Water Weight and Malnutrition
One of the most frustrating things that an eating disordered person experiences is seemingly unexplained fluctuations in their weight from day to day. A normal person’s weight will fluctuate 2-3 pounds on any given day. For an eating disordered person, the fluctuations can be even more dramatic. And when an eating-disordered individual wakes up one morning 5 pounds heavier than the day before, this can send them into a frenzy, and many will try to compensate by purging, exercising, or using laxatives or diuretics. Ironically, starvation itself, as well as the compensatory ED behaviors are to blame for much of the instability in their weight!
Terms Related to Water Weight and Malnutrition:
EDEMA is the term used to describe the accumulation of excess fluid in the body. Edema can occur in different places on the body, but is often found in the abdomen, face, or hands and feet of an eating disordered individual. There are a number of different ways in which a person’s eating habits or eating-disordered habits can result in this excess fluid accumulation:
INSUFFICIENT PROTEIN INTAKE: Protein in the blood, especially albumin, help to hold salt and water in the body’s cells. When the amount of protein in the bloodstream gets too low, fluid from the cells seeps out into the area around the cells.
PURGING: Vomiting causes a loss of potassium and acids from the stomach, which results in a low level of potassium in the body (hypokalemia). Potassium is an electrolyte, along with magnesium, calcium, and sodium. These electrolytes interact with each other in a delicate balance. Excess or insufficient amounts of one can result in excess or insufficient amounts of another. The kidneys also try to aid in restoring the balance by filtering extra amounts of complementary electrolytes out of the body. This can result in excess urine production, which results in dehydration. Also, loss of potassium and other electrolytes changes the osmolarity of cells, which means that fluid from within the cells is pushed out into the area around the cells, causing edema.
DIURETIC USE: The use of diuretics can induce a state of dehydration. The body reacts to the dehydration by holding onto as much water as it can. Many eating-disordered individuals react to this “rebound” water retention by taking more diuretics, which worsens the dehydration, which causes more rebound water retention. Diuretics also cause loss of potassium, which is another cause of edema. Caffeinated drinks, which are popular among those who are restricting their food intake have a diuretic effect.
LAXATIVE ABUSE: Laxatives work by pulling extra water into the large intestine, which causes waste in the intestines to be forced out more quickly. However, it also causes a loss of potassium, and potassium loss eventually results in water retention. Because extra water is lost through the large intestine, overall levels of fluids in the body drop, which means- (you guessed it) dehydration! And again, dehydration results in rebound water retention.
EXCESS INTAKE OF WATER: Eating-Disordered individuals commonly drink large amounts of water and other fluids in an attempt to control hunger or to fill their stomach. Many individuals crave salt as a result of dehydration; however, excess salt intake can often worsen edema. It is also common for eating-disordered individuals to crave extremely strong-tasting things, and salt is a common craving.