Purging Disorder and Bulimia Nervosa

Purging Disorder and Bulimia Nervosa

Understanding and identifying the uncanny similarities and stark difference between Purging Disorder and Bulimia Nervosa

Purging is a behaviour commonly associated strictly with Bulimia Nervosa, however Purging Disorder and Bulimia Nervosa are both very real and very serious eating disorders, independent of each other. Those suffering from both are deserving and worthy of unique treatment plans that are suited to the individual’s physical and emotional needs. A defining tenant of Bulimia Nervosa is purging post binge, with as much focus on the binging as there is with the purging whereas Purging Disorder is not defined by a binge purge cycle, it is simply a purge post consumption of any size. Bulimia Nervosa can be formally diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders whereas Purging Disorder is an Other Specified Feeding or Eating Disorder (OSFED). Both disorders, however, are serious, challenging, and complicated demanding of respect and compassion.   

What is Purging Disorder?

Purging Disorder is an eating disorder characterized by the incessant need to purge by way of (primarily) vomiting, laxatives, diuretics, and excessive exercise to rid the body of food to lose weight or prevent weight gain. Purging Disorder falls under the OSFED category which stands for Other Specified Feeding or Eating Disorder. When an eating disorder falls under the umbrella term of OSFED it essentially means that it does not fall under the standard or typical criteria of Anorexia, Bulimia, or Binge Eating Disorder. All eating disorders that fall under the OSFED label should not be treated as one, they still have their own idiosyncrasy, deserving of unique attention and treatment. Purging Disorder is adjacent to Bulimia, however, is not categorized as a subset of Bulimia because those who struggle with Purging Disorder become obsessed with purging, regardless of consumption size. Those with Purging Disorder typically don’t suffer from binges at all, a purge happens after consumption to compensate for said consumption to stave off weight gain and attempt to lose weight.

What are characteristics of Purging Disorder   

Those who suffer from Bulimia often express a feeling of being out of control around food which leads to a binge, and then a subsequent purge. Those with Purging Disorder, do not necessarily experience the same emotional discomfort around food. Typically, those who suffer from Purging Disorder do not engage in binging. Purging Disorder is an eating disorder and an unhealthy attempt at weight loss, however it is less about the inability to consume in a healthy and controlled way, and more about removing the food from the body post consumption.  Characteristics of purging disorder are as follows:

  • Self induced vomiting
  • Diuretic use
  • Laxative use
  • Extreme/over exercising

How is Purging Disorder diagnosed?

Purging Disorder is diagnosed, along with all other eating disorders by a trained professional after a psychological intake or evaluation. Eating disorders greatly impact the physical body, however they are not identified by administering physical tests such as scans, blood work, or imaging. Purging Disorder is diagnosed when the patient expresses the psychological pull to engage in purging activities on a regular and constant basis. The patient feels distress at the thought of not purging and actively finds ways to purge, regardless of their surroundings. Anyone who is actively purging is worthy and in need of intervention and support, a formal diagnosis is not required to seek help and begin treatment. 

What causes Purging Disorder?

Like all other eating disorders, there is no clear, definitive, or acute cause of. What there is, however, are similar emotions, sentiments, and situations that those who have been diagnosed or engage with eating disorders share. They are, but not limited to:

  • Nature (lived experiences)
  • Nurture (your genetics)
  • Self-worth
  • Self-confidence
  • Pre-existing mental conditions
  1. Anxiety
  2. Depression
  3. Obsessive Compulsive Disorder
  • Trauma
  • Health conditions (allergies, sensitivities)

What are treatments for Purging Disorder?

Eating Disorder treatments can loosely follow the same kinds of treatment, regardless of what disorder the individual is suffering from. It is important to acknowledge that eating disorders are psychological disorders with cascading impacts to the mind and body, meaning it is critical to treat the psyche first and foremost.  Engaging in therapy is a necessary step and practice for Purging Disorder. Coupled with therapy, nutritional counselling has also been identified as a helpful tool. Nutrition counselling can help increase the patients understanding of food, its importance to our bodies, dispel inaccurate food beliefs, and enlighten on the lasting impact and damage purging has. 

How do you cope with Purging Disorders?

Coping with an eating disorder is without a doubt, exhausting. Consuming the body and mind all day, everyday. However, with support through one’s network, family, friends, and a professional ally, it is possible to not only copy with one’s eating disorder but to actively reject it, reach full recovery and regain complete control of one’s life again. 


Q: Is Purging Disorder the same as Bulimia Nervosa?

A: No, Purging Disorder and Bulimia Nervosa and independent of each other.  They both, however, share a similar tenant in the act of purging.  Those with Bulimia binge prior to a purge, whereas those with PD do not.

Q: Does Bulimia Nervosa include purging?

A:  Yes.  Bulimia is characterized as incessant binge – purge cycles.  This cycle is the defining identifier of Bulimia Nervosa.

Q: What are some ways to purge?

A: Purging can be defined as a couple different activities.  Those with Purging Disorder may engage in all of the below:

  • Vomiting (most common)
  • Diuretic use
  • Laxative use
  • Extreme/excessive exercise

Q: What happens when you stop purging?

A: Our bodies are constantly seeking a state of homeostasis, where everything is functioning according to plan, on time and on track.  When eating disorders are present, our bodily functions are thrown out of whack because of the manipulation they are under.  When purging stops, our bodies miraculously return to…normal! In the immediate aftermath of resuming normal consumption, there may be some digestive discomfort as the body gets familiar with completing the digestive cycle, however, that is temporary.  When purging is no longer happening, the below will also stop:

  • Dehydration
  • Headaches
  • Fatigue
  • Swollen salivary glands
  • Acid burns on face

Dr. Natalie Mulligan graduated from the Canadian College of Naturopathic Medicine (CCNM). She completed her clinical internship at the Robert Schad Naturopathic Clinic with a focused interest in mental health. Prior to attending CCNM, she completed a Bachelor of Science degree at the University of Waterloo.