Purging disorder is an eating disorder characterized by recurrent purging to control weight or shape in the absence of binge eating episodes. Purging disorder differs from bulimia nervosa because individuals with purging disorder do not consume a large amount of food before they purge. In current diagnostic systems, purging disorder is a form of Other specified feeding or eating disorder. Research indicates that purging disorder, while not rare, is not as commonly found as anorexia nervosa or bulimia nervosa. This syndrome is associated with clinically significantlevels of distress, and that it appears to be distinct from bulimia nervosa on measures of hunger and ability to control food intake. Some of the signs of purging disorder are frequent trips to the bathroom directly after a meal, frequent use of laxatives, and obsession over one's appearance and weight. Other signs include swollen cheeks, popped blood vessels in the eyes, and clear teeth which are all signs of excessive vomiting. Purging disorder is studied far less often than anorexia nervosa and bulimia nervosa as it is not considered an independent diagnosis in the DSM-5, published in 2013. Because of this, little information is known about the risk factors for purging disorder, including how gender, race, and class could contribute to the risk for purging disorder. As with most eating disorders, it is suggested that purging disorder is gender specific because of cultural forces and social pressures. These social pressures are associated with a severe preoccupation with shape and weight, this puts women and transgender individuals at the most risk for eating disorders, including purging disorder. In one study of the risk factors for purging disorder 77% of the participants who presented with symptoms of purging disorder were female. Purging disorder progressing into bulimia nervosa has been observed, while it is extremely rare for the reverse situation, bulimia nervosa progressing into purging disorder. This was observed once in a transgender patient with a severe history of bulimia nervosa but presented with symptoms of purging disorder to an eating disorder treatmentfacility in New Zealand.