National Eating Disorders Association

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Is there an acceptable level of purging, and health effects?

My fiance has had an eating disorder since she was 16. She has been on medication since she was 17 as treatment for it. She is 48 now and at a healthy weight, but still purges every week. She also works out a lot and the purging gets much worse when she doesn't. She's always connected the ED with exercise and is honest (mostly) with me when I ask her about the purging. My concern is that this amount of purging seems to be acceptable to her, but I worry about the health affects. She's frequently clearing her throat and that's usually a tell that the purging is worse. She coughs a lot, too. Is there an acceptable level of purging for someone with a long term eating disorder? Ironically, her sister is a psychologist specializing in eating disorders and doesn't seem too alarmed when I've asked her about it, except to say that she should adjust her meds, so I haven't pushed getting help. When I've suggested it to my fiance, she says she's already tried everything. Thoughts? Should I be concerned? Is there anything I can do? Thanks in advance.

Unfortunately not

Purging is very dangerous. It can lead to death. I'm sorry she has been suffering for so long. In addition to damage done to the vocal chords, purging can lead to damage to the asophegus and stomach that are irreversible. It sounds like she needs professional help. It's disturbing that her sister isn't more concerned. It is one of the most deadly mental illnesses. Since I'm not a professional, I probably don't know all the consequences of bulimia. I've struggled with it, but it would be best to also talk to a medical doctor and therapist who specialize in this area as well as NEDA staff. I hope this helps.

Thanks for the response.

Thanks for the response.

I will talk to her sister to see if she can help. I think she's been aware of it so long, she doesn't know what to do for her, or thinks there's nothing she can do.

I think my fiance thinks she's not doing damage because she does it right after she eats, before the acid gets too bad. She doesn't need to use her hands or anything to initiate. She just bends over and takes care of it. She's so used to doing it that I don't think it seems abnormal any more.

There was a time she'd get upset about it and feel a lot of shame, but that doesn't seem to be the case now. Though, lack of exercise was her trigger in the past, general stress seems to be an equal trigger. I'll follow up after I talk to her sister about it. Thanks again!

Post Edited

Hi Wthomps429,We are glad to hear that you are finding support here on the NEDA forums. A portion of your post was edited and deleted due to the mention of specific numbers and behaviors. Our community guidelines are always available to review here: In the event you need further assistance, please do not hesitate to call the NEDA helpline at 1-800-931-2237 (Monday-Thursday 9:00am-9:00pm, Friday 9:00am-5:00pm EST). We additionally wanted to post up some signs and symptoms of a medical emergency just in case since you mentioned some issues with your fiance's throat. The following are just some of the signs of a serious problem that demands immediate medical attention:• accidentally or deliberately caused themselves a physical injury• become suicidal• confused thinking and is not making any sense• delusions (false beliefs) or hallucinations (experiencing things that aren’t there)• disoriented; doesn’t know what day it is, where they are or who they are• vomiting several times a day or has uncontrollable vomiting or diarrhea• experiencing dizziness or fainting spells• too weak to walk or collapses• painful muscle spasms• complaining of chest pain or having trouble breathing• blood in their bowel movements, urine or vomit• a body mass index (BMI) of less than 16• an irregular heartbeat, and fast heartbeat, or very low heart beat (less than 50 beats per minute)• cold or clammy skin indicating a low body temperature or has a body temperature of less than 35 degrees Celsius/95 degrees FahrenheitOr any other serious medical concernsIf your fiance experiences any of the above, we highly recommend seeking medical attention as soon as possible. Another option is 911.