Purging Disorder

What is purging disorder?

Purging disorder is recognized in the DSM-5 as a subtype of Other Specified Feeding or Eating Disorder (OSFED). It is defined by recurrent purging behavior — self-induced vomiting, or the misuse of laxatives, diuretics, or other medications — used to influence weight or shape, in the absence of binge eating. People with purging disorder are usually not underweight.

Purging disorder vs. bulimia nervosa

This is the key distinction. In bulimia nervosa, purging is a compensatory response to episodes of binge eating — eating an objectively large amount of food with a sense of loss of control. In purging disorder, there are no binges; the person purges after eating normal or even small amounts of food. The purging is the same; the eating that precedes it is not.

How it differs from anorexia

Purging can also occur in the binge-purge subtype of anorexia nervosa, but there the person is significantly underweight. In purging disorder, weight is typically in the normal range, which — as with atypical anorexia — can make the illness harder for others to spot.

Why purging disorder is serious and often missed

Because people with purging disorder are usually of normal weight and the behavior is done in secret, it frequently goes unnoticed. But purging itself carries significant medical dangers regardless of a person's weight or whether bingeing is involved. Purging disorder deserves the same clinical seriousness as any other eating disorder.