This is the website for Dr Shelagh Wright - Systemic and Family Psychotherapist
| PHYSICAL EFFECTS OF | |
• Laxative Misuse
People who binge may take laxatives to influence their shape and weight, though the practice is less common than self-induced vomiting and is pursued mainly by people with bulimia nervosa. Some people take very large quantities, as many as 50 or 100 at a time. Regardless of the amount taken, laxatives have little effect on calorie absorption. They act on the lower part of the gut, whereas calories are absorbed higher up. What they do produce is watery diarrhoea and a temporary fall in weight due solely to loss of water. The person regains the lost weight almost immediately as the body re-hydrates. Nevertheless, people with bulimia nervosa find the weight loss rewarding, believing that it is evidence of an effect on calorie absorption, which is the main reason they persist in taking laxatives. As with self in-induced vomiting, one wonders how many people would never begin using laxatives if they new how ineffective they are.
Laxative misuse, like self-induced vomiting, produces a variety of fluid and electrolyte abnormalities with symptoms of the type just described. Individuals who both vomit and misuse laxative are at particular risk. Some laxatives, when taken in high doses over long periods, result in permanent damage to the gut wall. Generally however, the adverse physical effects are reversible. Someone who has taken laxatives regularly may retain fluid (water) for a week or so after stopping suddenly. Obviously this will produce a temporary weight gain.
• Diuretic Misuse
Some people take diuretics (water tablets), usually over-the-counter preparations, to change their shape and weight. Again, this is a fruitless exercise since diuretics have no effect on calorie absorption. Like laxatives, they cause fluid loss, in this case through the production of excess urine, and thus have a short lived effect on body weight. When taken in large quantities, they can produce fluid and electrolyte disturbance. This is reversible. As with laxatives, those who stop taking diuretics after having used them for some time may experience temporary fluid retention. Clearly they should not take further diuretics at this point, or they establish a vicious circle.
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