What Does It Mean to Purge?

Generally meaning to get rid of something unwanted, the term "purge" refers to different things in different contexts.

From an eating disorder perspective, purging means doing things to compensate for eating, such as:

  • Self-induced vomiting
  • Taking laxatives/diuretics
  • Exercising excessively

This is done in an effort to influence a person's weight or shape.

This article discusses the signs and associated conditions of purging.

purging

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Definition of Purge

Purging disorder involves doing things to "get rid of" food that has been consumed, or the calories associated with it.

While several types of eating disorders can involve purging, purging disorder lacks some of the symptoms of anorexia, and doesn't have the "bingeing and purging" associated with bulimia.

In the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), purging disorder falls under the category of other specified feeding and eating disorder (OSFED), previously known as eating disorder not otherwise specified (EDNOS).

To meet the criteria for OSFED, someone must:

  • Have predominant symptoms characteristic of a feeding/eating disorder, but does not meet the full criteria for any of the other feeding/eating disorder diagnostic classes
  • Exhibit behaviors that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

The five presentations of OSFED are:

  • Atypical anorexia nervosa
  • Bulimia nervosa of low frequency and/or limited duration
  • Binge-eating disorder of low frequency and/or limited duration
  • Purging disorder
  • Night eating syndrome

A person with purging disorder has purging behaviors but does not meet the criteria for a diagnosis of another eating disorder such as anorexia or bulimia.

Types of Purging Behavior

Most people associate purging with vomiting, but that is just one behavior exhibited by people with purging disorder.

Purging includes at least one of the following:

  • Vomiting: The vomiting with purging disorder is self-induced, meaning the person intentionally causes themselves to vomit. For some people with purging disorder, vomiting after a meal begins to feel automatic.
  • Excessive exercise: Exercise is good for the body and encouraged as part of a healthy lifestyle. People with purging disorder do not exercise in healthy amounts, but rather are compulsive about exercise and do so to excess. They exercise to counteract calorie intake and/or to control body weight or shape. People with purging disorder feel very anxious, guilty, depressed, or irritable when they can't or don't exercise.
  • Abuse of laxatives and/or diuretics: Laxatives and diuretics used in excess or without a medical need such as constipation are sometimes used by people with purging disorder in an effort to rid the body of food before the calories can be absorbed. It is a myth that these medications work for weight loss. In fact, they induce diarrhea, which causes a loss of water, minerals, electrolytes, and indigestible fiber, and wastes from the colon. They do not cause a loss of calories or fat. Any "weight loss" is gained back when the person is rehydrated. Not rehydrating can cause dangerous dehydration.

Who Does It

Eating disorders—including purging disorder—can affect people of all genders, races, and ages.

While research often focuses on cisgender girls and women, one study indicates that about 25% (or more) of people who meet the criteria for a diagnosis of an eating disorder are male.

Trans and nonbinary people are also vulnerable to eating disorders. One study suggests that trans and nonbinary people who were assigned female at birth are particularly at risk.

Research and stereotypes about eating disorders are typically White-centered. This bias is both erroneous and dangerous.

Effect on Black People

One study showed that Black teenagers are 50% more likely than White teenagers to exhibit bulimic behavior, such as bingeing and purging.

While eating disorders can occur at any age, they typically appear in late adolescence and early adulthood. That said, risk factors are often present in early adolescence.

In terms of purging disorder specifically, about 2.5% to 4.8% of adolescent females are affected.

Of those who seek treatment for eating disorders, purging disorder is the presenting problem in 5% to 10% of adult patients and 24% to 28% of adolescent patients.

Signs of Purging

People with purging disorder may feel shame about their purging behavior and try to hide it from others.

Some do not realize their behavior is problematic, don't want to give up purging, or don't want others to offer advice, criticism, or concern. It may be difficult to know that someone has purging disorder.

Common Behaviors and Symptoms

Some behaviors and symptoms that are common among people with purging disorder include:

  • Frequent bathroom visits during or shortly after meals
  • Avoiding social situations that involve food
  • Exercising when injured
  • Exercising outside in bad weather
  • Refusing to interrupt exercise for any reason
  • Insisting on performing a certain number of repetitions of exercises
  • Exhibiting distress if unable to exercise
  • Exercise as permission to eat
  • Exercise that is secretive or hidden
  • Strong focus on body shape, weight, and appearance
  • Social withdrawal or isolation from friends
  • Avoidance of previously enjoyed activities
  • Distorted body image
  • Heightened sensitivity to comments or criticism about body shape or weight, eating, or exercise habits
  • Depression or anxiety
  • Moodiness or irritability
  • Obsessive behaviors or self-loathing
  • Change in clothing style (such as wearing baggy clothes or dressing in layers)
  • Sudden or rapid weight loss
  • Frequent changes in weight
  • Excessive use of mouthwash, mints, and gum
  • Swollen cheeks or jawline
  • Chronically inflamed or sore throat
  • Vomit smell on their breath or person
  • Broken blood vessels in the eyes
  • Calluses or scrapes on knuckles
  • Damage to teeth
  • Fainting
  • Dizziness
  • Fatigue
  • Stomach cramps, or other nonspecific gastrointestinal complaints (constipation, acid reflux, etc.) 
  • Packaging from laxatives or diuretics

The Danger of the Internet

Some people with eating disorders will search for websites that offer "tips" on dangerous eating disorder behaviors, including ways to purge. These websites are very dangerous and cause a lot of harm. Watch for signs that someone may be using them.

Dangerous Symptoms 

Purging can cause serious harm to the body, and even be fatal. Anyone with symptoms of purging disorder should see a healthcare provider for help with treatment and protecting long-term health.

Sometimes purging disorder can cause a need for immediate or emergency medical attention that cannot wait.

Serious symptoms that indicate urgent medical attention may be needed include:

  • Dizziness or fainting: Dizziness or fainting can be caused by a number of factors, but dehydration is a major and likely cause with purging disorder.
  • Chest pain, shortness of breath, or heart palpitations: Purging disorder can cause damage to the heart. It can also cause low electrolyte levels. These can lead to a drop in blood pressure, cardiac arrest, and other cardiovascular problems.
  • Dehydration: Dehydration is a major and common complication of purging disorder, and can happen with any of the forms of purging. It is dangerous and can be fatal. Signs of dehydration include headache, delirium, confusion, fatigue, dizziness, weakness, lightheadedness, dry mouth and/or a dry cough, high heart rate but low blood pressure, loss of appetite but may be craving sugar, flushed (red) skin, swollen feet, muscle cramps, heat intolerance or chills, constipation, and dark-colored urine.
  • Severe sore throat or acid reflux: Regular or forceful vomiting can damage the esophagus, sometimes irreversibly. It can cause a tear in the esophagus, causing bright red bleeding. It can also cause a burst in the esophagus, which requires emergency surgery.
  • Tremors, weakness, or blurry vision: The imbalance of electrolytes and minerals that comes with dehydration can cause these symptoms and indicate medical treatment is needed.
  • Abdominal pain: Purging disorder can cause a number of serious gastrointestinal and abdominal complications including kidney damage, tearing, and obstructions.
  • Rectal bleeding: Purging can cause problems such as rectal prolapse.
  • You think medical attention is needed urgently: If you think you or someone else needs immediate medical attention, seek it immediately, even if the symptoms don't fall under "typical" complications of purging. Purging can be damaging in many ways.

Help Is Available

If you are in a crisis and need help immediately, text “NEDA” to 741741 to be connected with a trained volunteer at Crisis Text Line. Crisis Text Line provides free, 24/7 support via text message to individuals who are struggling with mental health, including eating disorders, and are experiencing crisis situations.

Risks and Complications

Purging disorder can cause complications in many systems in the body.

Some complications of different methods of purging include:

Self-Induced Vomiting

  • Dental problems: Gum disease, decayed or discolored teeth, sensitivity, and damage to tooth enamel
  • Electrolyte imbalance or abnormalities: This can cause heart problems, and can be fatal.
  • Cardiovascular problems: Low blood pressure, heart palpitations (rapid pounding or fluttering), an abnormal rhythm of your heart, cardiac arrest
  • Enlarged parotid glands: Can cause pain and/or swelling under cheeks and in the jaw
  • Bloating and constipation: Vomiting can slow the intestines.
  • Frequent infections and sore throat: Inducing vomiting, and accidentally inhaling vomit, can cause throat and upper respiratory infections. Exposure to stomach acid can cause a sore throat and hoarse voice.
  • Involuntary vomiting: A loosened gastroesophageal sphincter from repeated vomiting can make vomiting happen even with a burp.
  • Cancer: Self-induced vomiting has been linked to esophageal cancer, though it is unknown if it causes the cancer.

Laxatives and Diuretics

  • Kidney damage: Dehydration can damage the kidneys and cause them to function improperly.
  • Electrolyte imbalance: Electrolytes such as potassium, sodium, chloride, calcium, phosphate, and magnesium that are needed for the body to function normally are lost through self-induced diarrhea. This affects the function of nerves, muscles, and vital organs. Kidney or heart failure or death may result
  • Edema: The body retains fluid in response to excessive fluid loss, causing swelling. This can cause tight or stiff joints and skin, decreased blood circulation, and difficulty walking.
  • Gastrointestinal problems: Can cause irregular digestive function, pancreatic damage, and constipation
  • Permanent damage to the muscles used during digestion: Can cause paralysis to these muscles. Surgical removal of a section or the whole colon may be necessary, resulting in the need for a colostomy bag.
  • Dependency: Prolonged use changes normal body functions, making the body dependent on the drugs to trigger bowel movement.
  • Increased risk of cancer: Damage to the colon increases the risk of colon cancer.
  • Cardiovascular and neurological problems: Misuse of laxatives and diuretics has been associated with cardiac arrest and seizures.

Excessive Exercise

  • Dehydration: Can lead to electrolyte imbalance, and kidney and heart failure
  • Stress fractures: From excess pressure on the bones
  • Increased resting heart rate: From too much stress on the heart during exercise
  • Overuse injuries: Joints, ligaments, tendons, and muscles can be injured or damaged.
  • Weakened bones: Caused by the body not having enough time to absorb essential nutrients
  • Missed menstrual periods: Due to low caloric uptake in your body
  • Sleep problems: Excessive workouts cause exhaustion, leading to restlessness and disturbed sleep.
  • Rhabdomyolysis: A condition where damaged skeletal muscle breaks down and releases a harmful protein into the bloodstream, causing kidney damage

Associated Conditions

Despite the considerable overlap between anorexia, bulimia, and purging disorder, each has distinct features and criteria for diagnosis.

  • With anorexia, a person is significantly underweight and regularly restricts food intake. A person with anorexia may also purge, but those two factors must be present for a diagnosis of anorexia.
  • With purging disorder, the person is of typical weight or heavier, and eats a typical amount of food. People with purging disorder do not binge and purge. They may feel full after a small amount of food, and purge even when they have not eaten a lot of food.
  • People with bulimia purge, but also binge, meaning they have episodes of eating a great deal of food in a relatively short period of time.

Purging disorder is also linked to other mental health conditions.

One study showed that compared with control groups, people with purging disorder have higher levels of suicidality, depression, anxiety, impulsivity, substance use, dietary restraint, body dissatisfaction, and eating psychopathology.

When to Get Help 

Getting help for purging disorder is vital. Early intervention is most effective.

If you think you may have purging disorder, see your healthcare provider.

If you suspect a loved one has purging disorder, encourage them to get help, but do so sensitively. Criticism and shame are likely to cause them to retreat. Establishing trust and communication, helping the person to see how their behavior is causing harm, is usually more effective.

For help with purging disorder coping and recovery:

Frequently Asked Questions 

How do you recognize purging behaviors in someone else?

Some signs to look for include:

  • Evidence of self-induced vomiting, such as frequent trips to the bathroom after eating, calluses/scrapes on the fingers, and swollen cheeks/jaw
  • Evidence of the use of diuretics and laxatives, such as packaging from the medications
  • Evidence of excessive exercise, such as exercising in bad weather or when injured, being distressed when unable to exercise, and exercise that is hidden or secretive

How can you help someone with anorexia?

To help someone with an eating disorder:

  • Be empathetic, but clear and direct.
  • Note signs or changes in behavior you have noticed or are concerned about.
  • Encourage them to seek help by helping to locate a treatment provider and offering to go with them.
  • Be patient. They may feel uncertain or uneasy about seeking treatment.

Is there an anorexia test?

Online screening tests for anorexia are available, but they are not substitutes for a medical consultation.

A Word From Verywell

Although it receives less attention than other eating disorders such as anorexia and bulimia, purging disorder is just as serious and dangerous.

Left untreated, purging disorder can cause complications that put your health at risk, and may be life-threatening. Untreated purging can be hard to handle psychologically as well.

Help for purging disorder is available and effective, especially when started early.

If you or someone you know has symptoms of purging disorder, make an appointment with a healthcare provider to discuss diagnosis and treatment plans.

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16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Bulimia Anorexia Nervosa Association. Other Specified Feeding or Eating Disorder (OSFED).

  2. Eat Well Health Centre. What is purging disorder and what does it do to your body?

  3. National Eating Disorders Association. Laxative abuse.

  4. Sweeting H, Walker L, MacLean A, Patterson C, Räisänen U, Hunt K. Prevalence of eating disorders in males: a review of rates reported in academic research and UK mass media. Int J Mens Health. 2015;14(2). doi:10.3149/jmh.1402.86

  5. Diemer EW, White Hughto JM, Gordon AR, Guss C, Austin SB, Reisner SL. Beyond the binary: differences in eating disorder prevalence by gender identity in a transgender sample. Transgend Health. 2018;3(1):17-23. doi:10.1089/trgh.2017.0043

  6. Goeree MS, Ham JC, Iorio D. Race, Social Class, and Bulimia Nervosa. Social Science Research Network; 2011.

  7. Rohde P, Stice E, Marti CN. Development and predictive effects of eating disorder risk factors during adolescence: Implications for prevention efforts. International Journal of Eating Disorders. 2015;48(2):187-198. doi:10.1002/eat.22270

  8. Keel PK. Purging disorder: recent advances and future challenges. Curr Opin Psychiatry. 2019;32(6):518-524. doi:10.1097/YCO.0000000000000541

  9. Keel PK, Forney J, Kennedy G. Clinical Handbook of Complex and Atypical Eating DisordersOxford University Press. 2018.

  10. Blythin SPM, Nicholson HL, Macintyre VG, Dickson JM, Fox JRE, Taylor PJ. Experiences of shame and guilt in anorexia and bulimia nervosa: A systematic review. Psychology and Psychotherapy: Theory, Research and Practice. 2020;93(1):134-159. doi:10.1111/papt.12198

  11. Eating Disorders Victoria. Eating disorders explained.

  12. Disorders.org. Telltale symptoms of purging disorder.

  13. Cleveland Clinic. Eating disorders. Updated October 2020.

  14. Forney KJ, Buchman-Schmitt JM, Keel PK, Frank GKW. The medical complications associated with purging. Int J Eat Disord. 2016;49(3):249-259. doi:10.1002/eat.22504

  15. Disorders.org. Purging disorder.

  16. Smith KE, Crowther JH, Lavender JM. A review of purging disorder through meta-analysis. J Abnorm Psychol. 2017;126(5):565-592. doi:10.1037/abn0000243