Diuretics: Usage trends

Last modified: Sunday, 31. May 2009 - 1:53 pm

The U.S. Centers for Disease Control (CDC) and the National Center for Health Statistics (NCHS) report that cardiovascular-renal drugs (including diuretics, beta blockers, and calcium channel blockers) were the most frequently prescribed medications in the United States in 1999 (the most recent year for which data was available). In fact, the loop diuretic Lasix was the second most frequently prescribed medication overall, with more than 12.9 million prescriptions written. It was second only to the allergy drug Claritin.
Scope and severity
Statistics on the misuse of diuretic drugs are more difficult to determine. Estimates vary as to the number of people currently suffering from eating disorders, and not all individuals with an eating disorder abuse diuretics. In addition, the sense of shame and emotional turmoil associated with the disease make the unreported incidence of eating disorders high. Federal and institutional estimates put the number at approximately 5-8 million Americans.
Age, ethnic, and gender trends
According to the National Institutes of Mental Health (NIMH), up to 3.7% of females suffer from anorexia, and up to 4.2% of females suffer from bulimia at some point in their lives. Males develop eating disorders much less frequently, representing only 5-15% of all U.S. cases of anorexia or bulimia.
The 1999 text Mental Health: A Report of the Surgeon General, states that the mortality, or death rate, among females age 15-24 with anorexia is an estimated 0.56% per year, approximately 12 times higher than that of girls of the same age in the general population. In addition to medical problems related to eating disorders, anorexia and bulimia are frequently accompanied by other psychiatric disturbances, including mood disorders (depression, anxiety) and substance abuse. Depression is the third leading cause of death for adolescents ages 15-24, and the eleventh leading cause of death for Americans of all ages.
In a Wesleyan University study of binge eating disorder (BED) published in 2000, researchers found that African-American women with the disorder reported laxative and diuretic abuse more frequently than white women. However, BED was considered a significant health problem in both racial groups.
Diuretic use and eating disorders in sports and professional athletics are growing concerns both in the United States and abroad. Sports that require weigh-ins, from wrestling to regatta sailing, can put the pressure on athletes to take extreme measures to lose weight quickly. Often, those measures include diuretic abuse, rubber suits, starvation diets, exposure to high temperatures, and other unsafe practices that can put athletes at risk for severe dehydration and even death.
A 1996 report in the journal Pediatrics that looked at a variety of studies and surveys of athletic weight-control practices reported that up to 52% of female collegiate athletes had engaged in unhealthy weight-control behaviors including diuretic use.
Weight loss in athletes is sometimes encouraged by coaching staff, as well. In sports such as gymnastics, swimming, and track — where “smaller is better” — female athletes in particular often develop eating disorders and unhealthy weight loss practices, including diuretic abuse. A 1999 NCAA-sponsored study of college athletes found that 13% of female athletes surveyed showed signs of bulimia or anorexia, and an additional 36% were considered at risk for developing an eating disorder. In addition, 3.89% of female and 3.65% of male athletes surveyed reported diuretic use for the purpose of purging at least once in their lifetime. In addition, one-fourth of the males surveyed used saunas or steam baths to lose weight at least once a week and 4.4% of females vomited for weight loss. Female athletes who develop eating disorders or eating disordered behavior are at a higher risk for osteoporosis and amenorrhea (interruption of the menstrual cycle).

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