Can you use laxatives to lose weight?

Laxatives are medications used to treat constipation and are usually intended for short-term use. However, thanks to a new TikTok trend, people are trying to use laxatives for weight loss. Coined as “budget Ozempic,” laxative drugs are becoming a trend as they fly off the shelves at pharmacies, creating shortages everywhere. But, like many social media trends, this is not sound medical advice. Laxatives should not be used for weight loss. Medical experts, such as Dr. William Chey, note that laxatives help constipation by eliminating water and stool—but this stool and water loss is not an effective way to decrease body mass or create long-term weight loss. What’s more, the use of laxatives can lead to many health issues if used improperly.

How do laxatives work?

There are many different forms of over-the-counter laxatives, and there are some prescription laxatives as well. OTC laxatives are generally used to relieve occasional constipation and increase bowel movements. There are several different types of laxatives, and they work differently.

• Bulk-forming laxatives help to add bulk to the stool in the form of soluble fiber. Soluble fiber brings water from the body into the stool, which makes it larger, softer, and easier to pass. Examples of bulk-forming laxatives include fiber supplements such as Metamucil, Citrucel, and FiberCon.
• Osmotic laxatives pull water from parts of the body and bring it to the colon, softening the stool and making it easier to pass. MiraLAX (polyethylene glycol, or PEG) is a popular osmotic laxative.
• Stool softeners help your stool absorb fat and water, making the stool softer. Colace (docusate sodium) is a popular stool softener.
• Lubricant laxatives add a coating to the colon, making it slippery, which makes it easier to pass stool. Mineral oil is an example of a lubricant laxative.
• Stimulant laxatives stimulate the colon into moving the stool. Examples include Dulcolax (bisacodyl) and Senna.
• Prescription laxatives, such as Lactulose or Amitiza (lubiprostone), are sometimes prescribed for medical treatment of chronic constipation.

Do laxatives cause weight loss?

Laxative abuse is when an individual takes either:

• A large quantity of laxatives at one time (high doses)
• A small amount of laxatives on a regular basis

This pattern becomes hard to stop, and people can become dependent on laxatives. Some people take laxatives because they think it will help with weight loss. However, although laxatives help eliminate water and waste from the intestines, they do not eliminate calories from the body—so they do not help with weight loss. Although there may be a temporary weight loss or short-term weight loss effect from losing fluids, laxatives do not cause true, lasting body fat and weight loss. What’s more, using laxatives when not needed for constipation can cause many other side effects and complications.

Side effects of laxatives

There are various side effects and risks associated with abusing laxatives, such as dehydration, electrolyte imbalance, intestinal damage, and other serious medical problems.

Dehydration

When someone uses excess laxatives and loses too much fluid in the resulting diarrhea, dehydration (a dangerous loss of body fluid) can occur. Symptoms may include excess thirst, less urination, headache, decreased sweating, lightheadedness, muscle weakness, and dry mouth. Severe dehydration can cause shaking, weakness, blurred vision, fainting, kidney problems, or even death in extreme cases.

Electrolyte imbalance

Individuals who abuse laxatives may also have an imbalance of electrolytes and minerals, including hyponatremia (low sodium levels) and hypokalemia (low potassium levels), causing weakness, abnormal heart rhythms, or even death.

Having both dehydration and low potassium levels together can cause kidney problems. Diarrhea resulting from laxatives sets off a process that can even worsen hypokalemia. The timing is not predictable—electrolyte imbalance can occur with the first cycle of laxative abuse, or it can occur after long-term use of laxatives.

Dependency and constipation

With excessive use of laxatives, the intestines are affected. They lose their muscle and nerve response, become dilated (widened), and have trouble moving stool out. Eventually, the body needs higher doses in order to relieve this constipation. This rebound constipation may involve gas getting trapped in the intestines—causing the individual to try to use more and more laxatives, and it becomes a “vicious cycle” of laxative use.

Damage to the intestines and other complications

Some other complications associated with laxative abuse may include:

• • Blood in the stool (due to irritation), which can lead to anemia.
  • Impaired intestinal function: the intestines lose muscle tone and nerve response and can no longer function properly to move stools out of the body
  • Rectal prolapse: Chronic severe diarrhea can cause this condition, where the insides of the intestines stick out through the opening of the anus. This condition generally requires surgery.

• Liver damage

• Increased risk of colon cancer

Alternatives to laxatives: How to lose weight safely

For individuals who abuse laxatives, it is important to understand that a laxative is not a weight loss aid. It’s best to quickly and completely stop using them, throwing out any laxative you have—even if withdrawal symptoms (such as bloating, constipation, and temporary weight gain) occur. Take steps to keep your bowel movements regular, such as eating more fiber and drinking plenty of fluids. For support, healthcare professionals can refer you to a registered dietician and therapist.  

To lose weight safely (and without laxatives), you can try some lifestyle changes such as eating a healthy diet, increasing your exercise, and drinking plenty of water. If these tips do not work, or for more support, check with your healthcare provider about various types of medications that help with weight loss.

Balanced diet

Eating a healthy diet can help you lose weight and maintain weight loss. The Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) Diet scored first and second place, respectively, in the U.S. News & World Report’s Best Diets of 2023.

• The Mediterranean diet focuses on fruits and vegetables, beans, nuts, whole grains, extra virgin olive oil, and a moderate amount of omega-3 fatty acid-rich fish.
• The DASH diet focuses on lowering blood pressure with calcium, magnesium, potassium, and fiber. This diet focuses on plenty of fruit and vegetables, as well as moderate amounts of low-fat or fat-free dairy, whole grains, lean proteins, beans, eggs, fish, nuts, seeds, and heart-healthy fats like olive oil and avocados.

Some people even combine tips from each eating plan. Alternatively, consult a registered dietician for personalized advice and an eating and exercise plan that works with your lifestyle,  preferences, and any medical problems you have.

Regular exercise

Getting regular physical activity can help with weight loss. The CDC recommends weekly exercise, including:

• 150 minutes of moderate-intensity physical activity per week.
• Two days of muscle-strengthening exercises.

Consult your healthcare provider before beginning a new exercise program. You can explore different ways to get this exercise in and break up the 150 minutes into manageable bits. For example, you can walk briskly for 30 minutes five times a week. Or you can walk for 15 minutes twice a day, five days a week.

Drinking plenty of water

Studies show that drinking more water helps with weight loss in two ways—causing you to eat less and helping the body burn more fat. What’s more, the opposite is true—if you are not drinking enough, you may have a higher body weight.

Drinking two cups of water before each meal not only helps you get in six cups of water a day but also helps you lose up to 5 extra pounds every year and maintain that weight loss.

You can even find free phone apps to remind you to drink your H20. Avoid sugary drinks such as regular sodas and juices.

More sustainable weight loss strategies

Some other weight loss tips include:

• Add fiber and protein to your food to keep hunger at bay. For example, replace a breakfast bagel with eggs and whole wheat toast.
• Don’t eat “naked” carbs. Adding fiber to your carbs can also help control blood sugar levels. If you like white rice, try swapping it to brown rice. Better yet, add beans and vegetables to brown rice.
• Focus on developing and maintaining healthy habits rather than just a number on the scale.
• Eat lots of non-starchy vegetables (think cucumbers and broccoli) and lower-sugar fruits like apples, pears, and berries.
• Try to eat healthy 80-90% of the time. If you enjoy some treats here and there, it won’t derail your efforts.
• Try out meal prepping—start by making extra portions of a healthy dinner and take it to lunch the next day or two. 
• Consult a registered dietician for personalized nutrition advice.