Laxative and Enema Abuse: What You Need to Know

“Did I get it all out of me?”

For those with bulimia who battle the binge-purge cycle, this may be a common thought that goes through your head following an episode of bingeing. Worried that the food you just consumed might get “stuck” inside of you, and that the longer it stays within, the more time the calories and fat have to stick to your digestive tract and absorb into your body.

A frequent form of purging behavior, laxative and enema misuse is another maladaptive tactic used to counteract the effects of food, whether that’s dispelling calories, losing weight, or feeling “empty” and lighter without food in the body’s system. 

Laxative abuse is widespread among eating disorder sufferers, with up to 75% of people with anorexia, binge-purging subtype, and bulimia using these expelling agents frequently as part of their disordered eating habits. In bulimic individuals specifically, 36.5% misuse laxatives, and 7.9% misuse enemas to supplement their purging methods. 

Unfortunately, Their Misuse is Just Causing More Damage, Not “Undoing” Eating

Not only do laxatives not really work in the way someone with bulimia may hope (most of the calories and nutritional components are already absorbed by the time they enter the large intestine–the place affected by laxatives and enemas), but their misuse and abuse can cause a pile-on of health issues to the already fragile physical state of a person with an eating disorder like bulimia. 

The myth that fuels laxative and enema abuse is that a user may feel that by emptying their digestive system and rushing to push the physical remains of eaten food out, they’re bypassing fat, calories, and weight gain. However, this simply isn’t true; as mentioned above, most of the components of food are already absorbed by the time laxatives and enemas get to work.

What’s Really Affected is Water Levels 

In reality, what really comes off is the “water weight,” which is easily affected by the dehydrating nature of expelling agents. Water, electrolytes, minerals, and fiber are especially targeted in bowel movements artificially caused by medication, with abuse resulting in diarrhea that can wipe out hydration levels in the body. 

When or if a user rehydrates, the “weight” is easily tacked back on, since water constitutes a majority of the human body and fluctuates easily. This is another reason laxative and enema use can be so enticing to those with bulimia or other eating disorders since distortion of the body’s water level typically takes the shortest amount of time to show up as weight loss.

If they maintain their laxative abuse, however, dehydration can begin to set in, furthering eating disorder health complications with major tolls on physical and mental health.

How Laxative and Enema Abuse Wreak Havoc

Prolonged laxative abuse can have serious effects on the body. Dehydration, electrolyte imbalances, disruption of organ functioning, and digestive system damage are just a few of the physical consequences that can result from excessive laxatives and enema misuse. In addition, the body may become dependent on laxatives to have a bowel movement, leading to further complications that impede natural waste removal. 

It's important to be aware of these potential outcomes in order to recognize the signs and symptoms of laxative abuse.

• Organ function failure, which may arise alongside the disruption in electrolyte and mineral equilibrium, causes imbalances of vital elements in the body. Sodium, potassium, and magnesium for example are all pivotal for the proper functioning of nerves and muscles and crucial for the colon and heart to stay working correctly. 

• Severe dehydration, a possible outcome of laxative misuse, can cause tremors, blurred vision, weakness, fainting, and kidney impairment. In severe instances, dehydration can prove fatal, necessitating immediate medical attention. 

• Laxative dependence may emerge from excessive usage, leading to a reduced response of the colon to typical laxative dosages and requiring larger and more frequent intakes of expelling agents to induce bowel movements. 

• Constipation driven by laxative abuse and dependency occurs when the intestines lose nerve sensation and muscle over time, unable to naturally construct and push waste out of the intestines alone 

• Organ damage that harms the colon and/or the excretory system can create conditions such as a stretched or "lazy" colon, colon infections, and irritable bowel syndrome; furthermore, it may also heighten the likelihood of developing colon cancer.

Signs and Symptoms of Laxative Abuse

Signs and symptoms of laxative abuse can vary from person to person, but common indicators may include chronic diarrhea, dehydration, electrolyte imbalances, abdominal pain, bloating, and fatigue. As listed in the symptoms above, some individuals may also experience changes in bowel habits or difficulty having a bowel movement without the use of laxatives. 

It's important to pay attention to these warning signs and seek help if you or someone you know may be struggling with laxative abuse. Seeking professional assistance and support is crucial in putting a stop to the overuse of laxatives and enemas. Not just in order to slow down their toll on the body, but to eventually make way for resolving the deeper mental and emotional roots of medication abuse and the eating disorder that might be propping it up. Addressing these physical and mental effects of laxative abuse is the first step in the journey toward recovery. 

Immediate Steps to Stop Excessive Laxative Use

Though it’s incredibly important to follow up with healthcare professionals during your recovery journey, there are some steps you can take at home to begin the process on your own. 

According to Cornell University’s Health Department, an individual wanting to end their laxative abuse and dependency can start by:

• Stopping and tossing away any products, as reducing slowly doesn’t generally benefit the body as much as stopping immediately does 

• Finding ways to alleviate potential constipation, such as drinking at least 8 cups of water a day, increasing dietary fiber, eating regularly, and scheduling necessary bathroom time for the gastrointestinal movement that typically follows after meals

• Planning ahead to resist the laxative urge by identifying when you might want to take a laxative (after a binge, after being constipated) and focusing on coping mechanisms like calling a friend or taking a walk to help deter the urge 

• Building support by letting an entrusted friend or relative know about your struggles and how they can help

• Seeking professional help, such as a doctor, nutritionist, therapist, or coach to reinforce your recovery goals and advise you on temporary health symptoms like bloating and constipation that may come after stopping laxatives 

Seeking Help in Laxative Abuse and Eating Disorder Recovery

When it comes to seeking help and recovery from laxative and enema abuse, it's important to remember that you are not alone in this journey. It can be difficult to acknowledge a problem and take the first step toward recovery, but reaching out to friends, family, and professional support is important to show you who is by your side during this tenuous process. 

Being vulnerable about the intimate nature of eating and excretory habits can be difficult since these routines look so personal and different for each and every person. Revealing the struggle with laxatives can be especially exposing or embarrassing for some, as it deals with typical functions that are taken behind closed doors. 

Don’t Give Up on Your Recovery Journey

But opening that door into damaging behaviors is crucial to shedding light on the negative mechanisms that are causing so much pain and discomfort in your life. It can be hard, but being open to seeking help and committing to recovery is how ultimate healing from the physical and emotional effects of laxative abuse and remission from eating disorders like bulimia occurs. 

Seeking help from a treatment team can motivate your first steps into recovery, with dedicated helpers behind you pushing for your success. Whether this is a physician, a family member, an eating disorder recovery coach, or a therapist, there are thousands of specialists out there who specialize in eating disorders and can provide you with the necessary tools and support to address underlying issues and develop healthier coping mechanisms that put an end to the dangerous practice of laxative and enema abuse. 

With Peace,

Whitney Chase

Whitney Chase is the Writer and Content Manager for Sarah Lee of Sarah Lee Recovery. She holds her degree in Psychology from Georgia State and has a strong passion for the mental health field, writing, and advocacy work.

Posted on April 17th, 2024.

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