Differences Among Purging Presentations at Admission to Treatment: Eating Disorder and General Psychopathology Symptoms

Objective Few studies have examined differences in eating disorder (ED) and general psychopathology among those who self‐induce vomiting only compared to those who misuse laxatives only and those who engage in both types of behaviors. The current study aimed to fill this gap in the literature. Method Participants were 1652 adults receiving treatment for an ED at a large multisite treatment facility in the United States between January 2021 and December 2024. Participants completed measures of ED psychopathology (Eating Disorders Examination‐Questionnaire; EDE‐Q), depression (Patient Health Questionnaire‐9; PHQ‐9), anxiety (Generalized Anxiety Disorder‐7; GAD‐7), and obsessive‐compulsive symptoms (Obsessive‐Compulsive Inventory‐Revised; OCI‐R) at admission. Results Significant differences among groups were found on all EDE‐Q subscales and the Global score, with the laxative only group and the group engaging in both behaviors scoring significantly higher than the vomiting only group. A similar pattern of results was found for the PHQ‐9, while significant differences on the GAD‐7 and OCI‐R failed to remain significant after multiple comparison corrections. Discussion It is possible that those who misuse laxatives, or engage in both laxative misuse and vomiting, may benefit from more intensive treatment than those who engage in self‐induced vomiting only. These individuals may also need a different form of treatment if laxative misuse is conceptualized as an addiction.