[Image description: a blue and white info graphic titled "EATING DISORDER HARM REDUCTION" in all caps. Below the title it says "This list was developed with input from ED specialists including nutritionists, dieticians, and dentists. It does not constitute medical advice, and should be discussed with a provider whenever possible. It is not intended for anyone currently at risk for re-feeding or under-feeding syndrome. It is non-exhaustive, and will be continually updated. To suggest a tip, email [email protected] with the subject line "ED HARM REDUCTION""
The first section is titled "VOMITING", and reads:
Use your hand not a foreign object. If scarring is a concern, alternate with your non-dominant hand.
Watch for blood in your vomit, especially if anything you ate might resemble or conceal blood keeping in mind that blood brought up this way might appear more brown than red. If you do see blood, stop - it might signify a tear in your esophagus or stomach lining.
Mix a little baking soda with water and rinse then spit. Fluoride works, too.
Wait at least an hour to brush your teeth or to consume any sugary or acidic foods.
Drink Pedialyte, Gatorade or something similar. Sip slowly.
Drink fluids. Doesn't have to be water - just non-alcoholic and non-caffeinated.
Use high-fluoride and/or enamel-buliding toothpaste.
Chew sugar-free gum to help promote saliva production.
Ask if your provider advises potassium chloride tablets.
If you regularly take Advil or a similar medicine processed through the kidneys try switching to acetaminophen (Tylenol) or another medication that's processed through the liver, purging can strain your kidneys, so you want to ease their workload.
Get your electrolyte levels, vitals, heart function, and kidney function checked as regularly as your provider recommends."
The next section is titled "RESTRICTING", and reads:
"Take a multivitamin, plus calcium, and vitamin D supplements.
To the extent that your body can safely handle, engage in 10-minute sessions of resistance or weight-bearing exercise (stair-climbing, lifting weights) to help keep your bones strong. Avoid contact sports, motions that twist/bend your spine and any exercise that involves risk of falling.
If eating solid food is difficult, try different forms of liquid nutrition - meal replacement shakes, medical supplements, pudding.
If you have a dietician or similar provider you trust ask for help establishing some baseline in-take/nutrition goals, and discuss them in the context of specific foods you feel safe eating."
The next section is titled "LAXATIVE USE", and reads:
"Try to not use more than a few days in a row and not in larger quantities due to increasing tolerance If you use stimulant laxatives (Ex-Lax, Senakot), try switching osmotic/non-stimulant ones (milk of magnesia, MiraLAX) which are less harmful. Pay no mind to whether the label vibe is natural vs artificial, you care only about the ingredient list.
Drink Pedialyte, Gatorade or something similar after you purge.
If you regularly use Advil or a similar medication that's processed through the kidneys try switching to acetaminophen.
There is no conclusive evidence for tapering vs stopping cold. What matters is that however you proceed is what best fits your pattern of use and your main concerns over changing it. Give your body a few weeks before judging progress. More than two poops/week during this time, you're doing great."
The next section is titled "BINGEING", and reads:
Go slow bingeing is usually done in a dissociated state - take your time and try to notice the foods as you're eating them.
Take a short walk (5-10 minutes) afterward to help with digestion.
Try a hot water bottle on your stomach if you're in pain while digesting. Avoid curling into a ball or lying on your back.
At the onset of a binge, have a large meal and explore eating to fullness rather than extreme pain."
The next section is titled "OVER-EXERCISING", and reads:
"Take the time to thoroughly stretch and warm up first.
When possible, work out with someone supportive who's been in conversation with you and your doctor about helpful/hurtful exercise habits. Try to reduce exercising alone.
Try exercises that involve slower movements, like walking or swimming (somewhere with a lifeguard). When no one's available to join you try walking outside when/where safe to do so - see if you can make that the primary form of exercise you do alone. Stick to familiar terrain close to your home."
The final section is titled "ALL", and reads:
"Take all medications and supplements at the time of day furthest from any purging.
Try reducing a harmful behaviours frequency - from several times a day to once a day or from once a day to a few times a week.
"Drink enough water" means different things for different people, so although eight glasses of non-alcoholic non-caffeinated fluids a day can be a starting point, ask your provider's input here if you can.
Get your electrolyte levels, vitals, heart function, and kidney function checked as regularly as your provider recommends." /end id]
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