Purging: A Psychological Review
Abstract
Purging is a type of disordered eating behavior that is characterized by frequent episodes of self-induced vomiting, laxative and diuretic abuse, and/or the misuse of other medications in an attempt to control one’s weight or shape. This review summarizes current research on the causes, risk factors, and treatments associated with purging. The review concludes that purging is a complex disorder that is likely to be caused by a combination of biological, psychological, and social factors. Additionally, it is associated with significant psychological and physical health risks and treatment should be tailored to meet the individual needs of the person.
Introduction
Purging is a type of disordered eating behavior that is characterized by frequent episodes of self-induced vomiting, laxative and diuretic abuse, and/or the misuse of other medications in an attempt to control one’s weight or shape (American Psychiatric Association, 2013). It is a serious mental health issue that can have serious physical and psychological consequences (Fairburn & Cooper, 1993; Fairburn, Cooper, & Shafran, 2003). Despite the fact that purging is a widely recognized form of eating disorder, research on the causes, risk factors, and treatments associated with this behavior is still in its early stages. The purpose of this review is to summarize the current state of the research on purging in order to better understand this complex disorder.
Causes and Risk Factors
The exact causes of purging are unknown, but research suggests that there are likely to be biological, psychological, and social factors involved (Hudson, Hiripi, Pope, & Kessler, 2007). Biological factors may include genetic predisposition (Fairburn & Cooper, 1993; Fairburn et al., 2003), hormonal imbalances (Kaye, 2008), or alterations in brain chemistry (Kaye, 2008). Psychological factors may include low self-esteem and body dissatisfaction (Fairburn & Cooper, 1993; Fairburn et al., 2003), perfectionism (Fairburn & Cooper, 1993; Fairburn et al., 2003), or difficulty regulating emotions (Hudson et al., 2007). Social factors may include cultural messages related to thinness (Hudson et al., 2007) or exposure to peers who engage in disordered eating behaviors (Hudson et al., 2007).
Risk factors for purging are also likely to include a combination of biological, psychological, and social factors (Hudson et al., 2007). Biological risk factors may include a family history of disordered eating (Fairburn & Cooper, 1993; Fairburn et al., 2003), or a past history of dieting (Fairburn & Cooper, 1993; Fairburn et al., 2003). Psychological risk factors may include low self-esteem and body dissatisfaction (Fairburn & Cooper, 1993; Fairburn et al., 2003), perfectionism (Fairburn & Cooper, 1993; Fairburn et al., 2003), or difficulty regulating emotions (Hudson et al., 2007). Social risk factors may include cultural messages related to thinness (Hudson et al., 2007) or exposure to peers who engage in disordered eating behaviors (Hudson et al., 2007).
Treatment
The treatment of purging is likely to vary depending on the individual needs of the person. Treatment may include a combination of pharmacological and psychotherapeutic interventions (Hudson et al., 2007). Pharmacological interventions may include the use of antidepressants, antipsychotics, or mood stabilizers (Hudson et al., 2007). Psychotherapeutic interventions may include cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), family therapy, or interpersonal psychotherapy (Hudson et al., 2007). Additionally, it is important to address any underlying medical issues that may be contributing to the disordered eating behavior (Hudson et al., 2007).
Conclusion
The review concludes that purging is a complex disorder that is likely to be caused by a combination of biological, psychological, and social factors. Additionally, it is associated with significant psychological and physical health risks and treatment should be tailored to meet the individual needs of the person. Future research should focus on identifying more effective treatments and interventions for purging.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Fairburn, C. G., & Cooper, Z. (1993). The eating disorder examination (12th ed.). Oxford, UK: Oxford University Press.
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behavior Research and Therapy, 41, 509-528.
Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61, 348–358.
Kaye, W. H. (2008). Neurobiology of Anorexia and Bulimia Nervosa. Physiology & Behavior, 94, 121–135.