Breaking the Urge to Purge: How Classical Conditioning Plays a Role in Reinforcing Purging Behaviours
Following binge eating, you might experience extreme discomfort, both physically and mentally. There is immense guilt, anxiety, perhaps shame. Regret likely creeps in, and you want desperately to “undo” what just occurred. You feel physically unwell, sick even. Purging can seem like a solution – something to “fix” the problem. Purging can provide a sense of emotional and physical relief. The relief that follows a purge reinforces the restrict-binge-purge cycle: You know it will “help” you feel better, conditioning you to seek out that same “positive” result by acting out a harmful behaviour. It is effective in relieving the discomfort – but is it a real, sustainable, and healthy long-term solution? How have purging behaviours contributed to harming your mental and physical health? How has it acted as a persistent mechanism reinforcing negative patterns of the restrict-binge-purge cycle?
The Physical Dangers of Purging
Purging through the use of laxative and diuretic misuse, excessive exercise, or intentional vomiting can be harmful to the body over time, and no doubt, the mind as well. Self-induced vomiting can cause tooth decay or infection, ruptured blood vessels in the eyes, damaged vocal cords, throat irritation, and swollen salivary glands which might appear as inflamed cheeks. The digestive system can also be impacted, as frequent purging can cause hemorrhoids, acid reflux, stomach discomfort, bloating, and constipation. Blood in vomit might be indicative of a tear in the esophagus, which can be dangerous and life-threatening. Abusing diuretics can lead to dehydration, a potassium deficiency, and in more serious cases, kidney disease or failure. Below are strategies that can support you in your recovery.
Strategies to Prevent or Resist Purging
Understanding Triggers
Being mindful of triggers can allow for preparation for their exposure. For example, perhaps a certain room in the home acts as a trigger. Noticing this, you might begin to become aware of thought patterns that arise. Disrupting maladaptive thoughts can weaken their impact. Perhaps grounding strategies or coming up with positive, reassuring and counteractive thoughts that provide a sense of safety can be used in these moments. Coming up with ways to mitigate the strength of the trigger can help to prevent or weaken the urge to purge.
Urge Surfing: Delay and Distract
An urge to self-inflict vomiting can be illustrated as an ocean wave. Incited by a trigger, the urge to purge might grow more and more intense with time, but eventually, with even more time, the urge will pass. Delay and Distract is a strategy that can help you “burn time”: surpassing the time of peak intensity and allowing its power to reduce. For example, when you feel an urge arise, you can try to call a friend, complete a task, go for a walk, read a book, or maybe watch a video to take your mind off the urge and distract yourself. Eventually, you might notice the urge become weaker and weaker, and eventually go away.
Reduce Restriction and Practice Mindful Eating
If we fuel our bodies, there is a reduced likelihood that overeating will occur. Overeating can be a trigger for purging, so utilizing strategies to reduce the chance for binge eating to occur is key. When food is restricted, the body increases its production of lectin, a hormone that serves to regulate hunger signals as an effort to maintain body weight. Increased levels of lectin can play a role in overeating due to ravenous hunger. It is a physiological response to food restriction!
In addition to fuelling the body, utilizing mindfulness strategies while eating can increase awareness of bodily sensations and remain in the present, here-and-now. Many clients describe a trance-like state while overeating occurs. If this resonates with you, grounding strategies can be helpful in increasing awareness and slowing down, being more mindful of the act of eating itself.
Want to learn more about how to break this harmful habit? Want to learn more specific and individualized strategies to reduce purging behaviours? We would love to support you, and welcome you to book a consultation with one of our therapists.
References:
Bennett, B. L., & Latner, J. D. (2022). Mindful eating, intuitive eating, and the loss of control over eating. Eating Behaviors, 47, 101680. https://doi.org/10.1016/j.eatbeh.2022.101680
Cleveland Clinic. (2022). Leptin & Leptin Resistance. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/22446-leptin
Johnson, J. (2018, August 23). What are the effects of bulimia on the body? https://www.medicalnewstoday.com/articles/322853
Hou, X., Wang, G., Wang, H., Liu, J., Liu, W., Ji, S., Wang, E., Qu, D., & Hu, J. (2022). Which came first? Bulimia and emotional symptoms: A cross-lagged panel analysis. International Journal of Clinical and Health Psychology, 22(3), 100320. https://doi.org/10.1016/j.ijchp.2022.100320
