
Laxatives are commonly used to treat constipation and are available over the counter without a prescription. However, laxatives can be addictive and dangerous when misused or abused, particularly for weight loss. This is a common issue for people with eating disorders, who may use laxatives to purge calories or food, or to achieve their ideal body weight. The abuse of laxatives can lead to physical dependence, causing the body to rely on them for bowel movements. This can result in constipation, as well as more severe gastrointestinal issues, such as intestinal nerve damage and colon infections. The overuse of laxatives can also cause dehydration, mineral deficiencies, electrolyte disturbances, and even organ damage.
Characteristics | Values |
---|---|
Addiction | Laxatives can be addictive and lead to physical dependence. |
Abuse | Laxative abuse is common among people with eating disorders, particularly bulimia nervosa. |
Weight Loss | Laxatives are misused as a weight-loss tool, but they are ineffective for this purpose and can cause severe health issues. |
Side Effects | Dehydration, electrolyte imbalance, organ damage, constipation, heart problems, increased risk of colon cancer, urinary tract infections, muscle spasms, intestinal paralysis, and more. |
Treatment | Treatment involves stopping laxative use, psychotherapy, and supportive care. |
What You'll Learn
Laxatives and weight loss
Laxatives are medicines to treat constipation by softening the stools to make them easier to pass, or by stimulating the lower intestine to push out the stool. They are available over the counter without a prescription and are usually harmless when taken according to the recommended doses. However, they are sometimes misused by people trying to lose weight.
Laxatives are often abused by people with eating disorders such as anorexia nervosa and bulimia nervosa. The thinking is that laxatives will quickly move food through the body and clear out calories before they can be absorbed. However, this is not true. By the time food waste reaches the large intestine, the small intestine has already absorbed the calories from the food consumed. The waste that moves into the large intestine is mostly full of water and some minerals. Therefore, if you use laxatives and lose weight, you are just losing water, which your body will quickly replace.
Laxative abuse can cause temporary weight loss due to a decrease in "water weight", but it does not reduce body fat or promote long-term weight loss. It can also create a false sense of weight loss by decreasing bloating.
The overuse of laxatives can lead to serious health problems, including:
- Dehydration
- Electrolyte disturbances/imbalance
- Mineral deficiencies
- Cardiovascular problems
- Damage to the digestive system, including the nerves and muscles of the colon
- Increased risk of colon cancer
- Infections
- Rectal prolapse
- Eating disorders
There are safer and more effective ways to lose weight, such as getting regular exercise, eating more fruits and vegetables, drinking less sugary drinks, and increasing your fiber intake.
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Laxative abuse and eating disorders
Laxatives are commonly used to treat constipation, but they can be misused by individuals with eating disorders as a method of weight loss or to "feel empty". This occurs particularly in those struggling with body image issues or eating disorders such as anorexia nervosa and bulimia nervosa. Laxatives are often misused because individuals mistakenly believe that they will help rush out food and calories before they can be absorbed. However, this is a myth, as by the time laxatives act on the large intestine, most calories have already been absorbed by the small intestine. The weight loss experienced is mainly due to water loss, which returns as soon as the individual rehydrates.
Laxative abuse can lead to physical dependence, requiring increased doses to achieve the desired effect. This cycle of dependence exacerbates constipation and significantly increases the risk of long-term gastrointestinal damage. The abuse of laxatives can cause a multitude of health risks, including:
- Dehydration, which can lead to symptoms such as thirst, dry skin, fatigue, tremors, blurry vision, kidney damage, and even death.
- Electrolyte imbalances, which can cause alterations in the levels of essential minerals like potassium, sodium, and magnesium. These disruptions can result in arrhythmias, muscle weakness, and seizures.
- Gastrointestinal issues, including intestinal nerve damage, laxative dependency for bowel movement, and, in severe cases, ischemic colitis (a condition where blood flow to the colon is reduced, leading to inflammation and ulceration).
- Infections and irritation: Laxative abuse strips away the protective mucus layer in the intestines, leaving them vulnerable to infection and irritation.
- Colon cancer: Some studies suggest that abusing laxatives increases the risk of colon cancer due to long-term inflammation.
- Rectal prolapse: Chronic severe diarrhea caused by laxative abuse can cause the inside of the intestines to protrude through the anal opening.
Treatment for laxative abuse involves a team of health professionals with expertise in treating eating disorders, including physicians, psychiatrists, psychotherapists, and dietitians. The first step often involves medical detoxification to manage withdrawal symptoms and restore fluid and electrolyte balance. Psychological therapy, such as cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), is also crucial to address the underlying issues contributing to the abuse, such as body dysmorphia and low self-esteem. Nutritional counseling is essential to help individuals recover and develop healthy eating patterns.
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Side effects of laxative abuse
Laxatives are commonly used to treat constipation. However, they are sometimes misused by individuals with eating disorders, such as anorexia nervosa or bulimia nervosa, who believe it will help them lose weight. This is a dangerous myth, as laxatives do not result in long-term weight loss. Instead, they can cause severe side effects and long-term health risks.
Dehydration and Electrolyte Disturbances
Laxative abuse can lead to dehydration as it removes water from the body. Dehydration can cause symptoms such as thirst, decreased urination, headaches, light-headedness, dry mouth, weakness, and fatigue. It can also lead to more severe issues such as tremors, blurry vision, kidney damage, and even death if not treated promptly.
Laxative abuse can also cause electrolyte disturbances, including abnormalities in sodium, potassium, and chloride levels. These electrolytes are essential for nerve and muscle function, including the heart. Electrolyte imbalances can lead to weakness, irregular heartbeats, and sudden death.
Mineral Deficiencies
Laxatives can cause mineral deficiencies, particularly of magnesium, sodium, potassium, and phosphorus. These minerals are necessary for the proper functioning of vital organs, including the colon and heart. A disturbance in mineral balance can lead to improper functioning of these organs.
Digestive System Damage
The overuse of laxatives can cause long-term and potentially permanent damage to the digestive system. This includes constipation, damage to the nerves and muscles of the colon, and chronic constipation. Laxatives work by artificially stimulating or irritating the nerves in the large intestine, and prolonged use can damage these nerves. This can lead to a "lazy colon", where the colon loses its normal muscle function and nerve response, resulting in impaired intestinal function.
Infections
Laxative abuse strips away the protective mucus layer and beneficial bacteria in the intestines, leaving them vulnerable to infection and irritation. It is also associated with an increased risk of irritable bowel syndrome.
Rectal Prolapse
Chronic severe diarrhoea caused by laxative abuse can lead to rectal prolapse, where the inside of the intestines protrude through the anal opening. This condition usually requires surgical treatment.
Mental Health Issues
Laxative abuse is often associated with mental health issues such as depression, anxiety, and shame. Constipation due to laxative abuse can cause physical discomfort and social isolation, further contributing to negative mental health effects.
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Laxative abuse treatment
Laxative abuse is a serious issue that can lead to severe health problems and even death. Treatment for laxative abuse typically involves a team of medical and mental health professionals, including doctors, psychiatrists, psychotherapists, and dietitians. Here is a detailed guide on laxative abuse treatment:
Initial Treatment
The first step in treating laxative abuse is to address the immediate physical health risks. The individual will need to be rehydrated, and their body electrolytes and minerals will need to be stabilised. This process should be carefully monitored by medical professionals, especially those with expertise in eating disorders. Laxative abuse can lead to severe dehydration and electrolyte imbalances, which can be life-threatening and require prompt medical attention.
Psychological Support
Laxative abuse often has a psychological component, so support from healthcare providers, therapists, and family is crucial. People recovering from laxative abuse may struggle with body image issues, low self-esteem, and mental health conditions such as anxiety and depression. Developing healthy coping mechanisms, improving self-confidence, and fostering self-acceptance are important aspects of treatment. Counselling and therapy can help individuals address these underlying issues and resist the urge to relapse.
Nutrition and Diet
As individuals recover and return to a normal eating routine, dietitians can provide guidance on eating plans that prevent constipation. This may include increasing fluid intake, gradually adding more fibre to the diet through fruits, vegetables, whole grain breads, and cereals, and regular exercise. These steps can help regulate the intestines and promote healthy bowel function.
Inpatient Programming
Inpatient treatment is recommended for those with severe laxative abuse issues. In this setting, individuals reside at a treatment facility with others in recovery and receive comprehensive medical and therapeutic care. Common therapies used in inpatient treatment include cognitive behavioural therapy (CBT) and dialectical behavioural therapy (DBT).
Partial Hospitalisation Programming
Partial hospitalisation is a step-down option for those who no longer require the intensity of inpatient care but still need more structure and support than traditional outpatient services. Individuals in partial hospitalisation may live at home or at the treatment facility, and they participate in a full day of therapeutic activities, both individually and in groups.
Outpatient Programming
Outpatient programming is suitable for those with less severe cases of laxative abuse. This option allows individuals to attend treatment for a few hours a day or a few days a week while continuing their daily lives. Outpatient treatment typically involves individual and group therapy sessions, as well as skill-building activities to promote long-term recovery.
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Signs of laxative abuse
Laxative abuse is a common problem, especially among those with eating disorders. It is important to be able to recognise the signs of laxative abuse in order to seek help for yourself or someone else.
Behavioural Signs
- Taking pills or drinking water mixed with powder before or after meals
- Spending a lot of time in the bathroom after eating
- Rearranging social plans, work or school around bathroom breaks
- A sudden urgency to use the bathroom after eating
- Hiding laxatives or buying them from different stores
- Lying about using laxatives, herbal supplements or cleanses
- Obsession and ritualistic behaviours surrounding laxative and bathroom use
- Other forms of self-harm, such as cutting
Emotional Signs
- Feelings of euphoria after bowel movements
- Expressing feelings of depression, anxiety or shame
- Negative body image or wearing baggy clothes to hide body shape
- Withdrawal from loved ones
- Shame and guilt about food
- Preoccupation with body image and thinness
Physical Signs
- Abdominal cramping
- Shivering or shaking
- Chronic stomach pain
- Rectal bleeding or blood in stool
- Increased dependency on laxatives and higher doses
- Fluctuations in blood pressure
- Feeling lightheaded or fainting
- Increased muscle weakness
- Dehydration
- Diarrhoea
- Gastrointestinal discomfort
- Gas
- Loose stool
- Rectal irritation
- Infections
- Urinary tract infections
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