I struggle with laxative addiction and it's an eating disorder we need to talk about

Gianluca Russo
Laxative addiction is taboo, but it shouldn’t be. (Photo: Getty Images)
Laxative addiction is taboo, but it shouldn’t be. (Photo: Getty Images)

Every night around 7 p.m., I’d pop the cap off the bottle, pour out two tiny, bright orange pills, and swallow them. Roughly five hours later, the cramps would begin, usually sometime around midnight and after I had gone to bed. I would wake, run to the bathroom, and wait for the intense pressure and aching within my intestines to fade. It had become unfathomable to me that weight loss could be possible without the assistance of my trusty orange pills. I was 15 years old and I was abusing laxatives, all because a so-called dietician told me to do so.

After years of battling body-image issues, I had made the decision to meet with a dietician and drastically alter my eating habits in an attempt to get fit. I sat at his desk as he walked me through a diet plan he had laid out. The diplomas hanging on his walls made me think he was legitimate; I trusted his word. The diet plan was strict but that wasn’t all: He instructed me to take laxatives every night before bed to help regulate my digestion and clear my system. I left the office with two bottles of the pills, 60 in each.

For two months, I followed the diet closely and took the laxative pills every day, sometimes twice a day if I had cheated on my food plan. Within approximately 60 days, I had lost 40 pounds. But as I fell off the diet for a variety of reasons, the weight came back. What stayed was my abuse of laxatives, an on-and-off addiction that I struggle to break free from to this day.

Laxative abuse is taboo. It’s often addressed either quietly on message boards or between close confidants. Laxative, as a word, is often said as a joke. But laxative abuse and addiction is real, and we need to start really talking about it. In high school, boys on the wrestling team who I was friends with would take laxatives regularly to fit within a certain weight class. Other people I knew would use them before a big dance or event, hoping to shed a quick few pounds and appear less bloated. I often wonder if they still take laxatives, like I do.

“About 50 percent of our patients come in with some type of laxative use,” Tanja Haaland, Clinical Director of the Meadows Ranch, an eating disorder rehab facility in Wickenburg, Ariz., tells Yahoo Lifestyle via phone. Haaland has been an eating disorder specialist for 15 years and is well-versed in laxative abuse. “We see it with all three of the eating disorder diagnoses that we treat: anorexia, bulimia, and binge-eating disorder. With laxatives, we see both oral laxative use and enema use. What typically happens is people become pretty dependent, so when people try to wean off of using laxatives, they really no longer are able to have bowel movements, they develop a physical and a psychological dependence to the laxatives.”

The proper use of laxatives is to help prevent and treat constipation. They are to be used temporarily, only for a very short time until the constipation is relieved. But, according to the National Eating Disorders Association, “laxatives are [often] misused following eating binges, because the individual mistakenly believes that the laxatives will work to rush out food and calories before they can be absorbed.” The truth is different. A decreasing number on the scale after the use of laxatives is due to dehydration and depriving the body of essential nutrients.

“People have created this myth around laxatives being something that provides them weight loss. We know that most of the calories are already absorbed in the body so there is very little caloric change that occurs with taking laxatives, but it’s people noticing weight loss on the scale that’s actually due to fluid loss and dehydration; they internalize that feeling ‘lighter’ with the laxatives working for them and creating a weight loss when in fact that’s really a misperception,” Haaland says.

Many don’t realize — my 15-year-old self included — the plethora of harmful risks associated with laxative abuse.

“With laxative abuse after awhile, the laxatives really irritate the intestinal nerve endings so then we see the irritation throughout the gut and the nerve endings no longer respond to the stimulation, so the person has to take greater and greater amounts of the laxatives to have a bowel movement,” Haaland says. “It’s really no different than someone struggling with drug addiction or alcohol addiction — the person’s tolerance gets greater and greater. They become laxative-dependent and without them, they might not have any bowel movement at all.”

Tomoko Udo, assistant professor of Health Policy, Management, and Behavior in the School of Public Health at the University at Albany, SUNY, in Albany, N.Y., says this about laxative addiction: “Essentially, you have diarrhea all the time; that’s what it is. Your body is going to be constantly dehydrated [which is] a problem. Your mineral balance and your body fluid balance — all of that is not in balance anymore. You let it go before your body absorbs it. If it’s long term, a lot of people [develop] a bone-density issue. Some people mess up their intestinal insides.”

Both Haaland and Udo agree that the issue persists mostly because laxatives are easily accessible at almost every grocery store or pharmacy. “There’s that myth of if you can get it over the counter, it’s safe, whether it’s diet pills or things that bodybuilders use,” Haaland says. That couldn’t be further from the truth.

Like all variations of eating disorders, laxative abuse can seem impossible to break, even after the person receives help. In the five years since I first started abusing laxatives, I’ve struggled to completely rid myself of their use, eventually switching to a diuretic tea that was, of course, just as accessible. For those who, like me, find it nearly impossible to shed weight without the harmful effects of laxatives, abusing these diuretic supplements is never the answer. What is the answer is open discussion, education, and information, and making known the life-changing risks involved with swallowing those little tiny pills.

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