Eating disorder behaviors function to manage uncomfortable emotions. Whenever I work with a client who struggles with purging we dig deeper to look into the significance and symbolism. The purging can come in many forms – vomiting, laxative abuse, exercise – but no matter the form the underlying functions remain similar.
For some people purging offers a sense of relief from the discomfort of having food inside their bodies. The relief comes from an underlying belief that they don't deserve the food, or the shame for eating it (especially if it was a binge).
Other times purging is a way to punish themselves or to get the "bad stuff" out. The food is symbolic of the negative emotions that are too uncomfortable to tolerate.
Purging can also serve to numb, distract or soothe a person. It's often viewed by the individual as a way to "fix" things by getting rid of calories consumed, a compensation for eating.
The myth about purging is that it's something a person can simply choose to stop doing. Reality is that it's a symptom of their illness. Sure, I'd love to choose to stop coughing when I have a cold, but that's not how it works. Discontinuing purging is really hard to do; it's the elimination of a coping skill that in many ways has worked for the person. Time and practice are required to develop new coping skills (that honestly may not be as effective at first).
Cessation of purging via vomiting or laxative abuse also comes with physical discomfort. Edema (fluid retention) is common which manifests as swelling, often in the feet and ankles, and fluid weight gain (which is highly distressing for a person with an eating disorder).
Letting go of exercise as a form of purging is also distressing, as it tends to result in high levels of anxiety and restlessness. Exercise itself has a biological calming effect on the brain, so not only does the person lose that benefit, but they likely also experience additional anxiety about not exercising.
Bottom line is that purging is a complicated symptom of an eating disorder that is highly symbolic in terms of the person's emotional needs. Behaviorally and physiologically it's extremely difficult to stop purging and almost never happens without slip-ups along the way. It is essential to give yourself grace and compassion.
You are worthy of love and comfort just for being you.
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