Eating disorders and laxatives

Laxatives are a form of medication taken to treat constipation. There are many different types of laxatives and most are available over the counter without prescription.

Laxative misuse involves taking this medication to get rid of food in order to lose weight. Some people with anorexia and bulimia take a large amount of laxatives as part of their harmful food behaviour.

Why do people with eating disorders misuse laxatives?

People with eating disorders frequently complain about constipation and bloating. This is because their bowel has slowed down as a result of a poor supply of food and fluid. So taking laxatives does not address the real cause of their constipation.

People may observe a decrease in their weight after taking laxatives to induce diarrhoea. However, this weight loss is entirely the loss of body fluid. There is no loss of body mass tissue, fat or calories.

The effects of laxative misuse

Laxative misuse causes dehydration, which results in a range of serious problems. When you are dehydrated, you are likely to feel faint, tired and develop painful headaches. The loss of fluid is likely to result in bloating, particularly around your stomach and ankles.

You lose essential minerals which are present in the fluid within the bowel. The most important mineral which is lost is potassium. Potassium plays a vital role in the function of nerves, particularly the nerves of the heart. If potassium levels fall, the heart beat may become irregular.

Potassium levels can be checked with a blood test and heart rhythm with an ECG (electrocardiograph). People with low levels of potassium may be given potassium tablets or if their condition is more serious, be admitted to hospital where potassium is given through an intraveneous (through the veins) drip.

Many laxatives work by stimulating the muscle wall of the bowels to contract and push the contents through quicker. But such artificial stimulation eventually leads to loss of bowel tone and the muscle wall becomes thin and flaccid. At this stage, bowel function may be permanently weakened and slow. Many people end up suffering severe and long term constipation, which will not respond to more laxative medication.

The benefits of giving up laxative misuse

Your physical appearance is likely to improve noticeably and quickly after stopping or reducing laxative abuse. Your skin will look better and your stomach is likely to become less bloated.

Advice on giving up laxatives

If you only take a small amount of laxatives or have been misusing laxatives for a short amount of time, you may be able to stop in one step. Some people find they can throw away the packets of laxatives they have and stop themselves from buying more.

If you have been misusing laxatives for a long time and take them every day, it is more realistic for you to gradually reduce the amount you take. Perhaps you can keep a few days laxative free, or aim to cut down your overall use week by week. Tips for giving up laxatives:

  • Eat plenty of fruit and vegetables and high fibre, wholemeal food
  • Drink lots of water
  • Don’t eat large quantities of bran because this can stop your body from absorbing minerals
  • Try not to panic about putting on weight. If you do gain a little weight, this is rehydration. You will not become overweight if you maintain a healthy diet. Remember, laxatives do not reduce body mass, fat or tissue.