Eating Disorders, Weight-Loss Supplements and Laxative Misuse

If you are in crisis or thinking about hurting yourself, call or text 988 (the U.S. Suicide & Crisis Lifeline). It is free, confidential and available 24/7. [1] In a life-threatening situation, call 911. [2] If you or someone else has taken too many pills, laxatives or diet products, call Poison Help at 1-800-222-1222. If someone collapses or has trouble breathing, call 911.

This page is written without judgment. Struggling with food, weight or body image is not a failing, and it is not rare. NIMH says eating disorders are serious and can be life-threatening, and also that they can be treated successfully. [2] Early detection and treatment are important for a full recovery. [2] If you want to talk to someone, NIMH points to the federal SAMHSA website for finding mental health services. [2]

Weight-loss supplements and teas

Products sold for weight loss are not a gentler option for someone with an eating disorder. The sources describe two kinds of problem.

• Hidden drugs. FDA says many diet pills, fat-burning pills and weight-loss supplements, pills and teas are likely to be contaminated with dangerous hidden ingredients. [3] They are sometimes falsely advertised as dietary supplements, food or all-natural treatments. [3] FDA's list covers only a small share of such products, and a product that is not on the list is not shown to be safe. [3] NCCIH says FDA has found weight-loss products sold as supplements that contain hidden prescription drugs or other illegal ingredients. [4]
• Weak evidence of benefit. NCCIH says the science does not support acai berry, bitter orange or green tea supplements for weight loss. [4]

For more, see unsafe products and warnings, hidden drugs in supplements, weight-loss supplements and fat burners and the detox and slimming tea claim check.

Laxative misuse

NIMH describes people with bulimia nervosa who regularly binge eat and then use unhealthy behaviors to prevent weight gain, such as forced vomiting or laxatives. [5] It lists intestinal distress and irritation, severe dehydration and electrolyte imbalance among the health consequences of bulimia nervosa. [5]

A 2016 review of purging found that laxative and diuretic misuse is present across many eating disorders and can be linked to severe medical complications across all body systems. [6] Its authors point out that most papers they found were case studies or small uncontrolled samples, so exact rates are uncertain. [6] That is a limit of the research, not a reason to dismiss the risk.

For ordinary laxative use, the NHS says that using laxatives too often or for too long can cause problems, including dehydration and low blood potassium. [7] Low potassium can bring muscle weakness, tiredness and heart rhythm problems. [7] Dehydration can bring headaches, light-headedness and darker urine. [7]

Herbal laxatives are not exempt. See senna and cascara sagrada for what each source says about them.

Thyroid medicine and weight

A review of purging notes that thyroid medicines are sometimes misused in eating disorders. [6] MedlinePlus says levothyroxine should not be used alone or with other treatments to treat obesity or cause weight loss. [8] If this is a worry, see thyroid conditions, iodine and biotin and tell a clinician.

What can help

• Tell a clinician or pharmacist what you take, including teas, gummies and powders. They are used to hearing it, and the aim is safety, not blame.
• NIMH says treatment plans can include psychotherapy and medical care and monitoring. [5]
• Do not stop a prescribed medicine on your own; ask the prescriber or pharmacist.
• Choose a clinician you trust. See talking with a health professional and how to tell your doctor without feeling judged.

"Proper evidence not found": we looked in NIMH, FDA, NCCIH and NHS pages for a measured safe amount of any laxative or weight-loss supplement for people with eating disorders and found none. We are not able to give a "safe" number.