Treatment for Habitual Users
Treatment for diuretic abuse starts with examining an individual's reasons for taking the drugs. People mainly abuse diuretics in order to lose weight. These individuals include people with eating disorders as well as athletes trying to make a certain weight class.
Help for Disordered Eaters and Athletic Abusers
The National Eating Disorders Association Web site suggests that "the most effective and long-lasting treatment for an eating disorder is some form of psychotherapy or counseling, coupled with careful attention to medical and nutritional needs." Experts consider emotional support and behavioral therapy—sometimes referred to as "talk" therapy—essential for treatment and rehabilitation. It is vital to address the emotional motives and distorted thinking behind the behavior of a patient with an eating disorder.
The main goals of treatment are: 1) to stabilize the patient's weight; 2) to put an end to self-destructive behaviors, such as diuretic abuse, binge eating, and self-starvation; and 3) to help the patient relearn healthy nutritional practices. Patients with anorexia may be so severely malnourished that they require intravenous feeding in a hospital setting. Nutritional counseling and advice on lifestyle changes can help the patient reach and maintain a healthy weight.
What is an eating disorder? Some basic facts
Eating Disorders—such as anorexia, bulimia, and binge eating disorder—include extreme emotions, attitudes, and behaviors surrounding weight and food issues. Eating disorders are serious emotional and physical problems that can have life-threatening consequences for females and males.
Anorexia nervosa is characterized by self-starvation and excessive weight loss.
Symptoms include:
- Refusal to maintain body weight at or above a minimally normal weight for height, body type, age, and activity level
- Intense fear of weight gain or being "fat"
- Feeling "fat" or overweight despite dramatic weight loss
- Loss of menstrual periods
- Extreme concern with body weight and shape
Bulimia nervosa is characterized by a secretive cycle of binge eating followed by purging. Bulimia includes eating large amounts of food—more than most people would eat in one meal—in short periods of time, then getting rid of the food and calories through vomiting, laxative abuse, or over-exercising.
Symptoms include:
- Repeated episodes of bingeing and purging
- Feeling out of control during a binge and eating beyond the point of comfortable fullness
- Purging after a binge (typically by self-induced vomiting, abuse of laxatives, diet pills and/or diuretics, excessive exercise, or fasting)
- Frequent dieting
- Extreme concern with body weight and shape
Binge eating disorder (also known as compulsive overeating) is characterized primarily by periods of uncontrolled, impulsive, or continuous eating beyond the point of feeling comfortably full. While there is no purging, there may be sporadic fasts or repetitive diets and often feelings of shame or self-hatred after a binge. People who overeat compulsively may struggle with anxiety, depression, and loneliness, which can contribute to their unhealthy episodes of binge eating. Body weight may vary from normal to mild, moderate, or severe obesity.
Other eating disorders can include some combination of the signs and symptoms of anorexia, bulimia, and/or binge eating disorder. While these behaviors may not be clinically considered a full syndrome eating disorder, they can still be physically dangerous and emotionally draining. All eating disorders require professional help.
SOURCE: "What Is an Eating Disorder? Some Basic Facts," National Eating Disorders Association, Seattle, WA, 2003. www.NationalEatingDisorders.org
Athletes who abuse or misuse diuretics for purposes of performance enhancement or "making weight" face special treatment challenges. Coaches, trainers, and teammates may praise weight loss and an excessively low percentage of body fat, making it harder to change one's behavior. In addition, obsessive exercise and workout routines are often rewarded in sports and competition rather than questioned. In these cases, a treatment strategy must include educational training for the coaching and training staff as well as the athlete.
