The easy accessibility of over-the-counter laxatives makes them a popular choice among dieters who mistakenly believe they lead to significant weight loss. Laxative abuse occurs when used for weight control or when used frequently for a long period of time. Most laxatives carry a warning that use should not exceed one week, but many laxative abusers admit to using laxatives several times a day over a period of many years.
Demographics
The population most likely to use laxatives for weight loss includes young women with the eating disorder, bulimia, and to a lesser extent, anorexia. Up to 2 percent of all women and 19 percent of college-aged women may suffer from bulimia nervosa, an eating disorder characterized by binging and purging. Binging involves uncontrollably and secretively consuming an excessive number of calories. Purging follows in an effort to eliminate the ingested calories and regain psychological control. A 2006 study of more than 1,000 patients with anorexia and bulimia, published in the journal "Psychosomatic Medicine," revealed that about 55 percent misused laxatives as purging agents. Laxative abuse seldom serves as the sole method of purging, though. Most people with bulimia use multiple method of purging, most notably self-induced vomiting, along with laxatives.
Types and Function
Laxatives work to facilitate stool passage from your body. The stimulant laxatives increase the contraction of the muscular lining of the bowels, speeding the elimination of stool. Most laxative abuse involves the stimulant class of laxatives because of this property of rapid elimination.
Other types of laxatives draw water into the intestines, making stool easier to pass. These laxatives tend hold less appeal for dieters because of the bloated feeling that precedes bowel movement.
In addition to ridding the body of calories, dieters often use laxatives to feel thin and eliminate bloating or a feeling of fullness.
Misconceptions
Dieters, bulimics in particular, often believe that laxatives will clear calories from the body before absorption. Most absorption of nutrients and calories takes place in your small intestine, but laxatives, especially stimulants, work primarily in the colon, further down the gastrointestinal tract. By the time the food bolus enters your colon, calorie absorption has already occurred. Loss of water and electrolytes occurs, however, and poses health risks, especially if laxative abuse continues over months or years.
Because laxatives do not require a prescription and because they assist in normal body functions, they are commonly perceived as harmless. Occasional use produces no serious health risks but misuse and abuse causes damage to your colon and changes your body's chemistry.
Dependence
Initially, dependence on laxatives involves psychological factors. The instant gratification of feeling empty and thin positively reinforces laxative abuse, and encourages repeated use. Over time, your body becomes confused by the upset in water and electrolyte balance and tries even harder to retain water. This leads to more laxative use to eliminate the resultant bloating.
The stimulant-type laxatives cause the colon to contract and work harder. Overuse of the smooth muscle in the lining of the colon eventually causes stretching of the colon wall. The stretching damages the nerves and muscles making it harder for the colon to contract naturally or effectively. Continued use of laxatives becomes necessary to help the colon do its job and results in a physical dependence, explains MayoClinic.com.
Warning
Water loss from laxatives leads to dehydration. People with serious eating disorders sometimes refuse to rehydrate because they feel bloated and fat and regain the water weight lost by laxative use. Organ damage and death result from severe or frequent dehydration.
The acidity of the blood changes with frequent laxative use. Further derangements in body chemistry result from loss of potassium, sodium and other electrolytes from the colon. Cardiac arrest occurs from laxative abuse because the electrolytes needed for the regular beating and contraction of the heart drop to critically low levels.
References
- "Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose, 4th ed."; Michael W. Shannon, M.D., M.P.H. et al, eds.; 2007
- "Psychosomatic Medicine"; Features Associated With Laxative Abuse in Individuals With Eating Disorders; Federika Tozzi, M.D., et al; 2006
- MayoClinic.com: Over-the-Counter Laxatives for Constipation: Use with Caution
- "Conn's Current Therapy 2010, 1st Ed."; Edward T. Bope, M.D., et al, eds.; 2010
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