Laxative Misuse

Reviewed by Amy Baker Dennis, PhD, FAED

Laxative misuse occurs when a person attempts to eliminate unwanted calories, lose weight, “feel thin,” or “feel empty” through the repeated, frequent use of laxatives.1 Often, laxatives are misused because the individual mistakenly believes that the laxatives will work to rush out food and calories before they can be absorbed — but that doesn’t really happen.2 Laxative misuse is serious and dangerous, often resulting in a variety of health complications and sometimes causing life-threatening conditions.3

The Laxative Myth


The belief that laxatives are effective for weight control is a myth. In fact, by the time laxatives act on the large intestine, most foods and calories have already been absorbed by the small intestine. Although laxatives artificially stimulate the large intestine to empty, the “weight loss” caused by a laxative-induced bowel movement contains little actual food, fat, or calories. Instead, laxative misuse causes the loss of water, minerals, electrolytes, and indigestible fiber and wastes from the colon. This “water weight” returns as soon as the individual drinks any fluids and the body re-hydrates. If the individual chronically abusing laxatives refuses to re-hydrate, they risk dehydration, which further taxes the organs and which may ultimately cause death.2

Health Consequences of Laxative Misuse3,4,5


  • Disturbance of electrolyte and mineral balances. Sodium, potassium, magnesium, and phosphorus are electrolytes and minerals that are present in very specific amounts necessary for proper functioning of the nerves and muscles, including those of the colon and heart. Upsetting this delicate balance can cause improper functioning of these vital organs.
  • Severe dehydration may cause tremors, weakness, blurry vision, fainting, kidney damage, and, in extreme cases, death. Dehydration often requires medical treatment.
  • Laxative dependency occurs from overuse, and can cause the colon to stop reacting to usual doses of laxatives so that larger and larger amounts of laxatives may be needed to produce bowel movements.
  • Internal organ damage may result, including stretched or “lazy” colon, colon infection, irritable bowel syndrome, and, rarely, liver damage. Chronic laxative misuse may contribute to risk of colon cancer.

Learn more about health consequences here.

Treatment Considerations6


Overcoming laxative misuse requires working with a team of health professionals who have expertise in treating eating disorders, including a physician, psychiatrist, psychotherapist, and dietician. Support from close friends and family is also helpful. Meeting with others to talk over anxieties, concerns, and difficulties can greatly aid in getting through tough times in the recovery process.

Learn more about treatment here.

Learn more about finding treatment providers in your area here.

Sources


[1]  Elran-Barak, R., Goldschmidt, A. B., Crow, S. J., Peterson, C. B., Hill, L., Crosby, R. D., Mitchell, J. E., & Le Grange, D. (2017). Is laxative misuse associated with binge eating? Examination of laxative misuse among individuals seeking treatment for eating disorders. The International journal of eating disorders, 50(9), 1114–1118. https://doi.org/10.1002/eat.22745

[2] Portalatin, M., & Winstead, N. (2012). Medical management of constipation. Clinics in colon and rectal surgery, 25(1), 12–19. https://doi.org/10.1055/s-0032-1301754

[3] Mehler, P. S., & Rylander, M. (2015). Bulimia Nervosa – medical complications. Journal of eating disorders, 3, 12. https://doi.org/10.1186/s40337-015-0044-4

[4]Forney, K. J., Buchman-Schmitt, J. M., Keel, P. K., & Frank, G. K. (2016). The medical complications associated with purging. The International journal of eating disorders, 49(3), 249–259. https://doi.org/10.1002/eat.22504

[5] Ragunathan, A., Singh, P., Gosal, K., Scibelli, N., & Collier, V. (2021). Laxative Abuse Cessation Leading to Severe Edema. Cureus, 13(6), e15847. https://doi.org/10.7759/cureus.15847

[6] Nitsch, A., Dlugosz, H., Gibson, D., & Mehler, P. S. (2021). Medical complications of bulimia nervosa. Cleveland Clinic journal of medicine, 88(6), 333–343. https://doi.org/10.3949/ccjm.88a.20168