Purging through vomiting is a common eating disorder behaviour in people with bulimia nervosa and anorexia purging-type. Despite the temporary relief it provides, purging itself often leaves you feeling wiped-out, uncomfortable and "unclean".
It’s hard. Hard on your mind and body.
Then begins the post purge ritual. A ritual that often lacks the compassion that you would show anyone else who had just been sick.
So what is the right thing to do after purging?
In this post, you’ll learn:
You can click the links to skip straight to any section. This post was originally published in 2020 and has been updated for comprehensiveness.
What is purging?
Purging is a maladaptive coping mechanism that is used by those who are suffering with an eating disorder. Purging is not only common in Bulimia Nervosa, it can also be present in Anorexia Nervosa, Other Specified Feeding or Eating Disorder (OSFED) and purging disorders.
Purging is an attempt to compensate for or eliminate foods consumed. In some cases, it follows binge eating, but it’s important to note that not everyone who purges also binges.
At the end of the post, I have also added some important information on when to seek medical attention as well as who to reach out to if you need professional support.
Types of Purging
This blog post gives guidance on what to do after purging through vomiting. It is not a replacement for individual medical or professional advice. Although vomitting is the most commonly recognised form of purging, there are other types of purging.
Different types of purge behaviours:
Regardless of the method of purging, all are signs of a serious mental illness that requires urgent medical and professional treatment.
What causes purging after eating
Purging is most often thought of as a way of avoiding or controlling weight gain. While there is almost always a fear of gaining weight, viewing purging solely as a weight loss "tool" is a common and significant misconception.
Purging sometimes gives a person temporary relief from the thoughts and feelings that accompany the sensation of feeling full after eating. It is this temporary relief that makes it so difficult to stop purging. Purging provides short term relief for a long-term problem.
More often than not, those who engage in purging are vulnerable to other co-occurring mental health disorders such as anxiety, depression, alcohol use disorder (AUD) and trauma (e.g., PTSD). Feelings of low self worth, lack of control and overwhelm can be triggers for purging.
Triggers such as unpleasant thoTriggers such as unpleasant thoughts and feelings can perpetuate the vicious restrict-binge-purge cycle.
What to do after bingeing and purging
Brushing your teeth, taking hot baths or showers, and drinking alcohol are among the most harmful things to do after being sick. Here's a checklist that you can save somewhere as a quick reminder (full explanation of each step is below).
Bicarbonate of Soda Mouth Rinse
Stomach acid weakens tooth enamel, which is damaging to teeth; therefore, it’s important to neutralise the acid as soon as possible. Rinsing with a mixture of 1 teaspoon of baking soda mixed with 200 ml of water will neutralise the hydrochloric stomach acid. If you don’t have bicarbonate of soda, plain water is better than nothing. However, bicarbonate of soda is the most effective solution due to its high PH concentration. Note: This is only for rinsing, not drinking. It’s also important to remember that brushing after vomiting will damage softened enamel. I recommend not brushing for at least an hour.
Vomiting is dehydrating due to the fluids and electrolytes lost in the process. This may also be exacerbated by other purging and compensatory behaviours such as exercise and laxative abuse. An electrolyte drink can help replace lost electrolytes and help rehydrate you.
Here are some electrolyte drinks that you can have after being sick:
O.R.S Hydration Tablets with Electrolytes, Vegan, Gluten and Lactose-Free Formula (affiliate link): https://amzn.to/3S2KKlA
Follow the product manufacturer's recommendations for the maximum daily dose, as these may differ. Lastly, avoid drinks such as fruit juice or lemon in water, as these can be harsh on your tooth enamel.
As your blood sugars are low, try to eat something that feels safe for you as soon as you can to rebalance your blood sugars. Symptoms of low blood sugar include sweating, dizziness, feeling shaky, a fast heartbeat and feeling confused.
What to eat after purging
Helpful foods include something that provides some carbohydrates, such as rice cakes, popcorn, toast, crackers, oatcakes, chocolate, some biscuits, or a banana. Take it easy for at least 15 to 20 minutes, as it may take a while for your blood sugars to pick up. In the meantime, you can engage in some positive distractions.
Change into something comfortable where possible
Hot showers and baths can exacerbate feelings of dizziness and disorientation. Moreover, they can cause sweating, which will further dehydrate you. Instead of taking a hot shower or bath, freshen up by washing and moisturising your hands and face. Then, if possible, change into something comfortable. Opt for loose-fitting clothing that feels comfortable (especially if you’re feeling bloated).
Self-care activities for after bingeing and purging
Self soothing and positive distractions to help you sit with difficult feelings and sensations. The activities below are things you can do by yourself, but reaching out to someone you trust is also a form of self-care.
Each Line, One Breath
Artist John Franzen demonstrates how he draws each line with one breath. It is a wonderful mindfulness practise. He explains more in the video on his blog here.
Draw your favourite song
I got this exercise from a wonderful book called "Essential Art Therapy Exercises: Effective Techniques to Manage Anxiety, Depression, and PTSD". Play your favourite song and use coloured pencils and a large piece of paper to express the sounds that you hear.
Listen to a meditation
This free Soundcloud playlist here accompanies the book Mindfulness: A Practical Guide to Finding Peace in a Frantic World.
Journaling can be a powerful mindfulness tool for your mental health. Below are a few journaling exercises you can try.
Write about a time when you felt safe. Who was there? How did being safe feel? Do you remember any smells, sounds or images that were present in that moment? If you were to use one word to describe that moment, what would it be?
Self-compassion letter. Write a letter to yourself from the perspective of an imaginary friend who loves and accepts you unconditionally. If you're having trouble connecting with this, consider what you'd say to someone you love and accept unconditionally if they were in your situation.
Understanding your trigggers. DBT (dialectical behaviour therapy) uses the Chain Analysis of Problem Behaviour (or Behaviour Chain Analysis) as a method of analysing problematic behaviour by analysing its causes and consequences.
Feel your feet on the ground
The video below is a quick and easy grounding technique that you can do anywhere (and people won’t even know you’re doing it!).
What happens to your body when you stop purging?
When you stop purging, the body resumes its healing process. Unfortunately, the side effects of this healing process can be triggering for some. You may experience digestive discomfort such as bloating, a tender jaw, or puffy face due to the swelling of the salivary glands and overall water retention as the body is recovering from dehydration. It can feel very uncomfortable and may trigger thoughts about weight gain, which may trigger compensatory behaviours.
As hard as it sounds, and it is really hard, the only way to heal is to continue to choose the path of recovery.
When you should seek urgent medical attention
If you vomit blood or have vomit that looks like ground coffee (a sign of internal bleeding), call 999 or go to A&E.
How to stop bingeing and purging
As you probably realise, the answer to this question is highly individual and complex. Recognising that you are ill and reaching out for help is the first step towards recovery. The reality is that those moments of wanting to change coexist with a fear of change. If that sounds like you, I can assure you that this is completely normal.
Have a treatment or support system in place (e.g., a doctor, a therapist, nutritional therapy, a loved one, a peer support group)
Identify and understand your triggers
Develop ways to self-soothe as a healthy coping mechanism
Eat regular meals and snacks to regulate your appetite.
Heal your relationship with food, your body and exercise
This is not an exhaustive list, nor does recovery happen in a linear fashion.
Be Gentle With Yourself
Recovering from an eating disorder is not an easy process. Therefore, it takes a while to understand, challenge and overcome behaviours like purging. There will even be times where you feel like you're moving backwards or when you just want the comfort that the eating disorder provides (albeit short-term).
Keep at it; recovery is possible.
Below is a list of free resources if you need urgent help.
Who to call if you need urgent emotional support
If you’re worried about your emotional state or are having suicidal thoughts, there are a number of helpful helplines that can provide support. If you aren’t able to get through to any of these lines and are feeling suicidal, call 999.
Samaritans: Call 116 123 (24/7)
Beat UK: 0808 801 0677 (9 a.m. to 8 p.m. on weekdays and 4 p.m. to 8 p.m. on weekends and bank holidays).
Childline: 0800 1111 (7:30 a.m.–midnight from Monday to Friday, or from 9 a.m.–midnight at weekends).
Nutritional Therapy for Recovery
I'm a registered nutritional therapist who specialises in eating disorder and disordered eating recovery. If you'd like to learn more about the one-on-one support I offer, schedule a FREE 30-minute discovery call here.
Or you can book a one off session with me here.
Disclaimer: This blog provides general information and discussions about health and related subjects. The information and other content provided in this blog, website or in any linked materials are not intended to be, and should not be considered a substitute for, medical advice, diagnosis or treatment.
Affiliate Disclaimer: As an Amazon Associate, I earn money from qualifying purchases. Some of the above links may be affiliate links, meaning if you purchase a product or service via these links, I may receive a small commission or reward at no additional charge to you.