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Cited by 130Eating Disorders and BehaviorsNutrition, Health and Food BehaviorChild Nutrition and Feeding Issues

The medical complications associated with purging

Open access
Forney, K. Jean, Buchman‐Schmitt, Jennifer M., Keel, Pamela K., Frank, Guido K.W.·2016·International Journal of Eating Disorders
DOI 10.1002/eat.22504PMC PMC4803618
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Abstract

OBJECTIVE: Purging behaviors, including self-induced vomiting, laxative abuse, and diuretic abuse, are present across many of the eating disorders. Here we review the major medical complications of these behaviors. METHOD: Although we identified over 100 scholarly articles describing medical complications associated with purging, most papers involved case studies or small, uncontrolled samples. Given the limited evidence base, we conducted a qualitative (rather than systematic) review to identify medical complications that have been attributed to purging behaviors. RESULTS: Medical conditions affecting the teeth, esophagus, gastrointestinal system, kidneys, skin, cardiovascular system, and musculoskeletal system were identified, with self-induced vomiting causing the most medical complications. DISCUSSION: Purging behavior can be associated with severe medical complications across all body systems. Mental health professionals should refer patients with purging behaviors to medical providers for screening and treatment as needed. The medical work-up for individuals with eating disorders should include a comprehensive metabolic panel, complete blood count, and a full body exam including the teeth to prevent severe complications. Medical providers should screen patients for purging behaviors and associated medical complications, even in the absence of an eating disorder diagnosis, to increase the detection of eating disorders. Recognizing the link between purging and medical complications can aid in identifying potential eating disorders, particularly those that often elude detection such as purging disorder.

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  • The exact mechanisms by which purging behaviors affect gut microbes remain largely unclear, but are expected to be a consequence of structural and functional changes in the colon, such as damage to mucosal lining, electrolyte imbalance, and changes in transit time and intra-abdominal pressure, which collectively alter the gut environment for microbial colonization.

    “The exact mechanisms by which these behaviors affect the gut microbes remain largely unclear, but are expected to be a consequence of structural and functional changes in the colon, e.g., damage to mucosal lining, electrolyte imbalance, as well as changes in transit time and intra-abdominal pressure, which collectively alter the gut environment for microbial colonization [81,82].”

    From Are the gut bacteria telling us to eat or not to eat? reviewing the role of gut microbiota in the etiology, disease progression and treatment of eating disorders (2017) · cites this paper as [82]

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  1. [60]Cellucci MF Dehydration and fluid therapy in children Merck Manuals Professional Edition 2014

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Authors
Forney, K. J., Buchman‐Schmitt, J. M., Keel, P. K., & Frank, G. K. W.
Affiliations
  • Florida State University (US)
  • University of Colorado Anschutz (US)
Corresponding author
Keel, Pamela K.
ORCID
Venue
International Journal of Eating Disorders
Publisher
Wiley
Published
2016-02-15
Volume
49
Issue
3
Pages
249-259
ISSN
  • 0276-3478 (ISSN-L)
  • 1098-108X
DOI
10.1002/eat.22504
PMC
PMC4803618
OpenAlex
W2278516255
Cited by
130
References
147
Citations by year
2026: 8 · 2025: 10 · 2024: 8 · 2023: 16 · 2022: 23 · 2021: 18 · 2020: 16 · 2019: 12 · 2018: 7 · 2017: 9 · 2016: 2
FWCI
1.48
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • International Journal of Eating Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (T32 MH93311, F31MH105082, T32MH093311)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords
purging behavior, self-induced vomiting, laxative abuse, diuretic abuse, eating disorders, medical complications, dental erosion, esophageal injury, gastrointestinal complications, renal complications, cardiovascular complications, musculoskeletal complications, purging disorder, eating disorder screening
MeSH terms
Feeding and Eating Disorders, Female, Humans, Male, Vomiting, Substance-Related Disorders

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