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Purging Unwanted Calories and Feelings

Sociocultural influences provide an insufficient explanation for why someone develops purging disorder because most people in our culture never develop this problem. Differences in how we perceive, respond to, and shape our environments emerge from psychological factors that impact our thoughts, feelings, and behaviors and explain why only some people purge. Psychological theories describe a pathway from anxious temperaments to the emergence of perfectionism to avoid threats and control uncertainty supported by evidence. During adolescence, changes in biology and in social context increase focus on the body, making it both a threat and a target for perfectionistic strivings. Inability to achieve perfection increases distress, and purging relieves distress temporarily. However, purging never resolves the original source of distress and becomes its own source of shame. Use of multiple purging methods is linked to childhood trauma history, comorbid depression, anxiety disorders, substance use problems, and suicidality.