On the Efficacy of Self-Induced Vomiting (Purging)

A single in-lab assessment of caloric consumption, loss, and retention during binge-purge episodes in individuals with bulimia nervosa (BN) is frequently cited as evidence that purging via self-induced vomiting is an ineffective strategy for calorie disposal and weight control (Kaye, Weltzin, Hsu, McConaha, & Bolton, 1993). These findings have been widely interpreted to mean that, on average, purging  rids the body of only about half of the calories consumed, regardless of total quantity.

However, a closer examination of the study does NOT support the notion that purging is an ineffective compensatory behavior. Indeed, the findings of Kaye et al. (1993) would appear to have been both misunderstood and overgeneralized in the subsequent decades. This has important implications for therapeutic alliance in clinical practice as well as for understanding the nature of symptoms, metabolic processes, and physiological alterations in EDs.


The study included 17 individuals, all of … Continue reading →

What's The Point of Bingeing and Purging? And Why Can't You Just Stop?

I defended my MSc on Tuesday and I’m not going to lie: I was pretty symptomatic with bulimia in the days prior to my defence. As I explained to my boyfriend: the anxiety-reducing effects of purging are so powerful, and the compulsion to binge and purge (when I’m stressed/anxious/”not okay”) is so strong that it is much easier to do it, get it over with, and continue working (in a much calmer state).

I’ve mentioned before, for me, purging is very anxiety-reducing and in some ways, almost a positive experience. It is so tightly coupled with bingeing that it is hard to separate the two, but the anxiety-reducing effects are strongest when I binge and purge, non-existent when I binge, and weak when I purge a normal meal (which is exceptionally rare/almost never.)

It turns out, of course, that I’m not alone.

Negative emotional states and stressors have long been … Continue reading →