To what extreme ends will people go to control their weight? When most people think of behaviors that individuals with eating disorders use to compensate for their eating, they usually think of restriction (associated with anorexia nervosa) and self-induced vomiting (associated with bulimia nervosa, anorexia nervosa binge-purge subtype, and some types of other specified feeding and eating disorders). However, there are actually a variety of ways that individuals suffering from these illnesses may attempt to monkey with their weight or body shape. For this reason, the DSM-5 broadly and simply defines these methods as any “inappropriate behaviors to avoid weight gain.”
Compensatory behaviors commonly – and uncommonly – may include:
- Laxative misuse
- Diuretics misuse
- Excessive, rigid or compulsive exercise
- Diet pill misuse
- Use of herbal remedies to “maintain health” or lose weight
- Misuse of prescription medication or illicit drugs
Though the methods are varied, they share a notable degree of ineffectiveness and/or dangerousness when it comes to weight control. For example, vomiting can lead to tooth decay, swollen glands, puffy cheeks, electrolyte imbalance (with consequences for heart function), and esophageal tears. And with all these risks, vomiting is not an effective way to get rid of calories at all, eliminating only a modest proportion of calories consumed. Diuretics – substances that promote the production of urine – are also ineffective—they do not have an effect on the food one has eaten and instead essentially dehydrate the body. Laxative abuse can also result in electrolyte imbalances, muscle spasms, and bowel dysfunction; these substances basically slow motility while building tolerance over time.
Diet pills and herbal remedies are often advertised as methods to easily lose weight or maintain health. However, the dietary supplement industry has been under scrutiny for its lack of regulation and the serious side effects that supplements may lead to. In fact, a recent study has shown that taking dietary supplements may be linked to severe injuries and hospitalizations. Using diet pills or herbal remedies is not a safe way to lose weight.
Exercise is another common behavior that individuals engage in to compensate for eating. Excessive exercise, however, can lead to fatigue, overuse injuries, or sleep disturbances. An overly rigid exercise routine, or one that occurs in relation to binge episodes, can have a direct, negative impact on a person’s social calendar, or responsibilities at home, work, or school. Some people may also exercise even when they are sick or injured, prolonging a state of poor health.
Less common but equally dangerous compensatory behaviors may include medication misuse or illicit drug use for the purposes of appetite suppression and avoidance of eating. Use of prescription or illegal stimulants – such as Ritalin or cocaine – for weight loss or weight control reasons is a very concerning phenomenon. Appearance and performance enhancing drugs, illegal substances whose use are associated with increased risk for eating disorders and body image problems in men with these conditions, represent another dangerous and potentially habit-forming method of compensating for eating behavior or body shape issues.
If you have attempted to lose or maintain weight using any of the methods described above, it is important to bring this to the attention of your primary care physician and your therapist. If you have a friend or family member who engages in any of the types of behaviors described in an attempt to make up for the food that they eat, speak up about your concerns for their well being. Additional information about the hazards of various weight control methods can be found through the National Institutes of Health and WebMD.