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Bulimia Nervosa vs. Anorexia Nervosa: The Difference Between the Two

Category: Eating Disorders
8 minute read.

Eating disorders and mental health struggles impact the lives of millions of Americans of all ages. At one time, the misconception that eating disorders were a choice or “in the head” of the individual was widespread. Fortunately, this viewpoint has changed. Today medical and mental health providers understand eating disorders to be dangerous mental health conditions that require comprehensive treatment. Research data provided by The National Association of Anorexia Nervosa and Associated Disorders (ANAD) suggest how widespread the prevalence of eating disorders is in America.

  • At least one person loses their life every 62 minutes from complications directly linked to an eating disorder.
  • More than 30 million Americans from all demographics struggle with an eating disorder.
  • Eating disorders are one of the most deadly mental illnesses (second only to opioid addiction and overdose).

Eating disorders are complex mental health challenges that have significant physical and psychological consequences.

Eating Disorders Explained

Eating disorders are complex mental illnesses characterized by abnormal and harmful eating behaviors. The effects of disordered eating do not stop at weight loss or gain. They can have a significant and detrimental impact on mental, physical, and psychological health. More than ten thousand Americans annually lose their lives to complications directly related to an eating disorder. Additionally, as many as five percent of those who struggle with an eating disorder will attempt suicide.

There is no one “cause” or specific risk factor that increases your chances of developing an eating disorder. Researchers believe a combination of genetic, social, cultural, and environmental factors contributes to the development of an eating disorder. Like alcohol for someone with an alcohol use disorder, someone who struggles with an eating disorder manipulates food intake to manage stress and feel a sense of control over their environment.

Anorexia Nervosa

When you struggle with symptoms of anorexia nervosa, staying “thin” is a critical motivation in your relationship with food. Some of the more visible symptoms of anorexia nervosa include low body weight, low blood pressure, anxiety, altered eating habits, dehydration, and mismatched body weight perception. Without help from a treatment program like The Los Angeles Outpatient Center, the mental and physical health impacts of anorexia nervosa can cause dangerous physical and psychological health impacts.

Annual studies show anorexia nervosa has the highest mortality rate of any eating disorder. Some research suggests it may have the highest fatality rate of all mental illnesses. The same reports show that as many as 4% of all women (regardless of age) are diagnosed with anorexia nervosa. Although the average age of onset for anorexia nervosa is one’s early teens, it can occur at any age.

A study conducted in 2003 of female teens with anorexia nervosa indicated they were 56 times more likely than those without an eating disorder to engage in self-harm, including attempted and successful suicide attempts. Also, women diagnosed with anorexia nervosa were more than twelve times more likely to die from complications linked to anorexia than women without the illness.

There are two types of anorexia nervosa; the restricting type and the binge-eating and purging type. Symptoms of the restricting type include calorie counting, meal skipping, and limiting specific foods or monitoring food intake. Someone with this type of anorexia nervosa may also omit particular food categories and follow strict rules regarding food.

Someone with the binge-eating and purging type of anorexia nervose will eat and then purge what they have eaten. This form of anorexia is not to be confused with bulimia nervosa, although it shares similar symptoms.

Recognizing Anorexia Nervosa

People with anorexia nervosa struggle with perceptions about body weight and food. They often have an intense fear of gaining weight, low body weight, and a distorted perception of “ideal” body weight. Someone who struggles with anorexia nervosa places an abnormally high value on controlling body shape and size and will do “whatever is needed” to maintain weight.

The signs and symptoms of anorexia nervosa include a combination of behavioral, emotional, and physical symptoms. A significant challenge with anorexia nervosa is body weight change. It can be challenging to know if someone is underweight due to an eating disorder as everyone’s ideal body weight is different. Also, people with anorexia nervosa often hide their bodies under baggy or ill-fitting clothing to disguise weight changes.

The physical signs and symptoms of anorexia nervosa are often easily noticed compared to other illness symptoms. They often include abnormal blood counts, dizziness, extreme weight loss, insomnia, fainting spells, stomach problems, irregular heartbeat, exhaustion, thinning hair or hair loss, and irregular menstruation (in females).

Many emotional and behavioral symptoms of anorexia typically relate to food control or weight loss. Examples include restricted food intake (through fasting or dieting), skipping meals, not eating in public, frequent weight checking, lying about food, excessive exercise, and rigid eating rituals.

Bulimia Nervosa

Anorexia is characterized by severely restricted food intake. Bulimia nervosa, on the other hand, is characterized by instances of binging and purging. Someone with bulimia nervosa will binge on food and then forcibly purge the food from their body. Purging is often accomplished by laxative use or (more commonly) self-induced vomiting. Other symptoms someone with bulimia nervosa may exhibit include anxiety, bad breath, weight changes, food aversions, hunger, and problems with dental hygiene. Bulimia is believed to affect as many as three percent of women and less than one percent of men. It is almost nine times more likely to occur in women than men and has a mortality rate of around four percent.

While bulimia nervosa is not as common or well known as other eating disorders, it is a severe and potentially life-threatening condition. Different than anorexia, bulimia nervosa involves eating rather than intentionally restricting calories. The Diagnostic and Statistical Manual of Mental Disorders (DSM) lists several specific diagnostic criteria for bulimia nervosa that set the illness apart from anorexia nervosa.

For medical or mental health providers to diagnose bulimia nervosa, you must experience recurrent episodes of binge eating followed by behavior to “compensate” for binge eating. Compensatory behaviors may include self-induced vomiting, laxative abuse, diuretic abuse, or misuse of other medications designed to enhance weight loss. The DSM explains binge eating as consuming an abnormally large amount of food in a specific period (usually 2 hours).

This amount of food is more considerable than most people would consume in the same period under similar circumstances. Additionally, there is a distinct lack of control over eating behaviors during this period. In addition to binging and compensating, you must engage in both binging and compensating at least once per week for a period of three months.

Symptoms of Bulimia Nervosa

Like many mental health conditions, bulimia nervosa presents with emotional, behavioral, and physical symptoms. Often the physical symptoms of bulimia nervosa are the most easily noted by friends and loved ones. The physical signs and symptoms of bulimia nervosa are many; however, some of the most common may include notable weight changes, stomach problems, chills, problems sleeping, cuts or bruises on the tops of the fingers (from inducing vomiting), dental problems, dry skin and nails, thinning and brittle hair, poor wound healing, and reduced immunity.

In addition to physical symptoms, notable emotional and behavioral symptoms often arise. Someone struggling with bulimia nervosa often exhibits certain attitudes about food, dieting, and eating around others. For example, their attitudes and behaviors indicate food and weight loss are primary concerns. Also, they may appear uncomfortable eating around others or make frequent trips to the restroom after eating. Skipping meals, trying “fad diets,” drinking excessive amounts of water, creating rituals around binging and purging, withdrawing from others, consistently checking the mirror, fixating on weight, eating in secret, and experiencing extreme mood swings are other examples of the emotional and behavioral symptoms of bulimia nervosa.

Seeking Eating Disorder Help at The Los Angeles Outpatient Center

Recovery from an eating disorder like anorexia nervosa or bulimia nervosa is possible with treatment. Unfortunately, those who do not get help at an eating disorder treatment program like ours at The Los Angeles Outpatient Center are at an increased risk for ongoing physical and emotional complications. There is also an increased risk of acute medical emergency and death for some. Treatment to address eating disorders is most successful when started as soon as possible. Research indicates that early medical intervention, therapy, and mental health support can help you begin your recovery journey before the dangerous medical and emotional effects of eating disorders have a lasting impact on your overall health and well-being.

An inpatient or residential treatment is typically the most beneficial treatment environment for someone ready to heal from an eating disorder. It is crucial to participate in a therapeutic program that addresses all aspects of your health, including physical, psychological, and spiritual wellness. Our eating disorder treatment programs at The Los Angeles Outpatient Center include mental health care, medical interventions, therapy, and nutritional counseling to ensure you can safely learn more about your eating disorder and how to put a troubled relationship with food in the past.

If you or a loved one struggles with symptoms of an eating disorder such as anorexia nervosa or bulimia nervosa, it is crucial to seek help. Eating disorders do not (typically) resolve on their own. In fact, symptoms often worsen, leading to significant and potentially dangerous physical and emotional health complications. At The Los Angeles Outpatient Center, our team will work with you to develop a treatment program to help you overcome and heal from an eating disorder. Let us help you begin your journey to recovery. Contact us today to learn more about our Los Angeles-based treatment programs.