ABSTRACT
Chapter 7 provides an overview of purging, which includes self-induced vomiting, laxative abuse (via tablets, teas, or enemas), and/or diuretic abuse, as well as compulsive exercise, thyroid hormone abuse, and insulin restriction. Bulimia nervosa, anorexia nervosa purging subtype, and atypical bulimia nervosa may all involve purging behaviors. Purging can quickly result in deadly electrolyte levels such as low potassium or sodium that can cause cardiac arrest and death. Many patients who purge have been harmed by the medical system because of a lack of awareness about the physiology of those who purge. This includes insensitive and harmful practitioner comments about a patient’s “normal”-looking or higher body weight or misuse of intravenous fluids such that patients gain a great deal of edema, or water weight, quickly. Purging can serve as a mechanism for patients to remain “empty” both physically and emotionally as well as offering up a form of self-harm. Patients may come to associate low electrolyte levels in the blood with validity of resting and seeking treatment. This is particularly complicated when blood tests are restored to normal and the patient no longer feels sick enough to work on recovery.
