Is laxative abuse a form of bulimia? Have you struggled with emotions like anger when you are in recovery from a laxative addiction? Do you think that health looks a certain way? In this podcast episode, Dr. Cristina Castagnini speaks about recovering from laxative abuse and an eating disorder with Khadija Morsi.

MEET KHADIJA MORSI

Khadija Morsi is a 20-year-old second-year student and a mental health advocate. She moved to England 3 years ago and is studying industrial design and technology. She has struggled with her mental health ever since she was 9 but only started getting help when she was 16.

Connect with Khadija on Instagram and TikTok, and find out more about her mental health support shop, yourinnerwill.    

IN THIS PODCAST

  • Bulimia exists in different forms
  • Becoming dependent on laxatives
  • Coping with the emotions
  • Stop commenting on people’s appearance
  • You will recover

Bulimia exists in different forms

Many people assume that those who suffer from bulimia are excessively underweight and try to make themselves smaller by forcing themselves to be sick after eating. However, you can suffer from bulimia and look a “normal” size. You can also suffer from bulimia if you abuse laxatives to induce food expulsion.

Becoming dependent on laxatives

If you abuse laxatives for an extended period, you risk experiencing unpleasant physical and mental side effects.
It sounds like for you it got to the point where you needed [laxatives] to digest anything. (Dr. Cristina Castagnini)
You may be abusing laxatives if you experience diarrhea, feel nauseous or constipated, or feel tired all the time, as these are some of the symptoms that can develop after continual use. Even when you are recovering from laxative abuse, you may still experience some unpleasant side effects such as constipation and bloating as your body and its digestive system recover.
When I tried to recover, I started to experience bloating and constipation, and weight gain, and no one warned me that this is temporary and it was not going to be like this forever. (Khadija Morsi)
You can find support and medical advice to help you through this transition and remember that recovery is possible.

Coping with the emotions

Like recovering from any addiction, when you experience withdrawal and feel isolated, upset, and vulnerable, many people become aggressive or angry.
I was angry … because it was like an addiction and when you stop it, you get angry and snap out at people, even the ones close to you. (Khadija Morsi)
Addiction can often develop from wanting a sense of control over life, and it can feel daunting to let go when you realize that it is a false sense of control. In those moments, people may become angry as a self-defense mechanism from the vulnerability they feel.

Stop commenting on people’s appearance

For anyone, stop commenting on people’s appearance because you have no idea which internal criticisms they are already battling when they hear your comments, even if you intended them to be well-meaning.
A lot of the time … people commented on my face, “Oh, you look so tired, you look so ill, are you okay?” and that actually kept feeding this voice in my head that I had to keep restricting and using laxatives. (Khadija Morsi)
Health has no size and health has no specific appearance.

You will recover

Recovery is always possible and always there for you. Even though there may be bad days, know that you can achieve recovery and feel secure, calm, and at peace with yourself and your body in a way that is loving and accepting.
I know you’re struggling still with body image and you have those hard days but keep moving forward for yourself too and know that it gets better. (Dr. Cristina Castagnini)

USEFUL LINKS

MEET DR. CRISTINA CASTAGNINI

I am a licensed Psychologist and Certified Eating Disorder Specialist. While I may have over 20 years of clinical experience, what I also have is the experience of having been a patient who had an eating disorder as well. One thing that I never had during all of my treatment was someone who could look me in the eye and honestly say to me "hey, I've been there. I understand". Going through treatment for an eating disorder is one of the hardest and scariest things to do. I remember being asked to do things that scared me. Things I now know ultimately helped me to get better. But, at the time, I had serious doubts and fears about it. If even one of my providers had been able to tell me "I know it's scary, but I had to go through that part too. Here's what will probably happen...." then perhaps I would not have gone in and out of treatment so many times. My own experience ultimately led me to specialize in treating eating disorders. I wanted to be the therapist I never had; the one who "got it". I will be giving you my perspective and information as an expert and clinician who has been treating patients for over 2 decades. But don't just take my word for it...keep listening to hear the truly informative insights and knowledge guest experts have to share. I am so happy you are here!

THANKS FOR LISTENING

Did you enjoy this podcast? Feel free to comment below and share this podcast on social media! You can also leave a review of Behind The Bite on Apple Podcasts (previously) iTunes and subscribe!

Podcast Transcription

[DR. CRISTINA CASTAGNINI] Behind The Bite podcast is part of a network of podcasts that are good for the world. Check out podcasts like the Full of Shift podcast, After the First Marriage podcast and Eating Recovery Academy over at practiceofthepractice.com/network. Welcome to Behind The Bite podcast. This podcast is about the real-life struggles women face with food, body image and weight. We're here to help you inspire and create better healthier lives. Welcome. Well, hello everyone. Welcome to the show. Whether you are returning or you are new, I am always so thankful that you have tuned in. Today I'm also very grateful that I have a guest on the show who is willing to be vulnerable and share more about her story and her journey with her eating disorder. Some of you may not know much about some of the nuances with eating disorders or some of the behaviors that we're going to talk about today and I think that is really important to bring awareness to some of the behaviors that aren't discussed as often. That's why I find today's show really important because when someone's vulnerable enough to talk about some of the side effects or some of the things that go on in the day-to-day when the eating disorder really has an effect on someone's day-to-day life I think that's the value in someone opening up and being on the podcast like this, because it's oftentimes the very difficult things about the eating disorder that nobody wants to talk about. For those of you listening, who can relate to some of the things our guest is talking about today maybe this can be an inspiring thing for you to reach out and get some help and seek treatment and just know you're not alone too. If you're experiencing any of the things she talks about today or if somebody who is going through any struggles with eating disorders or body image issues just try to have some understanding more about what their struggles are. I'm not sure who you are with in terms of listening, whether you're somebody who has a loved one and someone who has an eating disorder, a body image issue, or you're experiencing them yourself, but hope you find some value in what she has to share today. Who we have is Khadija Morsi and she is a 20 year old student from Egypt and she moved to England three years ago. She's studying industrial design and technology and she struggled with her mental health ever since she was nine, but she only started getting help when she was 16. Again, she's very inspiring and I'm really grateful that she's here to share her story today. So with that, I want to welcome her to the show. [DR. CRISTINA] Well, Khadija, welcome to the show. [KHADIJA MORSI] Hi, thank you for having me. [DR. CRISTINA] Congratulations on the one year of being laxative-free. That is really quite an accomplishment. [KHADIJA] Thank you. It was hard, but it's worth it. [DR. CRISTINA] It's interesting, I really haven't talked just specifically about this topic. I've alluded to it here and there, had moments on other podcasts where it's come up, but I haven't just focused on lax abuse. I think it's really important because I think a lot of people only consider purging as in self-induced vomiting and there's all sorts of other forms of purging and eating disorders and laxative use and abuse is really not discussed all that often. I think it's something that actually can have a lot of really horrible effects on the body and people don't really talk about it. I know for myself it was one of my dirty little secrets. I remember what I talked about it in my early podcast. One of my low points I found was writing a check to a convenience store in the middle of the night to write for my laxatives, because I just needed them so badly. It was like a really low moment in my eating disorder. Even talking about it now, I'm like, gosh I never would've told anybody that, but I don't think we do talk about it enough. [KHADIJA] I agree. A lot of people struggle with it, but it's not talked about enough. There's not enough awareness. [DR. CRISTINA] I mean, at that time, I didn't know that was purging. I just thought I was doing something for my diet. So for you, I don't know, at what point did you, I don't know if you're comfortable sharing, but at what point did you start turning to laxatives? Was it something that you started right away or was that further on in your struggles with eating disorder? [KHADIJA] Ever since I had anorexia, I used to take laxatives. I didn't abuse them, but I used to rely on them sometimes, but it was three years ago that I started abusing them. Back then I thought that I was recovering from anorexia, but actually I was developing bulimia, another eating disorder. Then when I started receiving treatment my therapist told me that it was bulimia and I was so shocked because for me, bulimia is vomiting. I didn't know that abusing laxatives was considered bulimia. [DR. CRISTINA] And I think that's so common too, people start with a diagnosis of anorexia nervosa and they don't realize that they start engaging in other behaviors and have now, like you said, bulimia nervosa, like you're shocked, wait, that's not what I thought this illness was. [KHADIJA] Yes, exactly. [DR. CRISTINA] It didn't look like what you thought. That's another reason I want to do the podcast is because I think people have these ideas in their head about what an eating disorder looks like, or what bulimia nervosa looks like, or what anorexia nervosa looks like. The realities and the day-to-day of it are so different than what's portrayed out there and I think that's why people don't think they have an eating disorder. [KHADIJA] Yes, definitely. For example, some people think that having anorexia means you're underweight, you're skinny and having bulimia is being a normal weight and vomiting. But when I started, when I first opened up to a friend about having bulimia, she was like, oh, so you vomit after you eat? It was like, no, that's not what I struggle with. It's actually that I abuse laxatives. She was shocked. She didn't know that it was bulimia just like me when I first found out. I was surprised. [DR. CRISTINA] So when, I mean, obviously you were in treatment at that time. So when you found that out, had you been having any physical symptoms also at the time in relation to using all the laxatives? [KHADIJA] Yes, I had very unpleasant symptoms, physical and mental, like side effects. I was tired all the time. I was pooping my pants in public and always had to wrap something on my waist to hide it. I used to wake up a lot during the night because I had diarrhea. I also felt like vomiting. I think that's because I was abusing laxatives, that's one of the side effects because I took a lot and constipation. If I didn't take laxative, I would be so constipated. [DR. CRISTINA] That sounds like for you, it got to the point where you needed them in order to digest anything. [KHADIJA] Yes. [DR. CRISTINA] So for you, anyone listening, how long, because you said initially you were using them, but not abusing them, how long would you say it was from when you started using them at all to when you got to the point where your body was really dependent on them? [KHADIJA] Well, like I said, I started using laxatives three years ago. It was just three years ago that I started abusing them, yes. [DR. CRISTINA] So when people say, oh my gosh, how will I know if I'm abusing them, how many would you say you used to in a day, a typical day at the end there? [KHADIJA] I can't remember exactly how much I used, but it was definitely over the recommended dose. I think that's how you know you're abusing them. Like if you get diarrhea, if you're nauseous, you feel tired all the time, yes, that's how you know you're abusing them. [DR. CRISTINA] Was there some relief though in being told, okay this is bulimia? Let's start you getting help to treat this and get you on a different path or were you like scared to stop? [KHADIJA] I was scared. I didn't want to recover, maybe because I found comfort in this suffering. Yes, I was comfortable in what I was doing because it was a lifetime for me. So yes, in the beginning I completely refused to recover from that, especially because when I tried to recover, I started to experience bloating and constipation and weight gain and no one actually warned me that this is temporary. It's not going to be like this. So it was like a cycle. Every time I tried to recover, I'd experience these things and go back to laxatives again, I started recovering once I finished therapy, which is a bit weird because I didn't have any support, but I was like, okay, I'm going to stop abusing because I can't make any plans with my friends. I can't go out because I'm going to. I was always tired. so it was like an impulsive decision, but it was a good decision. Yes, I stopped at cold Turkey, so that's [DR. CRISTINA] Good. Oh, wow. So I mean, my head spinning a little bit going, wow. I would be thinking you'd need some medical, like oversight or guidance. Did that ever cross your mind, to not do cold Turkey? [KHADIJA] I was scared but I told my mom as well, and she, I handed the laxative to my mom and told her I have to take this pill and laxative because I know she'd talk me and a of times actually I went the store to buy laxatives, but then I tried to go buy other things before I go straight to laxatives. Like every time I feel like I'm going to go by the laxatives I try go in a different direction. Does that sense? [DR. CRISTINA] You had moment of clarity. It sounds like you distracted yourself enough to be able to stop it? Interesting though, like you said, you were never told what some of the side effects would be once you stopped, which scared you, because you know so much of eating disorders is feeling in control? [KHADIJA] Yes. Actually, that's something I want to talk about. One of the things is I got told that I'm not actually losing weight. I'm just losing water weight. That didn't really stop me because in my head, I wanted to have control. It wasn't just about my body. It was more about having control, so even though I knew I'm not losing actual weight, I was just losing water weight I kept doing it. It's not always related to body image. [DR. CRISTINA] I think people think that that eating disorders are about vanity, it's about how you look and so much underlying that is like, what's really the root cause? What are you really engaging in these behaviors for because like you said, your life was, you were isolated, you couldn't go with your friends. You felt awful. There must be some big driver or something you're getting out of doing these things because that didn't sound like much of an existence for you. [KHADIJA] Yes. [DR. CRISTINA] But like you said, you got some comfort, it was what you were used to and so that was scary to let go of. [KHADIJA] Exactly, yes. It's really hard to break the cycle, especially when you've been relying on using laxatives. [DR. CRISTINA] Yes, and then I can imagine, too, if that's what helped you feel in control and then you stop and your body's doing all these things where you feel it's out of your control, like you're bloating and you're constipating, all these things. That must have been so scary for you. [KHADIJA] Yes, it really was. Another thing that really helped me was that I started looking at old pictures of me before I got sick and I tried to re keep in mind that if recovered and I'll be free again, I'm going to able make more memories. I just wanted my life back. [DR. CRISTINA] That's powerful actually. During that time, would you say your friends knew something was wrong and trying to reach out and you just isolated yourself and pushed them away or what was going on with your social life back at that time? [KHADIJA] They didn't know why I was isolating myself. Some people actually stopped talking to me because I wasn't, I didn't really message them. I was isolating myself all the time, so they thought that was personal, but it was actually me. I was struggling and some friends were actually supportive and they tried to help me. I remember one time I was FaceTiming my friend and I was talking to her about how I'm abusing laxatives and I want to stop, but I don't know how to. While we were FaceTiming she told me, take the laxatives and go out, bend them and that's it. I did that and the next day I was so tempted to go and buy more laxatives, but I tried to stop myself because actually, no, my bank account stopped me because I was, I didn't have money in my bank account. If I wanted to buy laxatives, I would have to ask my mom for money. [DR. CRISTINA] That's another thing, not talk much about is the expense of your social life, the relationships, and financially too. I mean, this is expensive. They're not cheap to keep up with some of the things that go along with maintaining your eating disorder as well. [KHADIJA] Yes, like 10 tablets, if is for like six pounds. It was quite expensive. [DR. CRISTINA] First time I'm hearing this. I'm glad your bank didn't enough in there for you. I can't actually engage in this. So you were forced to not do it. [KHADIJA] Exactly, exactly. [DR. CRISTINA] So do you remember that time what you went through, emotionally and physically, like just not being able to actually access the laxatives? [KHADIJA] I was angry because it was like an addiction. When you stop it, you just get angry and you snap out at people even the ones close to you. I remember I used to get into arguments with my mom and my sisters, all of that, just because I stopped laxatives. I felt like I was out of control. Having control isn't always a good thing. Sometimes you need to let go and go with the waves. [DR. CRISTINA] So how did you do that because it sounds like you were out of treatment at that point when you stopped? [KHADIJA] Yes, I think, like I said, I told my mom about it and she hid them from me and I stopped weighing myself, even though, like most of my childhood couldn't fit. Yes, these were, back then I so wanted to relapse. I had really strong urges, but my mom told me that I can buy new trousers, we can go shopping together. So that was some, it was good to have someone supporting me. [DR. CRISTINA] Well, it sounds like your mom was really great and I'm glad you could have her there for your support and that she was open. I think that's the other thing, is there's so much shame in all this, that most of the time people don't say anything to the people around them. They, like you said, just see people, somebody they love isolating or angry or in a bad mood and they don't really know what's going on. [KHADIJA] She didn't know what was going on in the beginning and she didn't really understand. She didn't understand any of it, but I tried to explain it to her and she tried to help me as much as she can. [DR. CRISTINA] So I want to get back to some of the things that people may not know, so if they start, let's say somebody is listening and they're going, okay, I really want to stop using the laxatives, but I'm scared. What might they start noticing right away in terms of what's going to happen in their body if they stop using the laxatives? [KHADIJA] For me, I experienced a lot of bloating and it was so hard to deal with it because whenever I looked in the mirror, I was like, I hate my body. I can't stand it. But I tried to wear oversized clothes in the meantime. I also experienced weight gain. I wasn't weighing myself, but I could see it because, like I said, most of my clothes fit. That's mainly like water weight and yes, even if it's like weight gain, there's nothing wrong with that. I know that I'm now my body is different from what it was before I got sick. I'm not the same weight. The fat distribution is different. I was also restricting while I was abusing the laxative so I gained both water weight and actual weight, which was hard to deal, but like I said it was temporary. Yes, really trusted the process because, when someone told me this, I was like, no, I'm the exception. I'm not going to be normal again, but yes, you're not the exception. [DR. CRISTINA] I know that this might be like a triggering thing for people hearing this and going, oh my gosh, what? I don't want to do that in a way. It's always a very difficult line to cross over into discussing that that's something that happens in recovery, is that your body's going to shift and change because you've been cheating it or starving it or doing all sorts of things to try to manipulate how it is in your eating disorder. So when you start in recovery, things are going to shift and change and that's the scariest part, I think for people and to not mean however your body shifts and changes or how it ends up looking after you're recovered or in recovery. But it's more of the point of, it's scary to see body changing, to see body changes happening. It's not so much about the weight gain or however it looks. It's more of like, wow, things are shifting and changing and that can even go for you start to have more emotions, you start to feel things more. So it's just more of everything comes up to the surface, everything's shifting and changing. I think if we just focus on, wow, my body's gaining weight or my body's shifting proportions of things like if people do just focus on that part, especially when they're right in the midst of your eating disorder, when ED is speaking to you loudly, you may not gain weight. That's the scariest thing ever. That can really scare people off from wanting to stop any of their purging techniques or eating disorder behaviors. [KHADIJA] I would say maybe you can make a pros and cons list that really helped me because I found, in the beginning, I found the pros list of continuing to use laxatives was, like it had more points the cons but I try rationalize it and see if it's good for me in the long-term. Yes, the cons list started to get longer and longer. [DR. CRISTINA] It's interesting the way you say that, it's like, do you think that the pros list was more your disorder talking to you, like, no, you've got to keep using me because all these things you're getting from me is enticing you? [KHADIJA] Yes, definitely. It's like this little voice that wants me to keep doing what I'm doing, but yes, you have to listen to your heart sometimes. [DR. CRISTINA] I think that, well, obviously there's so many reasons why people keep the disordered behaviors going on. Other people have fear of letting go of the eating disorder. Like you said, it was so comfortable and you didn't want to stop. [KHADIJA] Yes. I also want to talk about other people commenting on you being, looking ill or looking sick. A lot of the time people commented on my face, "Oh, you look so tired. You look so ill. Are you okay?" That actually kept feeding this voice in my head that I had to keep restricting and keep using laxatives. I don't know why, maybe, because it's the voice, it's not actually me and that is an interesting struggle with this as well. [DR. CRISTINA] So just interesting, sometimes I hear people say that when they're told something negative about how they look like, oh, you look so tired, you look so withdrawn, that could be a shift in them and like, oh gosh, I want to get better. But for you, it sounds like it was the opposite. You're like, oh --- [KHADIJA] Because it's proving to me that I was losing weight, punishing myself, because struggle a lot with self-esteem and confidence and that was a kind of punishment for me [DR. CRISTINA] It's the opposite. I know sometimes people go, wait, how does that comment actually trigger you? I know eating disorders are very complex and confusing to people who've never had them. [KHADIJA] It's the same as when someone tells me, oh, you look healthy now. It triggers me. [DR. CRISTINA] It's hard because people, when I work with loved ones, they go, well, I thought I was giving them a compliment or I'm just trying to be helpful. For someone with the eating disorder, like you say, hearing, oh, you look healthy, can be one of the most triggering statements ever heard. [KHADIJA] Exactly. [DR. CRISTINA] Sends you down a spiral. I think only someone who's had it who sort of can understand that. It's like, oh, well don't say that. [KHADIJA] Yes. It's so hard to understand our brain sometimes. [DR. CRISTINA] So for anyone listening, who's never had any eating disorder, like hearing comments about appearance, body, what you're eating, anything like that is just still triggering. So looking back now, I know nobody actually meant to trigger me. I know nobody's meaning to and it's so hard to understand, but I think to your point, it's you took everything in in that state when you were really in the illness and just used it as motivation or justification to continue on. [KHADIJA] Yes, exactly. Try not to make any comments on our physical appearance, especially when we're in recovery because it takes a lot of courage to actually commit to recovery and to give up all of this cycle, the binging. At some point I was binging, I wouldn't say I had an eating disorder. I think it's more of extreme hunger. Yes, it's really hard during this time. [DR. CRISTINA] Right, and I think that's another difficult thing for people to understand too, maybe who haven't experienced it, like going from the stage of maybe when you were really diagnosed with the anorexia nervosa, really restricting and then doing more behaviors that you were purging with the laxative for bulimia nervosa and then it goes all over the place. You like binging. What's happening here, but that's a response to the restriction phase where you're just like, oh my gosh, the body takes over. So I need to ea. [KHADIJA] Yes, exactly. It's completely normal to experience extreme hunger recovery because you've been starving your body for a long time and now your body is hungry. Your body just wants to protect itself. [DR. CRISTINA] Once you stopped therapy, did you ever go back or did you really just take this all on the last year yourself? [KHADIJA] I actually started therapy again, but not for bulimia. I started therapy for Borderline Personality Disorder. My last session was actually last week. [DR. CRISTINA] I applaud you because I think that's one of the hardest things in the world, is to really take on such a dramatic, shift in your eating, this sort of like trying to stop laxatives. I mean, I know you had the support of your mom and some of your friends, it sounds like, which is really amazing that you had that support system and so just phenomenal that you were able to stop, especially all of the physical distress and changes you went through, not knowing what they were going to be. [KHADIJA] Yes. Now I know that it's worth it. I also want to say something, if you're trying to recover from laxative abuse or you really want to stop it, try to keep them out of your reach. For example, I used to keep them on a table, on my bedside table, so it was really close to me. It was easier to use them but then I started to keep them in the kitchen, so it was hard and harder for me to reach them and I have to think about it a couple of times before actually using them. Maybe you can try using natural substitutes, for example, for me, I started drinking tea. It's not a solution, but I think it's not damaging in the meantime. You can take it step by step. [DR. CRISTINA] What did you, as you're going through that, what would you say helped you tolerate some of the physical symptoms as you were going through them? Was there anything that helped you? [KHADIJA] I bought new trousers, like I said. I started wearing oversight t-shirts. I always had a hot water bottle next to me because I experienced a lot of bloating and I wanted something on my stomach to make me feel comfortable. [DR. CRISTINA] So how does life look a year later for you? How's it different? [KHADIJA] I'm sorry, can you repeat that again? [DR. CRISTINA] Oh, how does your life look different a year later after you've stopped? What's going on for you that's different.]? [KHADIJA] I'm not going to lie and say that I have a perfect life now. Because I still struggle to be honest with my body image. A lot of days I just stare at myself in the mirror and myself. I try to remind myself that that is not an option. If have a bad body image day, I just try to do something that will make me feel comfortable, maybe watch a movie with my sisters. Yes, I don't pressure myself to wear, for example, a tight dress. I wear something comfortable. I still massively struggle with my body image. [DR. CRISTINA] Well, to be honest, I'm not surprised you're so, the fact that you've just been a year out of the laxative abuse and you didn't go through formal eating disorder treatment to do that on your own. That's phenomenal in and of itself. It's a process and as anyone listening is going through treatment for this, it's ebbs and flows. So I appreciate that you're being honest because I don't just want people on here going like, oh my gosh, nice story, amazing. This is the reality of it. There's struggles and it doesn't just wrap up like a nice story. [KHADIJA] Yes, you're actually tricking yourself. You're not actually losing weight. [DR. CRISTINA] From the laxative. You're doing more damage to your body because if you keep using them, there are very negative, harmful consequences to your body as you were starting to notice. [KHADIJA] Yes. [DR. CRISTINA] So for you, I'm very glad you got off of them and it sounds like your body is functioning on it and now your digestive system is great. [KHADIJA] Finally. I never believed that it's going to go back to more again. I didn't believe doctors back then, but it's all temporary. You're going to get your life back and digestive system back. Everything is going to go back normal. [DR. CRISTINA] That's the hard part to hold on, is things difficult. [KHADIJA] Yes, just trust the process and hold on. [DR. CRISTINA] For you too, I want to like give you that hope too. I know you're struggling still with body image and have those hard days, but keep moving forward for yourself too, and know that it gets better the more you work on that as well, too. [KHADIJA] Yes, thank you so much. [DR. CRISTINA] So you have some great content online, you have lots of great information and inspiration on Instagram. If people do want to follow you and read more about your path and all the great things you have posted, how can they find you? [KHADIJA] My Instagram is Dija Recoveries. I share a lot of personal experience, no triggering details, of course. But I share some of my experience and I also, I'm trying to raise as much awareness as possible. [DR. CRISTINA] Your name is difficult to spell so I have that all in the notes. So make sure you head over to the website after the show to make sure you can go and click on her social media profile and follow her. She's got some great stuff out there, like I said. [KHADIJA] Thank you so much. [DR. CRISTINA] Thank you so much for your willingness to open up and share about this. I know it's a very difficult thing to do and hopefully anyone out there who's been struggling with laxative use and abuse heard some things that can maybe inspire them to get on a different path and stop. So thank you so much. Appreciate it. [KHADIJA] Well, thanks for having me. Thank you so much. [DR. CRISTINA] This podcast is designed to provide accurate and authoritative information in regards to the subject matter covered. It is given with the understanding that neither the host, the publisher or the guests are rendering legal, accounting, clinical, or any other professional information. If you want a professional, you should find one.