Laxatives and enemas: not the way to go

By abusing laxatives and enemas, some people with eating disorders try to rush food through their bodies before the calories can be absorbed. These practices are harmful, even potentially fatal, and they don’t work to remove calories.

  • I have been using laxatives and enemas to control my weight. My mother says I am putting myself in danger. Is she just trying to control me?

Listen to your mother. This time she is right

    • Laxatives and enemas have no place in modern health care except in medical conditions monitored by physicians.
    • People with eating disorders abuse laxatives because they believe they can remove food from their bodies before the calories are absorbed (They can’t. See below.) Also, many are constipated. The little bit of food they allow themselves does not provide enough bulk to stimulate regular bowel movements.
    • The misuse of laxatives and enemas can cause serious, sometimes irreversible, sometimes fatal problems.
    • Many people can kick the laxative/enema habit, even after long-term use. To manage problems, work with a physician.
  • Why can’t laxatives help me control my weight? After I use the bathroom, I always weigh less than I did before.

A healthy bowel receives food residue from the stomach and small intestine. As the bowel fills, fecal matter stimulates nerve endings, causing muscle contractions that expel the residue from the body in a bowel movement.

Laxatives and enemas artificially stimulate nerve endings in the large bowel, which is also called the colon. The colon is one of the last structures in the digestive tract. By the time food arrives there, nothing is left but indigestible fiber and other non-nutritive material.

Laxatives remove lots of water from the colon as well as food residue. The scales indicate weight loss after a laxative-induced bowel movement, but it is false weight loss. The ounces or pounds return as the body rehydrates after liquid intake consumption. If the person refuses to drink liquids, s/he risks dehydration which can lead to fainting spells and in some cases death.

Laxatives and enemas cannot stimulate the small intestine, the part of the GI tract where food is digested and where nutrients and calories are absorbed. The small intestine does not even have the kinds of nerves that occur in the colon and respond to artificial stimulation.

In one experiment, a group of laxative abusers ate a high calorie meal. A group of normal people ate the same food, which totaled several thousand calories. The laxative abusers took their purgatives of choice. The normal people let nature take its course. Researchers collected all the material passed in bowel movements and tested it for calorie content. Even after consuming thousands of calories and massive amounts of laxatives, the laxative abusers managed to remove only about 100 extra calories from their bodies, the amount found in one small cookie.

  • How can I hurt myself my continuing to use laxatives and enemas?
    • You can upset your electrolyte balance. Electrolytes are minerals like sodium, potassium that are dissolved in the blood and other body fluids. They must be present in very specific amounts for proper functioning of nerves and muscles, including the heart muscle.
    • Laxatives and enemas (and also vomiting) can upset this balance, resulting in muscle cramps, tremors, spasms, irregular heartbeat, and in some cases cardiac arrest. The heart stops, and unless the person receives immediate emergency medical treatment, s/he dies.
    • Laxatives and enemas (and also vomiting) remove needed fluid from the body. The resulting dehydration can lead to tremors, weakness, blurry vision, fainting spells, kidney damage, and in some cases death. Severe dehydration requires medical treatment. Drinking fluid may not hydrate cells and tissues quickly enough to prevent organ damage or death.
    • Laxatives irritate intestinal nerve endings, which in turn stimulate muscle contractions that move the irritant through the gut and out of the body. After a while the nerve endings no longer respond to stimulation. The person must now take greater and greater amounts of laxatives to produce bowel movements. S/he has become laxative dependent and without them may not have any bowel movements at all.
    • Laxatives and enemas strip away protective mucus that lines the colon, leaving it vulnerable to infection.
    • Enemas can stretch the colon, which over time becomes a limp sack with no muscle tone. No longer can it generate the muscle contractions necessary to move fecal matter out of the body.
    • Laxatives abusers seem to have more trouble with the following problems than do nonusers: irritable bowel syndrome (rectal pain, gas, and episodes of constipation and diarrhea) and bowel tumors (both benign and cancerous).
  • How can I stop the laxative and enema habit?
    • Ask your doctor for help. Don’t let shyness or embarrassment stop you.
    • As your doctor advises, either taper off or go cold turkey. Expect to be anxious when time passes with no bowel movement and increasing feelings of fullness, bloat, and discomfort. Your body needs time to regulate itself and relearn how to respond to natural cues. Be reassured that most people who stick with their doctor’s recommendations manage to stop laxatives and enemas and resume normal functioning after an initial period of discomfort.
    • Make sure you eat enough food, especially high-fiber items like whole grains, fresh fruits, and fresh vegetables. Eat the skin and peels too; they are usually high in fiber. An inexpensive, effective way to increase fiber in your diet is to add a few spoonfuls of unprocessed bran to soups, stews, and cereals. Don’t go overboard with bran, however. It can generate intestinal gas which will increase your discomfort.
    • Drink a hot beverage (lemon juice in hot water is good), and then walk briskly for thirty minutes. The hot liquid and muscle movements in your legs and abdomen will help stimulate muscle contractions in the intestines.
    • Drink lots of water during the day. Doctors recommend eight to ten glasses. Don’t count caffeine beverages in your total; caffeine pulls water out of your body instead of adding it to cells and tissues.
    • Before breakfast, take a walk. Walking gets your intestinal muscles working so they can move the contents of your GI tract along and out of your body. A cup of hot water and lemon juice helps get things going too.
    • Eat breakfast! After breakfast, sit on the toilet for 5-10 minutes. Breakfast initiates a reflex that triggers the intestines to evacuate their contents.
    • Let your therapist help you deal with the anxiety that this recovery process may create. Remember that the human body has tremendous powers of restoration, but they sometimes take a while to kick in. Best wishes for health and happiness.