title: The medical complications associated with purging.
abstract: OBJECTIVE
  Purging behaviors, including self-induced vomiting, laxative abuse, and diuretic abuse, are present across many of the eating disorders. Here we review the major medical complications of these behaviors.
  
  
  METHODS
  Although we identified over 100 scholarly articles describing medical complications associated with purging, most papers involved case studies or small, uncontrolled samples. Given the limited evidence base, we conducted a qualitative (rather than systematic) review to identify medical complications that have been attributed to purging behaviors.
  
  
  RESULTS
  Medical conditions affecting the teeth, esophagus, gastrointestinal system, kidneys, skin, cardiovascular system, and musculoskeletal system were identified, with self-induced vomiting causing the most medical complications.
  
  
  CONCLUSIONS
  Purging behavior can be associated with severe medical complications across all body systems. Mental health professionals should refer patients with purging behaviors to medical providers for screening and treatment as needed. The medical work-up for individuals with eating disorders should include a comprehensive metabolic panel, complete blood count, and a full body exam including the teeth to prevent severe complications. Medical providers should screen patients for purging behaviors and associated medical complications, even in the absence of an eating disorder diagnosis, to increase the detection of eating disorders. Recognizing the link between purging and medical complications can aid in identifying potential eating disorders, particularly those that often elude detection such as purging disorder.
authors.affiliation: Department of Psychology, Florida State University, Tallahassee, Florida.
authors.forename: K Jean
authors.initials: KJ
authors.lastname: Forney
authors.affiliation: Department of Psychology, Florida State University, Tallahassee, Florida.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Buchman-Schmitt
authors.affiliation: Department of Psychology, Florida State University, Tallahassee, Florida.
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Keel
authors.affiliation: Department of Psychiatry and Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
authors.forename: Guido K W
authors.initials: GK
authors.lastname: Frank
mesh_terms: D001068:Feeding and Eating Disorders / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D019966:Substance-Related Disorders / Q000523:psychology*; D014839:Vomiting / Q000150:complications*
keywords: diuretic; laxative; medical complications; purging; self-induced vomiting