Laxatives have their uses for people with digestive issues but evidence suggests they're being widely misused by those with eating disorders. Now, the government is taking steps to tackle the problem.
More than half of sufferers have misused laxatives at some point, according to the Royal College of Psychiatrists, and currently, anyone can buy unlimited quantities of the drugs over the counter from pharmacies and supermarkets without a subscription. A review will look into introducing a minimum age on purchasers and possibly a ban on over-the-counter sales.
The eating disorder charity Beat, along with several health professionals, welcomed the review. Beat spokesperson, Rebecca Field, said "laxatives pose severe health risks for people with eating disorders" and should be regulated in the same way as painkillers, "to prevent people overusing them and harming their own health".
Beat wants to see a minimum age of 16 for purchasing laxatives, an upper limit on the amount that can be purchased, and for them to be sold at pharmacies only, not in general retail stores. Research by the charity in 2014 found that nearly 100% of eating disorder sufferers who had abused laxatives had bought them over the counter.
"It is vital that people are aware of the dangers of abusing laxatives and there should be more education on their effects," Field continued. "Doctors and pharmacists should also be made aware that overuse of laxatives is one of the signs of an eating disorder, so that they are able to intervene and ensure sufferers get treatment."
Marg Oaten MBE, from SEED Eating Disorder Support Service, would also welcome restrictions on the number of laxatives being bought at any one time, but believes people may simply go to several different shops or turn to the internet. Oaten is also calling for warning labels and information leaflets to be added to drug packets to increase awareness of the dangers of misuse.
"We know of people taking in excess of 100 per day, which poses a medical risk as their body fights the side-effects of such extreme behaviours," she told Refinery29. "People don’t understand that excessive laxative abuse can cause low levels of potassium in the body – potassium regulates the heart and people who abuse this are at risk of a heart attack."
"People need to recognise the signs and symptoms of low potassium levels," Oaten added. These include an irregular heartbeat and muscle weakness, aches and cramps. She recommends seeking medical advice if you experience any of these.
Like Oaten, Deanne Jade, a psychologist at the National Centre for Eating Disorders, believes more needs to be done to tackle laxative misuse than a review of over-the-counter sales. She described it as "probably pointless" because sufferers could buy them elsewhere, including online. "Frankly, people need to know why [they're dangerous] rather than just that they’re 'a bad thing'," Jade told Refinery29. "Currently there is a major TV campaign promoting a well-known brand of laxatives as being healthy."
We asked three eating disorder sufferers who have misused laxatives to control their weight about their experience, and what they make of the government's review. Will it make a difference?
"I once drank so much I wet the bed"
Alex, 28, from London, has suffered with eating disorders – anorexia, bulimia and binge eating disorder – since being sexually abused at 12 years old. They are chronically ill and require laxatives to treat their illness, but when they were 22 they began misusing a laxative juice that they bought online. They no longer take laxatives but experience disordered thinking around food.
I've always thought that being ill makes me thinner. At the height of my problem I'd drink a large bottle [of laxative juice] three times a day. One time I drank so much I wet the bed. I haven't told anyone about my problem. It's dumb but this was probably the most embarrassed I felt about having an eating disorder. It's a bad way of thinking and getting the weight off, I know.
I think more young women take laxatives than people think. The stereotype for young women is that they want their body to be as doll-like possible – with no bodily functions – but a lot of us are desperate.
I'm against regulations being introduced because chronically ill/constipated people really do need laxatives, and I have experience of struggles obtaining them through the NHS. But there needs to be a greater awareness of laxatives used for eating disorders.
"I now suffer with IBS which is probably caused by laxative abuse"
Ruth, 36, from Beverley in East Yorkshire, began using laxatives at age 14 and continues to do so on a weekly basis. She developed anorexia at 8 years old and bulimia at 12, both of which she lives with to this day.
The only time I didn't struggle with eating disorders was when I was lucky enough to be pregnant. From the age of 14 to 23 I used laxatives, at one point I would take around 30 to 40 on a bad day. I stopped using them for many years and started again when I was about 30. I used to alternate where I bought them, although I was once refused from a Boots in Hull because I was also buying diet pills. I now suffer with IBS which is probably caused by laxative abuse.
Emotionally, using them is a mix – being in agony and pain isn't fun and there's the guilt that you may be doing irreversible damage. But then there's relief that it is okay to eat something, as most of it is gone without having to purge.
I fully welcome the news that the government might restrict sales of laxatives. Because of social media and more and more pro-anorexia sites, it's so easy for people to read that laxatives are an easy way to lose weight. If there was an age limit, an amount limit or some kind of restriction then maybe it could help more people. If these restrictions had been in place for my younger self then maybe things would be different for me now.
"I was told my heart could stop at any point"
Debbie, 34, from Lincolnshire, suffers with anorexia after first developing it aged 14. She began using laxatives a year ago as an eating disorder outpatient and stopped a few months ago.
I used to take a box of laxatives every day. I started because I thought they would help me lose more weight than I already had. I used to buy them from any supermarket. It got to the point that I became really poorly and had horrendous stomach cramps every day, which interrupted my daily life and working life. I stopped them a couple of months ago, when I was at an appointment and was told my heart could stop at any point. That really scared me because although I knew this deep down, it didn’t really register with me as I was oblivious due to the eating disorder voice in my head.
It’s a good idea that the government may restrict the sales of laxatives because they are really dangerous, especially for people with eating disorders.
If you are struggling with an eating disorder, please call Beat on 0808 801 0677. Support and information is available 365 days a year.