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Purging is what you do to try to get rid of the calories you have eaten. Usually, you do it after bingeing. You do it because you don't want to gain weight. Here are some of the things we know about purging.

• People with anorexia purge by making themselves vomit, by taking laxatives or diuretics, or by giving themselves enemas.
• People who make themselves vomit do it by gagging on their fingers or on something like a toothbrush handle. If you've had anorexia for a long time, you may be able to vomit without trying very hard. But vomiting only gets rid of between a third and half of the calories you've just eaten.
• Vomiting and bingeing are things people do in secret.
• Laxatives make food move through your gut faster. If you take a lot of them, you get bad diarrhea. Taking laxatives can make you dehydrated and thirsty. Laxatives don't get rid of calories. This is because they don't work until they get into your intestines. By then, most of the calories you've eaten have gotten into your blood, from where they're either used to keep your body going or stored as fat.
• Some people take diuretics (also called water pills) to purge. They make you pass a lot of urine. This just makes your body lose water, not fat.
• Some people think they can get rid of calories if they have enemas (washing out the bowel). This doesn't get rid of calories.

Some people get rid of calories from their binges in other ways. One way is to burn them off by exercising. But when someone does this to purge calories, it's different from healthy exercise. They may:

• Exercise so much that it interferes with work or school
• Exercise late into the night
• Exercise very early in the morning
• Insist on running or going to the gym even when they're injured.

Another way some people try to make up for binges is by not eating anything (fasting) for a day or more.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.