Examining the associations between laxative use, substance use, depressive symptoms, and obsessions and compulsions in adults with an eating disorder

This study examined laxative and substance use in adults with an eating disorder, and the association with depression, compulsions, and obsessions. A retrospective chart review of 182 women who had a formal diagnosis of an eating disorder and were receiving specialized outpatient treatment was conducted. The chart review included questionnaires completed at intake assessment, including a demographic survey with questions asking about laxative use, substance use, and the types of substances used. Adults also reported their levels of depression, obsessions and compulsions on psychometric questionnaires. Overall, 31.3% of adults with an eating disorder endorsed engagement in laxative use. Substance use was reported by 34.6% of adults with alcohol (36%) and over the counter medications (39%) being the most endorsed substances. Engagement in laxative use and substance use did not differ across the eating disorder diagnoses of anorexia nervosa (AN), bulimia nervosa (BN) or other specified feeding or eating disorder (OSFED). Engagement in substance use was not associated with adults’ symptoms of depression, obsessions, or compulsions. Compulsions were found to be a significant predictor of engagement in laxative use. Variables associated with engagement in laxative use may help to inform the development of novel approaches for addressing these behaviors in adults with an eating disorder. More work is needed to better understand the complex interplay of these behaviors.