What Is Laxative Abuse?

What Is Laxative Abuse?

Laxative abuse involves chronic and compulsive laxative use. People may misuse laxatives because they assume the behavior will support weight loss goals. Likewise, they might take laxatives as an attempt to avoid calorie absorption. However, although laxatives flush water from the system (which may cause a brief water weight loss), they do not eliminate calories consumed.²

Laxatives may be prescribed for constipation, but they will cause more harm than good when abused. They may exacerbate problems with constipation, diarrhea, and gas.

Laxative abuse may include behaviors like:

• Binging on laxatives (taking the whole package at one time)
• Taking the recommended dose of laxatives every day or many days (when not medically needed)
• Using laxatives to combat weight gain or bloat
• Using laxatives if other compensatory purging behaviors (vomiting, excessive exercise, diuretics) are not possible

What Is a Laxative?

Laxatives are remedies intended to promote bowel movements and ease constipation. Laxatives work by either increasing the bulk of the stool, softening the stool, or stimulating bowel contractions to push out waste from the colon. They are mostly used to treat temporary constipation or to prepare for specific medical procedures. Laxatives may come in pill, liquid, or powder form and are typically ingested orally or as suppositories. Generally, short-term use of laxatives is safe, but prolonged, excessive, or inadequate use can have serious health complications and can even lead to life threatening consequences.²

Here are the most common types of laxatives:

• Stimulant Laxatives
• Bulk-forming Laxatives
• Osmotic Laxatives
• Stool Softeners

Why Excessive Laxative Use Doesn’t Help With Weight Loss

Many people inaccurately believe that laxative use can promote weight loss or prevent the absorption of calories from food. Someone can indeed feel “lighter,” or like they’ve lost some weight afterwards. However, this sensation is often minimal and temporary because, once a person eats or drinks anything, their weight will go back to normal.¹

Moreover, it’s important to keep in mind that a laxative induced bowel movement is simply a way to artificially stimulate the colon to expel water, minerals, indigestible fiber, and wastes. There is hardly any actual food or fat released, since these have already been absorbed by the small intestine. This means that calories are still consumed regardless of laxative use.¹

Cleanse Diets & Detox Teas

Like laxatives, some people may experience temporary weight loss after doing a cleanse or detox diet due to the caloric reduction and water loss. However, any initial weight loss is likely to be regained once normal eating resumes. It is vital to understand that these approaches are not long-term solutions for weight loss. More importantly, prolonged or extreme cleanses can cause adverse effects resulting in nutrient deficiencies, dehydration, and other serious health consequences.

Excessive Laxative Use & Eating Disorders

Laxative abuse often coincides with eating disorders. People may use laxatives as a weight control method, or abuse them to seemingly balance or offset the effects of overeating or binge eating. According to a 2020 journal, the prevalence of laxative use for weight loss among adults is approximately 5%, from which ‌15- 62% have an eating disorder.³

Laxative abuse is a common behavior in these types of eating disorders:

Bulimia Nervosa

People experiencing bulimia may abuse laxatives as a purging method to remove the guilt from overeating or binge eating. Over time, this pattern becomes compulsive. The individual finds it hard to binge without purging. Because of this, the “emptying” feeling from laxative abuse may trigger more eating, thus reinforcing a dangerous cycle.

Binge Eating Disorder

Those with binge eating disorder eat large volumes of food, and often feel like they cannot control or manage their eating behaviors. However, they do not routinely engage in compensatory purging methods such as laxative abuse.

Anorexia Nervosa Purging Subtype

People experiencing anorexia nervosa purging subtype may abuse laxatives during binge and purge cycles. Moreover, they may also abuse laxatives along with restrictive eating habits.

Other Specified Feeding or Eating Disorder (OSFED)

Chronic laxative abuse without binge patterns can fall under purging disorder, a classification listed within the umbrella term of OSFED. When this is the case, the individual often abuses laxatives to control weight or body shape. However, they may eat relatively normally or engage in disordered habits that do not meet the criteria for restriction or binge eating.⁴

Symptoms of Laxative Overuse

Many people try to conceal their laxative abuse due to shame, fear, and embarrassment. It can be hard to tell if a loved one is struggling. That said, chronic laxative abuse behaviors often have a negative impact on someone’s physical and mental health. These adverse symptoms can occur both in the short and long-term.

Physical symptoms of laxative abuse may include:

• Dehydration
• Diarrhea
• Electrolyte imbalances
• Increased risk of UTIs
• Reflex constipation
• Gastrointestinal distress
• Fatigue and poor energy

Psychological symptoms of laxative abuse may include:

• Anxiety
• Depression
• Low self-esteem
• Relationship problems
• Increased guilt and shame
• Social withdrawal

How Long Does It Take to Become Dependent on Laxatives?

As with other types of medications or drugs, laxative dependence can occur with long-term use, but the timeframe can vary from person to person. Yet, laxative dependence is more likely to ensue or progress faster when using the stimulant-type laxatives, which tend to be habit forming and conducive to tolerance development. Regardless, once people start a pattern of frequent laxative use, they often find themselves physically and mentally hooked on them and unable to stop even when they want to.^2,5

Effects of Long Term Laxative Use

Chronic laxative abuse can be extremely detrimental to your physical health. Dehydration caused by this problem can result in chronic headaches, fainting, delirium, tremors, and permanent kidney damage.⁶

Long-term effects of laxative abuse may include:^1,2,7

• Dependence: Frequent laxative use for bowel movements can eventually lead to dependence, as the person will need higher amounts to produce the same effect.
• Kidney failure: Laxative abuse typically causes electrolyte imbalance and other kidney malfunctions that can progress to a total loss of kidney functioning.
• Liver damage: Prolonged and excessive use of laxatives can lead to dehydration and electrolyte imbalances, which can indirectly result in liver damage.
• Impaired intestinal function: After long-term laxative use, the intestines’ muscle tone and nerve response decline, leading to an inability to naturally expel waste.
• Infections: Chronic laxative abuse disturbs bowel function and causes other deficiencies that can weaken the immune system, making the body more susceptible to infections.
• Rectal prolapse: This medical condition where the inside of the intestines swell outside the anus often arises due to the constant severe diarrhea produced by laxative abuse.
• Increased risk of colon cancer: Laxative abuse can create an array of colon-related issues and in severe cases increase the risk of developing colon cancer.

Warning Signs of Laxative Abuse

Even though laxative abuse symptoms may be insidious, you can look for specific signs and symptoms. If you observe rapid behavioral or physical changes in your loved one such as long bathroom visits, clogged toilets, or secretive eating habits, that could indicate a problematic pattern.

Warning signs of laxative abuse may include:

• The presence of empty laxative packages
• Fainting spells
• Long bathroom visits
• Frequent complaints of abdominal cramping
• Clogged toilets
• Secretive or shameful eating habits (which may indicate binging)
• Offhanded comments about feeling constipated or being “too full”

Laxative Abuse Triggers

People abuse laxatives for numerous reasons. Some simply start taking laxatives because they are curious about how they work. Or, they may be susceptible to the pervasive myth that laxatives block weight gain or eliminate calories. This mindset, of course, is toxic, but it persists in many online eating disorder communities, thinspiration accounts, and pro-ana content.

Societal expectations about weight loss and thinness may perpetuate problematic purging behaviors, such as laxative misuse. People may be more vulnerable to engaging in these behaviors during stressful times–or when their mental health is suffering. However, extended laxative abuse can become a behavioral addiction, and stopping the behavior may feel extremely difficult.

Symptoms of Laxative Overdose

Symptoms of a laxative overdose may vary depending on someone’s tolerance level, type of laxative, its strength, amount ingested, usage frequency, and other related factors. However, there are certain symptoms that may indicate a laxative overdose. If you suspect you might have overused laxatives, it’s crucial to seek immediate medical attention and prevent a life-threatening situation.

Common laxative overdose symptoms include:^1,2,5,7

• Chronic diarrhea
• Abdominal pain
• Nausea and vomiting
• Severe dehydration which causes dry mouth, excessive thirst, or dark urine
• Fainting or feeling lightheaded
• Extreme fatigue
• Irregular heartbeat
• Muscle spasms

When to Seek Emergency Help for Excessive Laxative Use

The extensive use of laxatives can have adverse effects on various organ systems, leading to significant health issues, so it is crucial to seek immediate medical assistance if you experience severe symptoms or complications. These may encompass persistent abdominal pain, chronic or nocturnal diarrhea, fainting, vomiting, irregular heartbeat, chest pain, bloody stools, among other indicators. Acting promptly at the first unsettling sign can prevent more serious health concerns and potential life-threatening consequences.^1,2,5,7

Laxative Abuse Treatment

Compulsive behaviors, such as laxative abuse, may require professional support. Therapy offers a safe and non-judgmental environment to understand your specific triggers. Likewise, you and your therapist will create a comprehensive plan to reduce and eliminate laxative use.

Ideally, you should find a therapist with experience and competence in treating eating disorders. Depending on the severity of your condition, you may briefly need acute support, such as hospitalization or inpatient care. For less acute care, an online eating disorder program like Equip Health or Within Health may be a great option.

Outpatient Therapy Options for Laxative Abuse Recovery

Enhanced cognitive behavioral therapy (CBT-E) tends to be one of the most common treatment methods for laxative abuse. Some people respond well to family therapy and interpersonal therapy (IPT) as well. These therapies typically target problematic thinking patterns, while also teaching a person to adopt adaptive coping responses.⁵

Inpatient Treatment for Laxative Abuse

Some people also benefit from in-person or online group therapies facilitated by mental health professionals or peer-led support groups, like Eating Disorder Anonymous or Overeaters Anonymous. Groups can provide a sense of validation and reassurance that you are not alone in your struggles.

Healthy Coping Methods for Recovering From Laxative Abuse

To stop excessive laxative use successfully, you will likely need to replace your unwanted behavior with healthier choices. Making proactive lifestyle changes can reduce the desire to purge and help you feel more empowered when facing self-destructive urges.

Healthy ways to cope with laxative abuse include:

• Dispose of any extra laxatives you have at home: Try to stop completely and quickly instead of weaning yourself off. Consider throwing out any left over laxatives you may have access to.
• Take steps to avoid immediate constipation: Take steps to prevent constipation right away by increasing your fiber intake, eating nutritiously, drinking lots of fluids, moving your body, etc.
• Pause and meditate when triggered: The next time you feel overwhelmed or triggered to purge, take a few moments to focus on your breathing and meditate. Consider listening to a guided meditation script to help you relax.
• Try journaling: Journaling can help you better understand the underlying emotions related to laxative abuse. Consider setting a timer and letting yourself write freely to “release” your thoughts and feelings.
• Use an eating disorder recovery app: There are many free and paid eating disorder recovery apps that can help support your recovery. These apps often focus on affirmations, engaging in positive behaviors, and community support.
• Read books about healthy body image: Reading healthy body image books can help you feel more inspired in your recovery. These books support building a healthier self-esteem and challenging negative thoughts you have about your body.
• Reach out to your support system: People who value your well-being care deeply about your mental health. If you are struggling, consider speaking to a trusted loved one about what you’re feeling.
• Distract yourself: At times, distraction may be helpful to stall or delay unwanted behavior. Consider doing chores, taking a nap, finishing your homework, or starting a consuming task to avoid sitting with your thoughts.
• Repeat positive affirmations: Remind yourself that you can get through difficult moments and that you are worthy of recovery. Consider writing down body positive affirmations that feel good to you and posting them in visible places.
• Avoid triggering situations: Try to minimize contact with certain people or situations that trigger your urge to use laxatives. If you can’t avoid them entirely, create an action plan for how you will cope during that time.
• Celebrate small successes: Recovery is built on thousands of tiny decisions. Every hour, day, or week that goes by without laxative abuse builds your strength and resilience. Recovery can be a bumpy road full of twists and turns, but don’t overlook recognizing progress.

How Long Does It Take to Recover From Laxative Abuse?

Overcoming laxative abuse usually requires mental and physical effort. That said, after cessation of laxative misuse, individuals can expect normal bowel function within several weeks. But if they are struggling with rebound symptoms like weight gain, edema, or constipation, it may take them longer.

Other considerations affecting the timeframe for recovery include severity and duration of the abuse, someone’s overall health, presence of an eating disorder or another underlying mental or medical condition, among other things. As such, full recovery from laxative abuse will vary from person to person.

Because recovering from laxative abuse is a complex task, it’s important to have psychological support and medical guidance. With the help of a mental health provider along with other specialists, the affected person can receive an individualized treatment plan that addresses their specific situation and needs. A healthy recovery and lifestyle can be attained with the appropriate interventions that are conducive to improving gut health and overall wellbeing.^1,2,4