What is the Difference Between Purging Disorder and Bulimia? | Symptoms, Treatment, Side Effects, Recovery of Purging Disorder

There are many types of eating disorders that affect people. One such eating disorder is purging disorder. Purging disorder involves indulging in purging behavior to manipulate body shape or lose weight. While it is not as well-known as other eating disorders like bulimia and anorexia, purging disorder is categorized as an ‘Other Specified Feeding or Eating Disorder.’ It is important to remember that eating disorders can be some of the deadliest mental health conditions in the world, and they can cause significant harm to both mental and physical health. Read on to understand purging disorder.

Purging disorder is a type of eating disorder in which a person purges to influence their weight or body shape but does not binge. Purging disorder is similar to another more common eating disorder known as bulimia nervosa but without the bingeing. There is a common misconception that vomiting is the default way of purging in people with this disorder. However, laxative and diuretic misuse are also equally common in purging disorders. Some people even engage in other behaviors to make up for the eating, including extreme fasting and excessive exercise.^{(1, 2, 3, 4)}

While purging disorder is not as well-known as other eating disorders like anorexia and bulimia, it is still a recognized eating disorder and categorized as an ‘Other Specified Feeding or Eating Disorder.’ However, purging disorder is not listed as an official disorder in the Diagnostic and Statistical Manual of mental disorders (DSM-5). The category of Other Specified Feeding and Eating Disorder includes clinically significant eating disorders that do not meet the criteria for one of the primary eating disorders that include bulimia nervosa, anorexia nervosa and binge eating disorder.^{(5, 6, 7, 8)}

It is important to keep in mind that eating disorders are some of the deadliest mental health conditions in the world as they cause significant harm to both a person’s mental and physical health.

Even though purging disorder has been around for a long time, it was only first formally recognized in 2005 by Keel and colleagues. Purging disorder has also been significantly less researched as compared to bulimia and anorexia. In fact, many people with purging disorder have often been incorrectly diagnosed as having bulimia, while many have not been diagnosed at all.⁽⁹⁾

It is important to understand the difference between purging disorder and bulimia nervosa in order to understand how the two eating disorders are separate from each other. Bulimia is a serious eating disorder that tends to occur in a cycle of binge-eating behavior, followed by a period of purging. While purging disorder and bulimia both share purging behaviors, the primary difference between both these disorders is that people with bulimia feel a compulsion to binge eat. Purging disorder is therefore defined as engaging in purging behaviors without it being a response to a previous binge-eating episode.⁽¹⁰⁾

Purging disorder can be identified by several of the same symptoms that other eating disorders also have. Some of the major symptoms of purging disorder may include: Recurring episodes of purging behaviors to lose weight. This may include:

• Self-induced vomiting
• Misuse of enemas
• Misuse of laxatives or diuretics
• Fasting
• Excessive exercise
• Fear of gaining weight
• Obsession with losing weight
• Significant emotional distress
• Disruption to work, social, or personal life
• Self-esteem issues that are heavily influenced by weight or body shape

An eating disorder does not affect only overweight or obese people. You can be of any size or shape and still have an eating disorder. This is why it is necessary to take note and recognize the symptoms before your health gets affected. There are many online self-assessment tests that you can take if you think that you or a loved one may have an eating disorder. These self-assessment tests help determine if any of your behaviors could possibly lead to an eating disorder.^{(11, 12, 13)}

However, these assessments should not be taken as a diagnosis. If you think you may have an eating disorder, you should consult a doctor.

Purging disorder can affect anybody. It mostly develops in late adolescence and early adulthood.⁽¹⁴⁾ This disorder majorly affects women than men and people who are classified as overweight/obese or even normal weight. Due to the present diagnostic system, which gives priority to the diagnosis of anorexia nervosa or bulimia nervosa, it is not specifically possible to diagnose purging disorder in people who are underweight.⁽¹⁵⁾

People who are underweight and have purging behavior are more likely to be diagnosed with binge/purge subtype, or anorexia nervosa.

As a percentage of people who are seeking treatment for an eating disorder, research shows that purging disorder is the main problem in five to ten percent of adults and 24 to 28 percent of adolescents.⁽¹⁶⁾ Purging disorder is likely to become a more common diagnosis if excessive exercise also gets classified as part of purging disorder.

As mentioned above, anyone can get purging disorder, regardless of:

• Age
• Gender
• Ethnicity
• Age
• Sexual orientation

There are several stereotypes that often assume that eating disorders only affect teenage girls are not only incorrect by also damaging. This idea also discourages people from seeking treatment for eating disorders.

There are some factors that are known to contribute to greater rates of eating disorders like purging disorder amongst certain people.

Physical and sexual abuse or participating in weight or appearance-focused sports are some of the main risk factors.⁽¹⁷⁾

While women are at a higher risk of getting eating disorders than men, this does not mean that men are not at risk. A recent review showed that nearly 25 percent of people with some type of eating disorder are male. Furthermore, eating disorders like purging disorder have been found to be increasing at a faster rate in males rather than females.⁽¹⁸⁾

People who have an eating disorder are also more likely to develop another mood disorder at the same time. For example, a 2006 study found that nearly 89 percent of people with eating disorders tend to have concurrent mood disorders like depression, anxiety, substance abuse, and/or impulse control issues.⁽¹⁹⁾

It is important to understand that eating disorders are not a choice but a type of serious mental health condition. This is why one should always seek help for eating disorders.

The exact treatment for purging disorder varies from person to person. Some people may benefit from taking more intensive inpatient treatment and recovery programs, while others may feel more comfortable with outpatient therapy options.

Inpatient treatment is more commonly used in cases where medical monitoring or daily assessments are required, while outpatient treatment typically includes nutrition counseling and psychotherapy.^{(20, 21)}

Medications are not usually used for the treatment of purging disorder. Instead, they might be prescribed to treat any concurrent mood disorders that might be leading to additional stress and making it more challenging to cope with recovery.

Purging disorder can cause many severe side effects to your health. These include:

• Tooth decay
• Feeling faint
• Mood swings
• Facial swelling
• Throat swelling
• Scarred hands
• Irregular heartbeat
• Other heart problems
• Kidney failure
• Pregnancy complications
• Constipation or other digestive issues
• Nutrient deficiencies
• Dehydration
• Electrolyte or chemical imbalances

Self-induced vomiting can also cause serious damage to other parts of your body over a period of time. This includes:⁽²²⁾

• Digestive system
• Esophagus
• Teeth
• Cardiovascular system

It is possible to make a full recovery from an eating disorder like purging disorder, but it is going to take time. You need to be patient with yourself during the course of recovery. Since everyone is different, the time it takes to heal also differs, and it is an ongoing process. You won’t recover overnight. You should consider continuing therapy, joining a support group, or journaling to help as you recover. It is possible to have relapses, but you should not give up on the recovery process even if you have a relapse. There is always help available to get you back on track and on the way to recovery.

Purging disorder is a severe eating disorder and mental health condition that is caused by repeated cycles of purging in an attempt to change body shape or weight. Purging can happen in many different forms, including self-induced vomiting, excessive exercise, and fasting. Purging can cause many severe metabolic and nutritional imbalances in the body and lead to permanent damage to your health.

It is important to seek treatment for purging disorder at the earliest. This can include seeking intensive therapy or joining a support group.

Remember that recovering from an eating disorder is an ongoing process, and it is possible to recover and go on to live a happy and healthy life.

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