Laxative abuse?
Posted , 3 users are following.
Hi all,
Back when I was 19 (now 29) I ended up becoming bulimic and anorexic. I wouldn't of said I was hugly overweight as I was between a size 12/14.
Don't get me wrong when I managed to get down to 9.7stone I was the happiest and even when the doctors told me I was underweight it was so happy as I have never been that small in my life.
Growing up I used to weigh 16stone and remember when I was 13yrs trying on a size 18 pair of jeans and they were too small.
My family then saw my dramatic change and the look of guilt on my mums face of her blaming herself for me making myself sick and not eating anything as she wasn't nearby to stop me.
From then I stopped making myself sick and I started eating more. But I hated the idea of feeling full or bloated. So as a comprise to myself I started taking laxatives. This way no one could hear me being sick and I could say I had an upset stomach.
Over the years I have tried to ease myself off these and now I only take them 3 times a week or if I have an occasion I take them more.
I've mentioned this to a number of doctors and no one seems to want to help. I've heard so many times "Your looking healthy so i wouldn't worry"
But I am worried and I don't want any long term illnesses or even get bowel cancer. But this is the reaction I get from doctors because I look healthy.
I'm hitting the gym and I do have a healthy lifestyle but I just can't seem to shift the pounds so this is making me do them more.
I buy the boots own brand laxatives and when I do take them I have 8 tablets. But like now, after about an hour I got the cold sweats, shakes and I was sick.
Does this mean I've damaged my body? This isn't the first time this has happened
Thanks all
Louise
0 likes, 4 replies
katlouise1989 louise4205
Posted
I'm sorry to hear about your struggles and I'm really sorry to hear that your GP has not been understanding. Unfortunately not all GPs understand mental illness fully, but it does sound like you need some support.
I'm sorry to hear about your "compromise" with laxatives. I don't know if you know, but laxatives are exceptionally dangerous, and rather depleting your body of weight, they deplete your body of crucial minerals, such as potassium and sodium, which are essential for heart function. This can create arrythmias and are also fatal. Laxative abuse can be very difficult to give up, because it tricks you into thinking you've lost weight, when actually it is just fluid. So yes the numbers on the scales go down, but you haven't actually lost any weight.
You are correct in talking about bowel cancer. There are links between bowel cancer and laxative abuse. Repeted abuse can also cause you to be incontentent as this area of the digestive system can stop working properly. Whilst it seems impossible to give up, do you want to have a bag fitted that you need to empty every time you need the bathroom?
You asked about the physical symptoms. If you are putting such pressure on your body, then it is going to want to fight back. Some of this is your heart, and a lot is dehydration and electrolyte imbalance, so in essence you are damaging your body.
Having been hospitalised with extremely low potassium, I am a champion of them being banned outright. There is no need for them, and for those who need them, this should be something prescribed. Remember you are also overdosing. You are not only taken well above the recommended amount, but you are also taking medication you don't need.
I know these are some horrible facts, and don't pretend its easy. I'll write again later in terms of practical steps surrounding your difficulties.
Kat
katlouise1989 louise4205
Posted
Hi Louise,
How are you doing today? I hope the below is helpful, although maybe tough.
From what you have written, I can see there are a number of positives to be taken. Firstly, no matter what the reason, you have achieved what a lot of the population can't. Being overweight, you have managed to lose weight to a size more healthy. That is something to be super proud of.
I can see that you are unhappy, and it's important to remember all your hard work, and learn to consolidate and maintain where you are now. One of the traps people often don't realise, is that by restriction and cutting food groups, people are very susceptible to bingeing, which does lead to weight gain.
One of the things I would recommend is trying to stick to regular meals, with snacks throughout the day, with a balance of all food groups. I am happy to chat through some ideas and meal plans if you feel that would be helpful.
I understand that it can be horrible when parents don't understand, and even more so when they feel they are to blame. They are not and you are not. Eating disorders are horrible illnesses, and they are not caused by a person's want to be thin. Rather they are coping mechanisms to deal with what life throws at us (bad coping mechanisms...but still a way of dealing with life). You don't choose to have one, and for some people their biology makes them more susceptible too. You can choose to fight eating disorders, and in doing so, you need the support of others around you.
I also understand that you feel unhappy about your body. It is common to have body dysmorphia alongside eating difficulties. This is why it would be helpful to look at having therapy. It will help you to confront some of these issues (CBT is really helpful). It will also help a little more the underlying issues which have led to your illness.
Please be kind to yourself, and do feel free to PM me, if you'd like to chat through nutritional advice.
Kat
ka77 katlouise1989
Posted
Hi Kat,
I've just come across your advice to Louise and I'd like to ask for your kind advice.
I'm so desperate to fid someone who could help me and knows exactly what I'm talking about...but let me tell you some things about me and my past. I don't know anything about you background and it will be long, sorry, but maybe by getting the full picture you can tell me sg which might help...
I'm 38 (yes, way too old to have fallen into this trap but I was 30 when my whole eating disorder story started...), I live in Hungary, my parents are doctors but when it comes to my problem they are unable to help any more and I don't expect them to do so as I don't really take their advice, knowing that even they want to help, they have never been through what I am therefore cannot really help...
Until the age of 29 I had never ever been on a diet, never cared about my weight but at the age of 29 I started an innocent diet, however, after a few months I started to restrict and lost about 20 lbs in 6 months (starting weight: 130lbs-ish).
Then we broke up and when we came back home from the Middle East, I kept on my diet and went down to about 98 lbs (I'm 5'6) but eating quite normally, I mean in terms of sitting down and eat - with little calorie intake though but no binging.
And then my body obviously started to fight back: I started to binge, first on foods that I 'allowed' to myself (nuts and seeds, fruits, yoghurt, healthy cookies), then after about 2.5 years on everything that I found in the kitchen. Additionally, that was the time when I discovered laxatives… I started to take 2-3 pills in the evening which added up to 40 (!) strong stimulant bisacodyl ones plus epsom salt every single evening for 5 years now...I went impatiend 3 months ago for one month but all did was to reduce this amount to 20 which I' still taking.
I can't really explain this, I feel so panicked with a very strong heartache or this very weird and eerie feeling if I don't binge, this especially gets very strong in the evening, then I eat for about 2-3 hours non-stop without chosing what is on my plate, I sit in front of the computer and watch TV and just eat and eat whatever I can lay my hands on…. I do understand the logic, I went through lots traditional and alternative therapies, I read very extensively about the topic, watched many videos etc, and I'm absolutely aware of the mechanism of the laxatives (calories are still absorbed as they work on the large intestines etc), but since I have this anorexic way of thinking that I do not want to gain weight, I feel the need to get rid of that junk food I'm eating. I went vegetarian a few years ago then got back to eating meat again and now for a weeks I'm vegetarian again, but I eat and drink so many things and so much in the evening that I always get extremely bloated even after drinking a glass of water and this bothers me very much. When I started to abuse the laxatives my weight went down to a very low weight and I could maintain it for about 3-4 years, but then in the past 1.5 years I gained about 20 lbs which frustrates me very much as my thighs and belly got much bigger, I don't like my body and even though I can see that this way of living (laxatives and binging) leads only to weight gain, I'm not able to stop. I know I’m still at a low BMI but I don’t seem so thin and the weight distribution is not proportional. If I don't take the pills, my weight goes up to 4-6 lbs straight to the next morning (after binging, of course which I do every single evening) and then I get so scared that it will never stop climing up that I take the pills again he next evening. And binge of course...I live alone and this is my stubborn evening routine, I don't have anything else to do but I could not even do anything else as I feel this strong urge and strange panic if I cannot do my rituals of eating for hours.
I tried to wean myself off the pills but then my weight immediately goes up by the morning for 4-5 lbs and I'm jusr so afraid it would climb forever on every single day...and I am constipated. I know many people advise to increase the fiber intake and the water but fiber doesn't work for me, and wanted to try the starch solution but starches make me even more constipated. It IS a vicious cirlce...I tried Miralax, prune juice, fiber, oils, senna tea etc. but it didn't work, either, Sometimes I use epsom salt and enema (actually I use them as well every day…) with the bisacodyl pills just to make sure that my belly is flat by the morning and I do not gain weight - which is, of course, not the case as I've already gained 20 lbs in the past few months.
It is very complicated and even the disorder specialists here in Hungary can't really do anything with me as I know more about the subject than they do;-), but I can't act...I don't have my period for 7 years and all my social life revolves around the pills and the binges, I can hardly dare to leave the house because they can kick in the most unexpected time. They either cause me diarrhea (every night and next morning for 5 years…) or don’t work at all leaving me constipated and bloated.
It makes me crazy and this is not a life a live at the age of 38... I'm just so tired and fatigued and as I know that I can't stop binging in the evening, I don't really dare to eat much during the day...
I understand the body is fighting back the deprivation caused by laxative abuse for years, and probably that's why I constantly binge but the fear of weight gain and not being able to stop binging keeps me in this vicious circle...And this constant panicking - for which i take some tranquilizers - also frightens me so much;-(
I know it is way too much information and I'm sorry for this but I wanted you to get a full picture about my case.
I would highly appreciate your kind advice where to (re)start my recovery and how to get rid of the binges/laxatives/fear of weight gain (=not to gain weight and be able to stop those evil pills…) etc for a life...I've seen so many specialist but noone could help me, I know only I can help myslef but I feel so hopeless...
Thanky you very mcuh for your kind advice in advance,
Aniko
katlouise1989 ka77
Posted
Hi Aniko,
I'm sorry to hear about your difficulties.
There are a number of things going on here, and I'll try and answer some of your questions, and perhaps revisit other parts at a later stage.
I'd like to address the following:
1) Body dysmorphia
2) "weight gain"
3) Laxative abuse
First of all, I'm amazed that during your inpatient stay, laxatives were even permitted! I tried to smuggle these in, and the nurses knew literally every trick in the book...low and behold these were confiscated.
It is also important to highlight that developing eating disorders later in life is perfectly common especially in the early stages of your adult life as there can be lots of challenges you face outside the safety net of your family home. I actually relapsed significantly when my parents moved from our family home and I was lost in the world of renting, my first job and establishing a social network in London. So be kind to yourself as it is certainly not just teenage girls who suffer with this (and then magically goes away once you turn 18!)
Body dysmorphia.
You have highlighted that you feel bloated, that your thighs and tummy feel enormous.
There is a behavioural reason for this. Our bodies have been conditioned to react to danger e.g. bear in the woods (or more hilariously, lioness when camping in a serengetti campsite...yes these things do exist...) I woke up to go to the loo in the middle of the night, and saw what I thought was a lionness and jumped back into the tent screaming. I had feared the lioness was a few metres away from me, it was huge and it was going to attack me. And more importantly I saw it as a lionness. Actually, it was a guard dog and was a lot further away than I thought but my brain had told me it was danger and therefore I needed to fight or flight - in my case flight. In the case of body dysmorphia, the exact same thing happens, and the lionness is replaced with being large (I don't like to use the word fat, because feeling or being fat is not correct. Fat is a naturally occuring tissue in the body and whilst some people have more of it than others, you cannot feel fat). Therefore your brain perceives what scares you to be bigger than it actually is, and closer. This is hampered even more when you put your body at risk such as low weight, restriction etc. Your body goes into fight mode because it senses danger and therefore is in a heightened state of anxiety. This is why your organs also go into "safe mode". Your metabolism slows down, you can experience breathing difficulties, you feel cold, your concentration goes etc etc. Your body is trying to conserve as much energy as possible. The heightened anxiety means that at a low weight you trip yourself even more. Ironically as you get healthier the anxiety does decrease, although it is natural to still feel dissatisfaction with the body.
With your metabolism (and I am taking the laxatives out for the time being), it will have slowed down substantially and therefore as you gain weight, it will be confused and trying to adjust, so you will find weight gain occurs in odd places, and that you will start to need even more food because your body is trying to rebuild. This is why in inpatient units malnourished patients will eventually increase to around 3000 calories a day, because you need more than your recommended daily allowance in order to gain weight.
2) Weight gain
Weight gain is a funny one. As I just outlined above, you need to be eating more than your RDA in order to gain weight. Now this will also happen as you start eating more (and below your RDA), because as I mentioned your metabolism needs to recover, but also tries to conserve energy. So yes, more food = body mass gain.
Your weight is a transient thing, moving up and down all the time when you eat, drink, sweat, go to the loo etc. It will not stay at the exact same number. Women experience even greater fluctuations during during their period (mine can increase any where between 1kg to 3kg, because I retain a LOT of fluid, but I haven't gained weight, I've retained water, and it goes back down again after). There is some mass gain in that obviously, because my meal plan is trying to increase my mass, but if I were maintaining, it would just be changes in fluid.
so this is important to be aware of, but even more so with laxative abuse. Laxatives don't cause body mass loss, although people think they do because your weight goes down on the scales after you have taken them. You mentioned that as soon as you eat or drink, your weight goes back up again. The reason for this is all your have lost is fluid. Like when a person first starts a crash diet, the first few days will see an enormous decreasing in their weight, because the body loses fluid, then it can be frustrating because the weight loss is not as great as before. Furthermore, when the person eats properly again, their weight bounces back up because it has regained lost fluid. This is all that is happening with laxative abuse and will explain your loss and gain. You will also feel way more bloated because as the laxatives act on your stomach, it pushes lots of water down into the intestines before emptying more than is normal.
3) Laxative abuse
I probably don't need to tell you how dangerous laxatives are, but in addition to the water loss you lose core electrolytes which are essential for the heart to function. Laxatives can be fatal for this very reason. You can also do permanent damage to your liver and kidneys and many long term abusers need dialysis as a result.
When I was admitted as an inpatient, my consultant was very clear that another week and I may have died. I have also more recently in 2014 been admitted because of my critically low potassium levels...a consequence of the laxative abuse.
It infuriates me that laxatives are readily available and not behind the counter. If you buy a certain amount of paracetamol then you will be stopped, because paracetamol overdose can be fatal. Laxatives should, but don't, fall under the same regulation.
I would decrease your laxative use bit by bit. You will be constipated, because your body has relied on laxatives to empty your bowels, and not natural processes. Reducing bit by bit will help get your bowels working again, but you will need to be patient with it. I would also speak with your doctor to work a plan on how to reduce these safely.
On recovery. Sometimes, we aren't ready to recover. When I was inpatient age 18, I was not ready. I had to, but mentally I wasn't, despite the unit being brilliant, and my consultant one of the leading people in the country. I am still under the same consultant (and funnily enough the terrifying dietitian I had in hospital, who is SO much nicer than I remember). But the difference is I am determined and committed to recovery. It doesn't mean it is any easier, and at times extremely tough going, but it is like a full time job, you have to work and work at it. But, it is worth it...I am getting there and my life is so much better than it has been. I played my cello yesterday for the first time in months (as I've been studying part time for an MA alongside recovery and working full time) and whilst I got tired fairly easily, what amazed me more was how on earth I played so well and such a high level when I was so poorly. I am fairly sure it was adrenaline that got me through, but I remember constantly being in a daze or trance, and there are huge parts of my adolesence that I can't remember or am in disbelief about how I survived. Recovery is so worth it, because you can live.
Hope this helps, do message me if you have any more questions or concerns.