hurting your body a little each time.
Over long periods of time, some people experience their purging as little more than a bad habit. However, apart from serving to compensate for calories or helping ease the discomfort of a too-full stomach, for most people I speak to, purging also serves an emotional function. Vomiting acts as a kind of tool for self-soothing: when the person feels anxious - sometimes because they are unhappy with their body, but just as often because of unrelated stress, like a fight with a partner - it is used to help calm down. Therefore, to help someone break the cycle and stop purging, we need to help them develop alternative coping strategies to replace it with.
If you are purging - sometimes, or all the time - you need to get help ASAP. Your GP will explain the impact on your body in more detail to you, and will help you treat any problems that have come up. They can also refer you to a Clinical Psychologist and Dietitian who can work with you to address your relationship with food and your body. It all sounds scary, I know - but there are certainly things we can do to help you work on and ultimately stop purging completely.
Below are some links to eating disorder resources to help you expand your understanding of purging. But please do remember, this is a complex issue and one that is not really a matter for self-help alone.