What Is Purging? Understanding a Common Eating Disorder Behavior

Melanie D'Andrea, manager of clinical partnerships at Equip, began overexercising after a breakup when she was 18. Overexercising is a non-purging compensatory behavior, used to “compensate” or “make up” for eating.

What began as an interest in yoga and treadmill running eventually spiraled into an obsession that consumed her day and night. “I started tracking calories in and calories out, using exercise as a form of punishment for eating ‘poorly,’ and making sure to ‘burn off’ every cookie or Frappuccino I consumed,” she says.

Over time, D’Andrea discovered another way to achieve the “empty” feeling she craved: laxatives. Laxative misuse is a classic purging compensatory behavior.

“It began in small doses but quickly escalated to taking large volumes daily,” she says. “Laxatives, along with compulsive exercise, became my daily habits. Eventually, the laxative abuse meant I could no longer exercise due to lack of energy, inability to run without needing to use the restroom, and increasing depression.”

In this article, we explore purging vs. non-purging compensatory behaviors, purging after eating, types of purging, and more.

What is purging?

Purging is used to “make up” for eating food or as a way to “get rid of” food. Purging behaviors include self-induced vomiting, laxative misuse, and diuretic misuse.

“Purging is the intentional act of compensating for calories,” says Hannah Bishop, LPC, a therapist at Equip who is also in recovery from bulimia nervosa herself. “The stereotype for what is purging is recognized as vomiting, but that doesn’t mean other behaviors can’t fall into this definition.”

Purging is a compensatory behavior used to “undo” the effects of eating. Other compensatory behaviors, while closely related to purging, are called non-purging compensatory behaviors. These include fasting, overexercising, and other extremes, according to 2025 research published in the journal Eating Disorders.

Researchers distinguish between purging and non-purging compensatory behaviors because they can affect health differently. Both types are harmful to overall health, however.

• Purging involves “expelling” food, fluids, or waste from the body. Beyond affecting overall health, purging often damages certain areas. For example, self-induced vomiting can erode tooth enamel.
• Non-purging involves burning calories or restricting food. Beyond impacting overall health, the behavior heavily affects your muscles, bones, and endocrine system.

Compensatory behaviors: purging vs. non-purging

We share the distinction between purging and non-purging compensatory behaviors because clinicians you encounter might use these hard-and-fast definitions. Other clinicians sometimes lump all compensatory behaviors together and call them purging.

Non-purging behaviors can also fly under the radar as “healthy.” So the distinction may be helpful for awareness. “These behaviors are often socially praised or normalized, which makes them harder to recognize and easier to dismiss,” says Alix Turoff, RD, a registered dietitian, nutrition consultant, and personal trainer.

However they are classified, purging and non-purging compensatory behaviors are disordered eating behaviors and could be a sign of an eating disorder.

Purging and other compensatory behaviors

Purging and non-purging compensatory behaviors are used to “compensate” for food intake. Many people who use compensatory behaviors engage in more than one type. All are dangerous, and they can occur in people of any size.

Self-induced vomiting

Self-induced vomiting is an effort to expel food that’s just been consumed. It can lead to a variety of medical complications.

Complications of self-induced vomiting

• Stomach rupture
• Heart and kidney problem
• Dental problems including stained teeth, tooth erosion, and cavities
• Irregular menstrual periods
• Inflamed esophagus
• Electrolyte imbalances

Self-induced vomiting is a serious purging behavior and can become even more serious when combined with other compensatory behaviors.

Misuse of laxatives, diuretics, or other medications

Laxative, enema, diuretic, and medication misuse involves using these tools to “eliminate” food consumed. Other medications that might fall under this category include various “diet pills” or “diet supplements.”

Using a laxative, enema, or diuretic occasionally and as directed for easing constipation or bloating is normal and not considered purging. But if you use these medications regularly and outside of the recommended dosage, it becomes a problem.

Laxatives help produce a bowel movement that can make a person feel “empty.” But your body absorbs calories well before waste reaches your colon. The “weight” that's lost from laxatives, diuretics (water pills), or diet pills is most often a combination of water, electrolytes, minerals, indigestible fiber, and colon waste.

The list of medical problems associated with laxative abuse is long, and it includes electrolyte imbalances and changes to the body’s pH levels, which can result in potentially lethal kidney and cardiovascular complications.

Insulin omission (diabulimia)

Insulin misuse or mismanagement, sometimes called “diabulimia,” is a form of purging specific to people with diabetes, usually type 1 diabetes.

“Diabulimia is probably the least well-known because it impacts a smaller subset of individuals with eating disorders,” Turoff says.

Complications from insulin mismanagement include (among many others):

• Cardiovascular, kidney, and liver disease
• Diabetic ketoacidosis
• Eye damage or blindness
• Serious infections
• Severe hyperglycemia (high blood sugar)
• Severe dehydration
• Neuropathy (nerve damage)
• Potential amputation
• Death

Compulsive exercise

As D’Andrea experienced, non-purging compensatory behaviors can often appear in the form of compulsive exercise (some people refer to this as “exercise addiction.”

“The easiest form of purging to dismiss as ‘healthy’ is probably excessive exercise,” Turoff says. “Because exercise is so normalized and generally praised as a healthy behavior, it’s easy for compulsive or compensatory movement to fly under the radar.”

Bishop has firsthand experience with this praise. “I struggled with compulsive exercise and would often receive many compliments on my ‘determination,’ which would fuel the eating disorder,” says Bishop.

Overexercising can result in everything from fatigue and depression to overuse injuries and the loss of menstrual periods. Turoff adds that it also “reinforces the belief that food needs to be earned or erased, which keeps the eating disorder cycle going.” Compulsive exercise can also lead to a variety of medical complications.

Complications from overexercising:

• Hormone disruption
• Irregular or absent menstrual cycles
• Impaired bone health
• Strain on the cardiovascular system
• Fatigue
• Worsened mood and anxiety

“Exercising seems so normalized in today’s society, but the ‘why’ behind it is what matters,” says Gabrielle Terzano, an Equip recovery coach. “If you’re using exercise to compensate for what you ate, then it may be a sign that you’re using exercise to purge.”

Fasting or restriction

Fasting means abstaining from food for a certain period, while restriction can mean eating very little food. Restriction is a symptom that’s common to all eating disorders, even though it’s most associated with anorexia nervosa.

Here’s why:

• Some eating disorders or disordered eating behaviors follow a binge-restrict cycle.
• In most cases, binges are preceded by periods of restriction.
• The resulting biological hunger from that restriction can trigger a binge and make you or a loved one feel out of control around food.
• This combination often leads to restriction after binges in an attempt to “make up” for the episode. But the restriction only perpetuates the harmful cycle.

Which eating disorders involve purging?

Purging is most associated with bulimia nervosa, but it also appears in other eating disorder diagnoses.

• Bulimia nervosa is characterized by eating large quantities of food followed by purging behaviors, often self-vomiting. “Non-purging bulimia” is an outdated term and is no longer used in bulimia nervosa diagnostic criteria. But it refers to bulimia nervosa in which someone uses non-purging compensatory behaviors, such as compulsive exercise.
• Anorexia nervosa is characterized by restricting food intake relative to what your body needs for energy. Fasting, food restriction, and overexercising are common compensatory behaviors. Anorexia nervosa, binge eating/purging type is a type of anorexia that involves a cycle of food restriction, binge eating, and purging.
• Purging disorder is a subtype of the eating disorder other specified feeding or eating disorder (OSFED). People with this condition engage in purging behavior to control weight or alter body shape, but they do not binge.

Purging may also emerge as a pattern without a formal eating disorder diagnosis. But it is a sign of disordered eating that shouldn’t be ignored.

How to get help for purging

Purging and all compensatory behaviors are treatable with specialized eating disorder care. However, some symptoms warrant emergency help.

Seek immediate medical attention for the following:

• Black, tarry, or bloody stool
• Chest pain, pressure, or tightness
• Confusion or slurred speech
• Heart palpitations
• Inability to keep fluids down
• Fainting
• Sudden or severe weakness
• Severe abdominal pain
• Severe throat or neck pain
• Shortness of breath or difficulty breathing
• Thoughts of self-harm
• Vomiting blood or vomit that looks like coffee grounds

If you are experiencing any of the above symptoms, seek emergency medical care at your nearest emergency room.

If you are in immediate crisis related to thoughts of self-harm, call or text 988 to reach the Suicide & Crisis Lifeline.

For knowledgeable eating disorder care, call 855-374-1710 to reach Equip. You or your loved one can seek out specialized treatment from providers who are educated on the complexities of purging and other compensatory behaviors.

“The most important step in treating purging is early, specialized intervention with professionals who specialize in eating disorders,” Turoff says. “If purging isn't addressed, it can escalate quickly. Getting help as early as possible is critical, because purging behaviors can become more ingrained and medically risky the longer they continue.”

Many of the serious physical consequences of purging—particularly electrolyte imbalances, cardiovascular strain, and hormonal disruption—can develop quickly and may not be obvious at first. This is why Turoff says immediate care is critical.

“Early treatment improves outcomes, reduces medical complications, and makes recovery more achievable,” she says.

However, no matter how long you (or a loved one) have been struggling, recovery is possible.

Treatment for purging

A multidisciplinary team of specialists can address the different aspects of disordered eating behaviors, including purging. A care team will usually include a therapist, dietitian, and medical provider, at a minimum.

At Equip, patients work with a team specialized in using evidence-based treatment modalities. Providers work together to help you or your loved one understand and stop purging behaviors.

Effective treatment should be personalized to each patient’s unique needs, but care for purging behaviors often involves some similar, evidence-based approaches. These include:

• Urge surfing: This mindfulness technique helps you or a loved one avoid acting on harmful behaviors by “riding out” the urge, almost as if surfing a wave. “If you feel the urge to purge, set a timer for 10 minutes before you act on it,” Terzano says. “Even if you do end up going through with the behavior, it’s still progress if you’re able to delay it. And then do this over and over again, because repetition is key.”
• Therapy: Therapy can also be a key to recovering from purging behaviors. Using modalities like enhanced cognitive behavioral therapy (CBT-E) and dialectical behavioral therapy (DBT) can help. A therapist uses these modalities to guide you or a loved one in unpacking the underlying issues that may be driving purging. They also help create a plan for breaking the cycle.
• Relapse prevention: Relapse can be a common part of the recovery journey. But relapse doesn’t equal failure. “It can take time to completely stop the behavior and even more time for the urges to stop completely,” Terzano says. “Oftentimes when we feel stressed, we want to turn to a behavior that will make us feel better in the moment. Purging may give you instant satisfaction and gratification, but it won’t help in the long term.” At Equip, patients work with their team to develop a relapse-prevention plan that provides concrete, actionable guidance to address slip-ups and protect recovery.

The bottom line

Purging is a behavior used to “get rid of” or “make up for” food you’ve eaten. Self-induced vomiting or misusing laxatives or diuretics are examples. Purging falls under the larger umbrella term of “compensatory behaviors,” which encompasses any behavior used to compensate for food. Some non-purging compensatory behaviors are fasting and compulsive exercise.

All compensatory behaviors, regardless of their type, are dangerous and considered disordered eating behaviors. They are also characteristic of several formal eating disorder diagnoses.

No matter what type of purging behaviors you (or your loved one) are struggling with, recovery is possible with the right support. Talk to a trusted medical provider, or schedule a call with Equip today.

FAQ

Is exercise a form of purging?

Exercise in moderation is a healthy lifestyle choice. However, when excessive or compulsive exercise is repeatedly used to compensate for eating, then it’s considered a non-purging compensatory behavior. Compensatory behaviors that are considered purging include self-induced vomiting and laxative or diuretic misuse.

Can you purge without binge eating?

Yes, people purge without binge eating. Purging behaviors include self-induced vomiting and laxative or diuretic misuse.

Can you recover from purging?

Yes, recovery from purging is possible with the help of a knowledgeable care team that is well-versed in care for eating disorders and disordered eating behaviors.