Effective Medical Treatment Strategies to Help Cessation of Purging Behaviors

International Journal of Eating Disorders
By Philip S. Mehler, MD, FACP, FAED, CEDS

Abstract

Objective: Herein we review the major medical issues involved in the "detoxing" of patients who engage in purging behaviors and the pathophysiology of why they occur.

Methods: Given a limited evidence base of randomized controlled trials, we conducted a thorough qualitative review to identify salient literature with regard to the medical issues involved in "detoxing" patients from their purging behaviors.

Results: Pseudo Bartter's Syndrome is the root cause of much of the medical difficulties which can arise when purging behaviors are abruptly discontinued. However, this is imminently treatable and even preventable with a judicious medical treatment plan which targets the increased serum aldosterone levels which would otherwise promote salt and water retention and a propensity towards severe edema formation. Effective recommendations are provided which can make this process much less vexing for patients attempting to cease their purging behaviors.

Conclusions: "Detoxing" from purging behaviors can be fraught with medical complications which frustrate these patients and can lead to unsuccessful outcomes. Medical providers should become familiar with the pathophysiology which is the basis for Pseudo Bartter's Syndrome and the effective medical treatments which can lead to a successful outcome.

Keywords: Pseudo-Bartter syndrome; chronic purging; constipation; diuretic abuse; edema; electrolyte imbalance; hypovolemia; laxative abuse.

Written by

Philip S. Mehler, MD, FACP, FAED, CEDS

Dr. Philip S. Mehler began his career at Denver Health more than 35 years ago and was formerly its Chief of Internal Medicine and then Denver Health’s Chief Medical Officer (CMO) until he was promoted…

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