Dying to be thin – Laxative abuse in eating disorders

*TRIGGER WARNING – This post discusses the abuse of laxatives as an eating disorder behaviour. If you feel that reading this may be potentially triggering for you then please do not continue. Always keep yourself safe.”

So having an eating disorder is far from glamorous. Whichever your particular poison happens to be…. anorexia, bulimia, a toxic combination of the two, binge eating disorder?  NONE of the options are pretty or pleasurable. The methods behind the “picture perfect” body are a far cry from the airbrushed end result that we see slapped across magazines, billboards and sites online. The word Eating Disorder seems to have somewhat lost it’s shock value. And that’s completely understandable when you consider that BEAT estimates that 1.25 million people in the UK have or are afflicted.  Starving yourself, throwing up – we hear about it all the time. It’s no longer taboo. But there seems to be one eating disorder behaviour that still has that “sssssssshhhhhh” stigma attached to it – The use or over-use of laxatives to control weight. Society seems to be much more accepting of self induced vomiting as opposed to self induced shitting. Funny really isn’t it? Especially seeing as going to the toilet is actually a normal, (often) every day function for pretty much the entire human race. I don’t know many people who vomit every day, do you? But still it’s not polite to talk about poo. So perhaps it is this stigma that keeps the truth about laxative abuse in eating disorders shrouded in shame. But for many sufferers out there, it’s their reality. It has been mine. So I feel it’s important to talk about. The dangers of laxative abuse in eating disorders are real. And these easily available over the counter “natural” remedies can be dangerous; potentially even deadly.

So what do laxatives actually do?

Laxatives are widely used to treat constipation. There are three main types: Bulk forming laxatives, osmotic laxatives and stimulant laxatives, the latter being the most common. All three types are available from pharmacies and supermarkets without prescription. I’m going to focus mainly on the stimulant laxatives here, otherwise known as bisacodyl, senna and/or sodium picosulfate. Stimulant laxatives do exactly what they say on the tin. They stimulate and trigger the muscles in the intestines so as to move waste through the body more quickly. They usually advise one dose for an adult and to use no more than a few times a week. The over use of stimulant laxatives can cause the bowel to become lazy, therefore it needs those stimulants and in larger quantities to function properly. And this is of course where the problems start. It’s similar to the idea that a drug user needs just a little more each time to achieve that same high. But of course introducing larger and more frequent doses of laxatives puts more and more strain on the body.

Laxatives don’t help you to lose weight

I’ve lost count of the amount of doctors and medical professionals who have told me this over the years. I heard them. I understood. I read all of the research. But I did it anyway. The eating disorder is sneaky. It also thinks it knows better than everyone else. All I knew was that I did in fact see the numbers on the scales go down. It didn’t matter to me that I hadn’t actually lost any “real” weight. That I hadn’t actually gotten rid of calories or any real food. I didn’t care that what I was in fact losing was fluids and electrolytes. The number was all that mattered.

And whilst I’ve already mentioned that the long term usage or over-use of laxatives can cause the body to have a dependency. There are also some other very serious effects of laxative abuse. Let’s talk dehydration and the disturbance of electrolyte and mineral balances. Sodium, potassium, magnesium, and phosphorus are electrolytes and minerals that are present in very specific amounts necessary for proper functioning of the nerves and muscles, including those of the colon and heart. It’s a delicate balance, and the disruption of these levels can compromise the functioning of vital organs. I know that potentially sounds like scare mongering, and everyone always assumes that the warnings on labels won’t apply to them. I thought the same.

Truth is, and there is no point writing this post if I’m not going to be honest; I’ve been a serial flirt with most eating disorder behaviours. I’ve dabbled let’s say. I was always most comfortable with restricting. I didn’t find it difficult. I liked the euphoria that came with starvation. I liked the way being empty made me feel. I even liked how I felt cold in a warm room. Because that made me successful at this, I could do THIS. But inevitably I would always have to eat. And that feeling of no longer being empty was torturous and I wanted to fix it. Turns out I wasn’t such a good bulimic. Vomiting isn’t fun or easy. It feels terribly violent, and I suppose that’s because it is. It seemed a million miles away from the silent, somewhat gracefulness of anorexia. Also, it needed to be fairly immediate. The urgency made me feel uneasy, especially if I were out with friends or family.

Don’t get me wrong, the end game of taking a large dose of laxatives is also not pleasurable. But it felt like less effort somehow, I didn’t really need to do anything. It was also a much more private affair. If I was going to take them I would do so in the evening, meaning they would usually start to work in the middle of the night and therefore I could be alone. Which is all well and good, until you take so many that you collapse with low blood pressure. It happened more than once. It was terrifying in the moment. But not enough to stop me from doing it again and again. I spent far too many nights lying alone on bathroom floors, wondering if perhaps this time was the time I’d finally taken too many.

I won’t talk about how many laxatives I would take in one go. I would hate for this post to somehow become a sort of screwed up instruction manual. But I will talk about the ramifications and the lasting damage that abusing laxatives may and can cause. At age 33 I was sent for an ECG due to consistent heart palpitations. I’ve suffered from a dangerously low heart rate, low blood pressure, a weakened immune system, poor digestion, bloating, water retention, a lazy and sluggish colon. I’m currently undergoing slightly more invasive tests than I would like to rule out potentially more serious colon problems. My electrolytes have been, no pun intended, a complete shit show. I’m regularly low in potassium and I still suffer from palpitations to this day. Recently whilst I was on holiday my digestive system basically just decided to shut down and I was forced to seek out medical intervention. Getting my body back to a healthy weight was actually the simplest part. Getting my organs used to regular eating again was not so easy. I’ve had considerable pain. It’s been a really tough and long slog and now when I think about it, I hate how much I hurt myself. I wasn’t thinking about the possibility that my frenzied decisions in those moments might actually impact on my future wellbeing. I just knew the cramps and the nausea would pass. If I could get through that episode it would all be ok again. Because I’d be empty. I just needed that emptiness.

When I decided to write this post I reached out on social media to see if I could find other people willing to talk about their experiences with laxatives. I drew a bit of a blank. I’m pretty certain that this supports my original thinking that nobody wants to a) share this or b) hear about this. But if we don’t talk about it then how will people ever know about the dangers of laxative abuse in eating disorders? How will they ever know how to help, what signs to look for, that this problem even exists? How will those who are suffering feel able to reach out for help if they can’t even say the words? It’s totally cliche of course but sharing really is caring. And with mental health awareness growing all around us, now feels like the perfect time to be starting these conversations. If you are someone who is abusing laxatives as a means of losing weight or if you suspect someone you care for is engaging in this behaviour, you can contact the incredible team at BEAT on 0808 801 0677. They will be able to support and advise you in the best way to start recovering/helping. You can also speak to your GP or anyone that you trust. And even though it isn’t talked about all that much, please don’t feel that you’re alone in this.

I, of course, don’t have the answers. I’m quite obviously still recovering. I have had to be weaned off laxatives slowly because I can’t go cold turkey. My body has forgotten how to function properly without that little bit of help, but we will get there. I am getting there. Every day that I eat, every day that I don’t purge food from my system, every day that I don’t look in the mirror and hate what I see, every time that I just smile at my reflection – it’s all a win. I’m going to fucking win this war. Because in all seriousness, where’s the sense in dying to be thin my friends? If dying is what it takes to get there…… it’s too high a price. And maybe that seems fairly obvious to so many of you. Perhaps it seems laughable that it’s taken me almost 40 hours of therapy to finally come to this conclusion. I don’t care if that’s what people think really. I just know that my head is a much nicer place to be these days. Considering the state I was in 6 months ago, I will take that and and run. If I can do it, then you certainly can too.

Sending Love and Light to anyone who needs it

Beth Anne xoxo