Purging disorder is an

eating disorder An eating disorder is a mental disorder defined by abnormal eating behaviors that negatively affect a person's physical or mental health. Only one eating disorder can be diagnosed at a given time. Types of eating disorders include binge eating d ...

characterized by the

DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiatric ...

as self-induced

vomiting Vomiting (also known as emesis and throwing up) is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the Human nose, nose. Vomiting can be the result of ailments like Food-poisoning, foo ...

, or misuse of

laxative Laxatives, purgatives, or aperients are substances that loosen stools and increase bowel movements. They are used to treat and prevent constipation. Laxatives vary as to how they work and the side effects they may have. Certain stimulant, lubri ...

diuretic A diuretic () is any substance that promotes diuresis, the increased production of urine. This includes forced diuresis. A diuretic tablet is sometimes colloquially called a water tablet. There are several categories of diuretics. All diuretics in ...

s, or

enema An enema, also known as a clyster, is an injection of fluid into the lower bowel by way of the rectum.Cullingworth, ''A Manual of Nursing, Medical and Surgical'':155 The word enema can also refer to the liquid injected, as well as to a device ...

s to forcefully evacuate matter from the body. Purging disorder differs from

bulimia nervosa Bulimia nervosa, also known as simply bulimia, is an eating disorder characterized by binge eating followed by purging or fasting, and excessive concern with body shape and weight. The aim of this activity is to expel the body of calories eate ...

(BN) because individuals do not consume a large amount of food before they purge. In current diagnostic systems, purging disorder is a form of

other specified feeding or eating disorder Other specified feeding or eating disorder (OSFED) is a subclinical DSM-5 category that, along with unspecified feeding or eating disorder (UFED), replaces the category formerly called eating disorder not otherwise specified (EDNOS) in the DSM-I ...

. Research indicates that purging disorder, while not rare, is not as commonly found as

anorexia nervosa Anorexia nervosa, often referred to simply as anorexia, is an eating disorder characterized by low weight, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. ''Anorexia'' is a term of Gr ...

or bulimia nervosa. This syndrome is associated with clinically significant levels of distress, and that it appears to be distinct from bulimia nervosa on measures of hunger and ability to control food intake. Some of the signs of purging disorder are frequent trips to the bathroom directly after a meal, frequent use of laxatives, and obsession over one's appearance and weight. Other signs include swollen cheeks, popped blood vessels in the eyes, and clear teeth which are all signs of excessive vomiting. Purging disorder is studied far less often than

and

as it is not considered an independent diagnosis in the DSM-5, published in 2013. However, it has been argued that purging disorder should be considered a distinct eating disorder, separate from bulimia nervosa. Because of this, little information is known about the risk factors for purging disorder, including how gender, race, and class could contribute to the risk for purging disorder. As with most eating disorders, it is suggested that purging disorder is gender specific because of cultural forces and social pressures. These social pressures are associated with a severe preoccupation with shape and weight, this puts women and transgender individuals at the most risk for eating disorders, including purging disorder. In one study of the risk factors for purging disorder 77% of the participants who presented with symptoms of purging disorder were female. Purging disorder progressing into bulimia nervosa has been observed, while it is extremely rare for the reverse situation, bulimia nervosa progressing into purging disorder. This was observed once in a transgender patient with a severe history of bulimia nervosa but presented with symptoms of purging disorder to an eating disorder treatment facility in New Zealand. Estimates of lifetime prevalence of purging disorder have been estimated from 1.1% to 5.3%.

Signs and symptoms

* Recurrent purging to influence body weight or shape * Absence of binging episode(s) * Purge behaviors occur at least once per week for at least 3 months * Undue influence of body shape and weight *

Russell's sign Russell's sign, named after British psychiatrist Gerald Russell, is a sign defined as calluses on the knuckles or back of the hand due to repeated self-induced vomiting over long periods of time. The condition generally arises from the patient's ...

Causes

Risk Factors

Dieting Dieting is the practice of eating food in a regulated way to decrease, maintain, or increase body weight, or to prevent and treat diseases such as diabetes and obesity. As weight loss depends on calorie intake, different kinds of calorie-redu ...

* Thin-ideal internalization * Body dissatisfaction

Genetic

The

heritability Heritability is a statistic used in the fields of breeding and genetics that estimates the degree of ''variation'' in a phenotypic trait in a population that is due to genetic variation between individuals in that population. The concept of h ...

of some eating disorders has been well established, but to date there are no documented family studies of purging disorder to understand the familial nature of purging disorder.

Diagnosis

The

is used as a reference to diagnose Purging Disorder. A patient with Purging disorder will be diagnosed with

Complications

Purging behaviors, specifically self-induced vomiting and laxative use are associated with the following medical complications: * Subconjunctival hemorrhages (small bleeds in the eyes) * Cuts or scars on the top of the hands (

) * Dental abnormalities such as enamel erosion * Swelling of the

parotid gland The parotid gland is a major salivary gland in many animals. In humans, the two parotid glands are present on either side of the mouth and in front of both ears. They are the largest of the salivary glands. Each parotid is wrapped around the man ...

* Mild

esophagitis Esophagitis, also spelled oesophagitis, is a disease characterized by inflammation of the esophagus. The esophagus is a tube composed of a mucosal lining, and longitudinal and circular smooth muscle fibers. It connects the pharynx to the stomach; s ...

heartburn Heartburn, also known as pyrosis, cardialgia or acid indigestion, is a burning sensation in the central chest or upper central abdomen. Heartburn is usually due to regurgitation of gastric acid (gastric reflux) into the esophagus. It is the m ...

, or

acid reflux Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is one of the upper gastrointestinal chronic diseases where stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/ ...

* Renal (

kidney The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blood ...

) inflammation

Treatment

Treatment for purging disorder can be multidisciplinary. One approach to treatment is

cognitive behavioral therapy Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions (suc ...

Prognosis

Children and teenagers with purging disorder have been found to have poorer health-related quality of life than their healthy peers. A small review of 11 cases of purging disorder where death occurred found that only 5 of the 11 deaths could be contributed to the purging disorder. The remaining 6 deaths were a result of suicide.

References

External links

Defining Purging Disorder in Practice
* {{cite web , title=Professor Identifies New Eating Disorder - Purging Disorder , url=https://www.medicalnewstoday.com/mnt/releases/81505 , work=MedicalNewsToday Eating disorders