Eating Disorders / Question
Published: July 13, 2009
Dear TeenHealthFX,
I have become very dependent on laxatives in recent years. Within the past few months, my dependency has gotten even worse. I've tried to quit taking them and just use Colace and increase my fiber and water intake, but that just caused me to be extremely constipated for two weeks. My life has begun to revolve around my dependency. It's gotten to the point where if I don't take at least 8 laxatives every other day, then the bottom of my stomach bulges out and becomes very hard. Could I have some sort of medical condition? Or is my constipation just getting worse because I am so dependent on laxies? I would greatly appreciate any insight that you have. Please, I do not want to spend the rest of my life taking laxatives. Signed, Miserably Constipated
Signed: Dependent On Laxatives
Dear Dependent On Laxatives,
Ongoing laxative abuse is a very dangerous thing that can have some serious consequences. Many people get hooked on abusing laxatives as a means of losing or maintaining weight (which it actually does not help with, as explained below). The abuse of laxatives can become quite addictive for some and can lead to significant health problems. It sounds like you feel addicted to taking them, since you mentioned you have tried unsuccessfully to quit in the past. It also sounds like you are starting to experience some of the many consequences of abusing laxatives in terms of the negative effects on your digestive system you describe.
FX thinks that it is very important for you to speak with a medical and mental health professional about your laxative abuse. It is critical that you get the medical attention you need to help your digestive system to be more regulated, but it is also equally important for you to get the mental health treatment needed to help you break your addiction.
If you don't have a doctor and live in northern New Jersey, you can call the Adolescent/Young Adult Center for Health at 973-971-6475 for an appointment. Outside of New Jersey, you can contact your local teen health center or you can call your insurance company to get a list of in-network medical providers.
If you live in northern
TeenHealthFX has listed some general information about laxatives and laxative abuse below so you can become well-educated about what the impact of laxative abuse can be:
What are laxatives?
Laxatives are substances used to induce bowel movements, most often used to treat constipation or to clean out the colon for rectal and bowel examinations. There are certain dietetic changes, illnesses, medication, or conditions that contribute to constipation and sometimes laxatives are recommended as a temporary treatment in these situations. Laxatives can be taken by mouth (oral laxatives in the form of liquids, tablets, wafers, gums, or powders that dissolve in water) or in your rectum (in the form of enemas or suppositories). While there are times that laxative use becomes medically necessary, laxatives can also be abused by people with eating disorders, such as bulimia nervosa or anorexia nervosa.
The myth about laxatives and weight loss:
Many people trying to lose weight quickly or to reach weight levels that are too low for their body type turn to laxatives because they think by going to bathroom more frequently they will be losing body weight. However, this is a common misconception as laxatives do not help a person to lose body weight. Once ingested, the laxative works in the colon, not the stomach – and by the time food reaches the colon all of the calories from the food have already been absorbed into the body. So you may feel like you lost weight after going to bathroom so much, but, the lost weight is basically water weight. And this water weight will just come right back on because within 48 hours of using a laxative, the body starts to retain water to make up for all it has lost.
The dangers associated with using laxatives for weight loss:
For some people the feel of losing weight is reason enough to continue with the laxatives. However, it is important to be aware of the medical risks that are associated with abusing laxatives (whether the laxative is in pill, suppository, herbal, or liquid form). Problems linked with laxative abuse include:
- Severe abdominal pain
- Chronic diarrhea. This can occur because after repeated use of laxatives you eventually lose control of your rectum.
- Dehydration
- Gas
- Nausea and vomiting
- Electrolyte imbalance, which can lead to heart arrhythmias and heart attacks.
- Intestinal paralysis: prohibits the passage of food through the intestine, leading to intestinal blockage. It can cause constipation and bloating.
- Irritable Bowel Syndrome (IBS): functional bowel disorder characterized by abdominal pain and frequent changes in bowel habits.
- Pancreatitis (inflammation of the pancreas)
- Renal failure (kidneys fail to function adequately)
Laxatives and eating disorders.
If a person repeatedly abuses laxatives, that person is considered to have an eating disorder and will generally fall under the category of being either bulimic or anorexic (two types of eating disorders that have some similarities and some significant differences) depending on the other symptoms that are present along with the laxative abuse.
Bulimia Nervosa
Bulimia nervosa involves repeated episodes of binge eating, followed by ways of trying to purge the food from the body or prevent the expected weight gain. People can have this condition and be of normal weight. There are two subtypes of bulimia, the purging type and non-purging type. The purging type involves using methods that will rapidly extricate the contents from their body using self-induced vomiting, diuretics, laxatives, enemas, or ipecac. The non-purging subtype of bulimia is less common, involving excessive exercise or fasting after a binge as a way to try and rid the body of such a large number of calories that have been taken in.
The signs and symptoms of bulimia can include:
- Recurrent episodes of binge eating
- Feeling that you can't control your eating behavior
- Eating much more food in a binge episode than in a normal meal or snack
- Following a binge with efforts to prevent weight gain — such as self-induced vomiting, using laxatives or other medications, fasting or excessive exercise
- Unhealthy focus on your body shape and weight
- Dehydration
- Fatigue
- Depression
- Constipation
- Damaged teeth and gums from gastric acid contained in vomit
- Swollen cheeks from regular vomiting
- Irregular heartbeat
Anorexia Nervosa
Laxatives can also be abused by people suffering from anorexia nervosa. Anorexia is essentially self-starvation characterized by a restriction of food and a refusal to eat enough to maintain a normal body weight. In severe cases it can be life threatening. Most anorexics lose weight by restricting food intake, excluding certain foods from their diet, or including the use of vomiting, laxative abuse, or other methods for weight loss.
The signs and symptoms of anorexia can include:
- Weight loss, sometimes achieved by self-induced vomiting, abuse of laxatives, use of diuretics or exercise
- Refusal to maintain normal body weight, sometimes weighing 15 percent or more below normal body weight
- Intense fear of gaining weight
- Negatively altered body image
- In females, menstrual changes or the absence of menstruation
- Anxious or ritualistic behavior at mealtimes
- Fatigue
- Depression
- Irregular heart rate
- Baby-fine hair covering the body (lanugo)
- Mild anemia
- Brittle nails and hair
- Low blood pressure
Eating disorders and addiction.
The same personality factors that place individuals at risk for substance abuse are often found in individuals with eating disorders. People who abuse laxatives often feel addicted to them because they feel dependent on them and in need of the immediate gratification they feel when they take the laxatives. And the same as people abusing drugs and alcohol, there can be a real denial that what they are doing is problematic and harmful in various ways. And between the denial and the strong desire to keep using laxatives, it can be a problem that is hard to recognize, accept, and change – especially without the help of trained professionals.
With addiction and eating disorders, the following also tends to occur:
- Emotional experiences are discharged through action rather than through feeling or being able to talk about feelings.
- There is an inability to regulate tension.
- There is a need for immediate gratification.
- Poor impulse control is present.
- There is a fragile sense of self.
Treatment and resources:
Dealing with behaviors associated with eating disorders requires the attention of medical and mental health professionals to ensure your physical and emotional well-being. If you are abusing laxatives, or have any other signs or symptoms of bulimia nervosa or anorexia nervosa, TeenHealthFX recommends that you seek treatment with doctors and therapists trained in working with people with eating disorders.
If you live in northern
If you don't have a doctor and live in northern
Signed: TeenHealthFX
In the 
