Purging in a way that’s different from what’s usually

through self-caused vomiting has been a common means of eliminating calories in
BN and AN/purging type. people who purge and alternate between periods of food
restricting, bingeing and purging. Unlike extreme food restrictors, people who
eat or drink way too much and purge do not usually separate far from social
gatherings. They can present themselves as normal eaters in social settings
while their weight usually remains in an normal range. Because there is no
obvious extreme weight loss and there is an appearance of healthy eating, the
secret bingeing continues. The purge often begins with an binge, which can be
triggered through stress. A binge is defined as eating a large amounts of food
in a short amount of time in a way that’s different from what’s usually
expected, within two hours and usually in private. The binge itself is often
not only seen as pleasant-feeling and comforting, but can also be the outlet
for emotional expression that was not present in the family unit or used as a
method of avoiding feelings like pain and anger. The binge continues until
abdominal pain occurs, the individual falls asleep, is caught, or self-causes
vomiting. In times of stress and loneliness, the purge can provide a sense of
comfort. For some, purging continues without the binge for the purpose of
relaxation and decreasing fear and stress. Purging after an binge not only provides
physical relief, bloating and discomfort, but also is viewed as ridding the
body of calories and guilt associated with the eating of the food. Common
laboratory findings related to self-caused vomiting includes hypokalemia, mild
ST changes and metabolic acidosis or alkalosis. Oral problems are most commonly
connected with this purging behavior. Longlasting vomiting of stomach-related
contents can lead to smooth enamel wearing away of the teeth, perimylolysis
that can be seen after about two years of bingeing and purging; parotid
swelling of the glands, soft palate injury, dry skin from not having enough
water or loss of water, electrolyte imbalance, swelling/fluid buildup, stomach
and intestinal problems, and irregular menstrual cycle. Almost the same as
self-caused vomiting, laxative use can become an addictive cycle due to its
false impression of immediate weight loss. For many, the use of laxatives is
viewed as “cleaning” that suggests a sense of starting over, and
which, like selfinduced vomiting, relieves the body of the swelling and
abdominal pain associated with binge eating. Excessive exercise has been noted
to play a role in the development and/or maintenance of eating disorders. High
levels of exercise reduce calories, hold down and stop desire to eat and
increase physical performance in sports. The initial weight loss associated
with exercise provides social reinforcement, leading to increased awareness of
one’s physical appearance. This heightened awareness then leads to a
narcissistic preoccupation with the body.


the body reduces in weight, physical exercise is increased. Likewise,
hyperactivity has been noted to be a characteristic of approximately one-third
of the anorectic population. Exercise out of control exhibits a pattern similar
to that of a chronic dieter. The compulsive exerciser arranges his or her life
to ensure that rituals and routines are not disturbed. When the routine is
disturbed, depression, guilt and anxiety can result. Several other indicators
that exercise behavior might be out of control include: avoiding social
contacts, preoccupation of thoughts regarding when, where and how much to
exercise, avoidance of work and social responsibilities, exercising when
injured, and an inability to exercise for enjoyment or relaxation. There is a
decrease in self-esteem and an increase in rigidity and compulsiveness, hormone
levels are altered, increased stress fractures, an increase in torn muscles,
ligaments, tendons and cartilage, amenorrhea, increased susceptibility to infectious
diseases, mood disturbances, fatigue, dehydration, upper respiratory
infections, and many other.

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