The eating disorders medicine cabinet revisited: A clinician's guide to ipecac and laxatives

Abstract

There are numerous laxative products readily available to patients, and many of them have significant associated toxicities. Patients with BN tend to endorse high rates of laxative use. While ipecac is used infrequently, it can have deleterious consequences. Patients with BN should be screened for use of both ipecac and laxatives and should be educated about the potential consequences associated with the misuse of these agents.

Medical complications of bulimia nervosa and their treatments

“…Of note, they are not a effective method to lose weight because most caloric absorption has occurred before the site in the bowel where laxatives act. 24 Only 10-12% of ingested calories are lost as a result of laxative use, 25 because laxatives have little effect on the small intestine, the primary site of caloric absorption.…”

Household Expenditures on Dietary Supplements Sold for Weight Loss, Muscle Building, and Sexual Function: Disproportionate Burden by Gender and Income

“…Despite their widespread use, dietary supplements for weight loss, muscle building, and sexual function are not medically recommended and have been shown to be ineffective in many cases (Steffen et al, 2007;Roerig et al, 2003;Blanck et al, 2007) and to pose serious health risks to consumers due to adulteration with banned substances, prescription pharmaceuticals, and other dangerous chemicals (U.S. Food and Drug Administration, 2017; U.S. Food and Drug Administration, 2010;Cui et al, 2015). In fact, the U.S. Food and Drug Administration has been well aware of this heightened risk for many years, and in 2010 issued a special warning to consumers regarding supplements sold for weight loss, muscle building, and sexual function as being more likely than other supplements to be deceptively marketed and tainted with toxic ingredients (U.S. Food and Drug Administration, 2010).…”

“…In fact, the U.S. Food and Drug Administration has been well aware of this heightened risk for many years, and in 2010 issued a special warning to consumers regarding supplements sold for weight loss, muscle building, and sexual function as being more likely than other supplements to be deceptively marketed and tainted with toxic ingredients (U.S. Food and Drug Administration, 2010). Effects with adverse health consequences can include for weight-loss supplements: chronic diarrhea and constipation, dehydration, hypokalemia, metabolic acidosis, and other electrolyte imbalances, cardiac arrhythmia, hemorrhagic and ischemic stroke, hepatic and renal failure; (Steffen et al, 2007;Roerig et al, 2003;Schneider, 2003;Copeland, 1994;Tozzi et al, 2006;Vanderperren et al, 2005;Crow, 2005) for muscle-building supplements: infertility, testicular cancer, stunted growth, coronary artery disease, pulmonary embolism; (Liyanage and Kodali, 2014;Li et al, 2015) and for sexual-function supplements: changes in blood pressure, hypomania, insomnia, anxiety, irritability, nausea, headaches, loss of consciousness, seizures (Cohen and Venhuis, 2013;Corazza et al, 2014).…”

Gender Conformity and Use of Laxatives and Muscle-Building Products in Adolescents and Young Adults

“…Laxatives are medically recommended for constipation only, so use for any other purpose, including weight loss, may constitute abuse. 1,2 Despite their availability over the counter, laxatives are dangerous substances when abused and can lead to dehydration, dependence, and organ damage. 2 Muscle-building products include anabolic steroids, over-the-counter products such as creatine, and numerous dietary supplements that are marketed for increasing muscle growth, strength, recovery, and endurance.…”

“…1,2 Despite their availability over the counter, laxatives are dangerous substances when abused and can lead to dehydration, dependence, and organ damage. 2 Muscle-building products include anabolic steroids, over-the-counter products such as creatine, and numerous dietary supplements that are marketed for increasing muscle growth, strength, recovery, and endurance. 3 Although musclebuilding products are easily acquired via online markets and through grocery, health, and nutrition stores, they are often identified by the Food and Drug Administration as being dangerous because of their underregulation and potential inclusion of dangerous or untested ingredients.…”