Table of ContentsView AllTable of ContentsWhat Is Purging Disorder?CharacteristicsDiagnosisCausesTreatmentCoping
Table of ContentsView All
View All
Table of Contents
What Is Purging Disorder?
Characteristics
Diagnosis
Causes
Treatment
Coping
Purging disorder also has additional features that differentiate it from bulimia and other eating disorders like anorexia nervosa (AN).
Man suffering bulimia.doram, Getty Images
Unlike bulimia, purging disorder is not a formal diagnosis in theDiagnostic And Statistical Manual Of Mental Disorders, 5thEdition(DSM-5). Rather, it is classified as an “Other Specified Feeding or Eating Disorder (OSFED),” which was previously known as “Eating Disorder Not Otherwise Specified (EDNOS).” As such, PD does not have one clear definition like other specified eating disorders.
The lack of clear definition does not mean this type of disordered eating is any less serious than bulimia or anorexia. Research suggests that PD is a clinically significant eating disorder (ED) that has substantial comorbidity (meaning its likely to accompany other diagnoses) and shares many dimesnsions of pathology with some full-threshold ED diagnoses (i.e., AN, bulimia, and binge eating disorder), but is less severe than bulimia nervosa in most domains.
That said, people with purging disorder have significant morbidity and mortality.
Characteristics of purging behaviors can include:
Eating disorders like purging disorder can be triggered through any life stage, but typically emerge in adolescence or early adulthood.
Unlike anorexia, PD predominantly affects women in normal or larger weight categories.
Disordered Eating Treatments
Feeding and eating disorders are diagnosed based on criteria established in the DSM-5. A person must present with feeding or eating behaviors that cause clinically significant distress and impairment to be diagnosed with one.
Some defining characteristics of purging disorder may be able to help identify affected individuals, including:
Medical complications of compulsive purging:
Eating disorders are medical illnesses with complex biological and social factors that severely impact one’s well-being. Researchers continue their efforts trying to isolate the underlying causes of this disorder. Research suggests sexual or physical abuse and/or participating in appearance- or weight-focused sports or competitions may increase the likelihood of developing an eating disorder.
Examples of biological risk factors include:
Examples of psychological factors include:
Examples of sociocultural factors include:
Purging as a Form of Self-HarmPurging disorder can be considered a mode of self-harm much like self-inflicted non-suicidal injuries. One study estimated that PD have a mortality rate of 5%.People with purging disorder are at higher risk of suicidality, as well as depression, anxiety, impulsivity, substance use, dietary restraint, body dissatisfaction, and eating psychopathology, compared with controls in a study.
Purging as a Form of Self-Harm
Purging disorder can be considered a mode of self-harm much like self-inflicted non-suicidal injuries. One study estimated that PD have a mortality rate of 5%.People with purging disorder are at higher risk of suicidality, as well as depression, anxiety, impulsivity, substance use, dietary restraint, body dissatisfaction, and eating psychopathology, compared with controls in a study.
Purging disorder can be considered a mode of self-harm much like self-inflicted non-suicidal injuries. One study estimated that PD have a mortality rate of 5%.
People with purging disorder are at higher risk of suicidality, as well as depression, anxiety, impulsivity, substance use, dietary restraint, body dissatisfaction, and eating psychopathology, compared with controls in a study.
Eating disorder treatment generally encompasses the following factors:
Psychotherapy, specifically cognitive behavioral therapy (CBT), is generally advised since it has shown effectiveness in treating a range of eating disorders. Research has shown that after intervention, CBT improves anxiety and depressive symptoms, drive for thinness, body dissatisfaction, and symptoms of bulimia.Other options for treatment can include medical care and monitoring via hospitalization or in outpatient treatment programs, nutritional counseling, medications, or a combination of these approaches.
While pharmaceuticals should never be the sole treatment approach, selective serotonin reuptake inhibitors (SSRIs) antidepressants like Prozac (fluoxetine) and Zoloft (sertraline) can be helpful in managing symptoms of depression, anxiety, and obsessive compulsive disorder. One study suggests these medications may aid in relapse prevention and improvement of psychiatric symptoms in weight-restored anorexic patients.
Prognosis in WomenResearch has shown the prognosis for women with PD who receive treatment over time is greater in purging participants than those with other forms of disordered eating. The biggest improvements were in body dissatisfaction and anxiety.
Prognosis in Women
Research has shown the prognosis for women with PD who receive treatment over time is greater in purging participants than those with other forms of disordered eating. The biggest improvements were in body dissatisfaction and anxiety.
Here are some helpful tips people with purging disorder can try to cope with their condition. Remember that nothing can take the place of professional treatment for an eating disorder.
Don’t Try to Recover in Isolation
Eating disorders do not develop in isolation, and they are not treated in isolation either. Reaching out for professional help is important to recovery. Being open and honest with others like parents, friends, and school advisors is also a way to gain support and understanding. If you feel like you are alone or have no support network, talk to your treatment provider about ways to process ongoing relationships and feel less alone.
Don’t Play the Blame Game
It really is no one’s fault. While you may have a complicated family dynamic or have experienced abuse and trauma, remember that no one thing or person (including yourself) is responsible for your eating disorder. Eating disorders occur due to a complex web of factors, and blaming yourself or others will only create additional emotional stress.
Don’t Give Up Hope
Recovery is possible and you are worthy of receiving and following treatment. It doesn’t matter if you think someone else has it worse or if you feel like there is no end in sight right now. Getting better from an eating disorder is an ongoing journey that requires you to trust in the process.
Resources for HelpReach out to the following organizations for more information:The National Eating Disorders Association (NEDA) is a leading eating disorder nonprofit.Alliance for Eating Disorders Awareness(“The Alliance”) is a nonprofit organization providing programs and activities aimed at outreach, education, and early intervention for all eating disorders.The National Association of Anorexia Nervosa and Associated Disorders, Inc. (ANAD) is a nonprofit organization serving in areas of support, awareness, advocacy, referral, education, and prevention.
Resources for Help
Reach out to the following organizations for more information:The National Eating Disorders Association (NEDA) is a leading eating disorder nonprofit.Alliance for Eating Disorders Awareness(“The Alliance”) is a nonprofit organization providing programs and activities aimed at outreach, education, and early intervention for all eating disorders.The National Association of Anorexia Nervosa and Associated Disorders, Inc. (ANAD) is a nonprofit organization serving in areas of support, awareness, advocacy, referral, education, and prevention.
Reach out to the following organizations for more information:
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Smith KE, Crowther JH, Lavender JM.A review of purging disorder through meta-analysis.J Abnorm Psychol. 2017;126(5):565-592. doi:10.1037/abn0000243.xNational Eating Disorder Association.Other Specified Feeding and Eating Disorders.Rohde P, Stice E, Marti CN.Development and predictive effects of eating disorder risk factors during adolescence: Implications for prevention efforts.Int J Eat Disord. 2015;(48)2:187-98. doi:10.1002/eat.22270.xSmith KE, Crowther JH, Lavender JM.A review of purging disorder through meta-analysis.J Abnorm Psychol. 2017;126(5):565-592. doi:10.1037/abn0000243.xMitchison D, Hay P.The epidemiology of eating disorders: genetic, environmental, and societal factors.Clin Epidemiol. 2014;6:89-97. doi:10.2147/CLEP.S40841.xKoch, S., Quadflieg, N. & Fichter, M.Purging disorder: a pathway to death? A review of 11 cases.Eat Weight Disord. 2014;19, 21–29. doi:10.1007/s40519-013-0082-3.xThe National Eating Disorder Association.What to Expect From Treatment.Avargues-Navarro ML, Borda-Mas M, Asuero-Fernández R, et al.Purging behaviors and therapeutic prognosis of women with eating disorders treated in a healthcare context.Int J Clin Health Psychol. 2017;17(2):120-127. doi:10.1016/j.ijchp.2017.03.002.xMarvanova M, Gramith K.Role of antidepressants in the treatment of adults with anorexia nervosa.Ment Health Clin. 2018;8(3):127-137. doi:10.9740/mhc.2018.05.127.x
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Smith KE, Crowther JH, Lavender JM.A review of purging disorder through meta-analysis.J Abnorm Psychol. 2017;126(5):565-592. doi:10.1037/abn0000243.xNational Eating Disorder Association.Other Specified Feeding and Eating Disorders.Rohde P, Stice E, Marti CN.Development and predictive effects of eating disorder risk factors during adolescence: Implications for prevention efforts.Int J Eat Disord. 2015;(48)2:187-98. doi:10.1002/eat.22270.xSmith KE, Crowther JH, Lavender JM.A review of purging disorder through meta-analysis.J Abnorm Psychol. 2017;126(5):565-592. doi:10.1037/abn0000243.xMitchison D, Hay P.The epidemiology of eating disorders: genetic, environmental, and societal factors.Clin Epidemiol. 2014;6:89-97. doi:10.2147/CLEP.S40841.xKoch, S., Quadflieg, N. & Fichter, M.Purging disorder: a pathway to death? A review of 11 cases.Eat Weight Disord. 2014;19, 21–29. doi:10.1007/s40519-013-0082-3.xThe National Eating Disorder Association.What to Expect From Treatment.Avargues-Navarro ML, Borda-Mas M, Asuero-Fernández R, et al.Purging behaviors and therapeutic prognosis of women with eating disorders treated in a healthcare context.Int J Clin Health Psychol. 2017;17(2):120-127. doi:10.1016/j.ijchp.2017.03.002.xMarvanova M, Gramith K.Role of antidepressants in the treatment of adults with anorexia nervosa.Ment Health Clin. 2018;8(3):127-137. doi:10.9740/mhc.2018.05.127.x
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Smith KE, Crowther JH, Lavender JM.A review of purging disorder through meta-analysis.J Abnorm Psychol. 2017;126(5):565-592. doi:10.1037/abn0000243.xNational Eating Disorder Association.Other Specified Feeding and Eating Disorders.Rohde P, Stice E, Marti CN.Development and predictive effects of eating disorder risk factors during adolescence: Implications for prevention efforts.Int J Eat Disord. 2015;(48)2:187-98. doi:10.1002/eat.22270.xSmith KE, Crowther JH, Lavender JM.A review of purging disorder through meta-analysis.J Abnorm Psychol. 2017;126(5):565-592. doi:10.1037/abn0000243.xMitchison D, Hay P.The epidemiology of eating disorders: genetic, environmental, and societal factors.Clin Epidemiol. 2014;6:89-97. doi:10.2147/CLEP.S40841.xKoch, S., Quadflieg, N. & Fichter, M.Purging disorder: a pathway to death? A review of 11 cases.Eat Weight Disord. 2014;19, 21–29. doi:10.1007/s40519-013-0082-3.xThe National Eating Disorder Association.What to Expect From Treatment.Avargues-Navarro ML, Borda-Mas M, Asuero-Fernández R, et al.Purging behaviors and therapeutic prognosis of women with eating disorders treated in a healthcare context.Int J Clin Health Psychol. 2017;17(2):120-127. doi:10.1016/j.ijchp.2017.03.002.xMarvanova M, Gramith K.Role of antidepressants in the treatment of adults with anorexia nervosa.Ment Health Clin. 2018;8(3):127-137. doi:10.9740/mhc.2018.05.127.x
Smith KE, Crowther JH, Lavender JM.A review of purging disorder through meta-analysis.J Abnorm Psychol. 2017;126(5):565-592. doi:10.1037/abn0000243.x
National Eating Disorder Association.Other Specified Feeding and Eating Disorders.
Rohde P, Stice E, Marti CN.Development and predictive effects of eating disorder risk factors during adolescence: Implications for prevention efforts.Int J Eat Disord. 2015;(48)2:187-98. doi:10.1002/eat.22270.x
Mitchison D, Hay P.The epidemiology of eating disorders: genetic, environmental, and societal factors.Clin Epidemiol. 2014;6:89-97. doi:10.2147/CLEP.S40841.x
Koch, S., Quadflieg, N. & Fichter, M.Purging disorder: a pathway to death? A review of 11 cases.Eat Weight Disord. 2014;19, 21–29. doi:10.1007/s40519-013-0082-3.x
The National Eating Disorder Association.What to Expect From Treatment.
Avargues-Navarro ML, Borda-Mas M, Asuero-Fernández R, et al.Purging behaviors and therapeutic prognosis of women with eating disorders treated in a healthcare context.Int J Clin Health Psychol. 2017;17(2):120-127. doi:10.1016/j.ijchp.2017.03.002.x
Marvanova M, Gramith K.Role of antidepressants in the treatment of adults with anorexia nervosa.Ment Health Clin. 2018;8(3):127-137. doi:10.9740/mhc.2018.05.127.x
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