What is the Difference Between Anorexia and Bulimia?

Eating disorder
  • Anorexia nervosa primarily involves extreme food restriction leading to significant weight loss, while bulimia nervosa is characterized by cycles of binge eating followed by purging behaviors like vomiting or excessive exercise.

  • Poor self-esteem, a family history of eating disorders or mental illness, and childhood trauma are among the risk factors for both anorexia and bulimia.

  • Distorted body perception, an intense fear of gaining weight, and a preoccupation with food are some of the symptoms of both of these eating disorders.

  • With the correct therapeutic and medical interventions, it’s possible to treat and manage an eating disorder.

Are you curious about the difference between anorexia and bulimia?

In this article, we delve into the unique characteristics of these two complex eating disorders, shedding light on their distinct impacts and challenges.

Anorexia Nervosa and Bulimia Nervosa: How Do They Differ?

Anorexia nervosa and bulimia nervosa are both serious eating disorders rooted in a distorted body image and a deep fear of weight gain.

The key distinction lies in their physical manifestations. Anorexia is characterized by abnormally low body weight and health issues related to underweight status.

Bulimia, on the other hand, isn’t necessarily diagnosed by low body weight.

In anorexia, body weight is deemed abnormally low when it falls below the expected range for one's age, sex, and height, often measured by body mass index (BMI) in adults, or weight-for-age and BMI-for-age in children and adolescents.

Anorexia and Bulimia: How are They Similar?

Individuals with anorexia and bulimia nervosa primarily share similar psychological patterns and perceptions. Both disorders stem from an overwhelming fear of weight gain, often perceived as a personal failure.

Sufferers commonly exhibit a distorted view of their bodies and weight, alongside a strong preoccupation with food.

This can involve calorie counting, collecting recipes, and cooking for others despite their own restrictive eating habits.

Furthermore, both anorexia and bulimia nervosa are recognized as mental health disorders, highlighting the significant psychological elements they have in common.

What are the Risk Factors for Anorexia and Bulimia?

Both anorexia and bulimia are complex eating disorders and multiple factors contribute to their development.

We’ll take a look at the psychological, social, and biological aspects of these disorders below.

Psychological factors

Poor self-esteem

Low self-esteem can lead to eating disorders when individuals fixate on perceived physical flaws.

This obsession often manifests as an intense fear of gaining weight and a pursuit of extreme weight loss, driven by a warped body image and a deep-seated feeling of inadequacy.

A history of substance abuse

Previous struggles with substance abuse can significantly impact mental health, leaving individuals with a psychological void that they may seek to fill with other unhealthy behaviors.

The mental preoccupation that was once centered around substances can transition into an eating disorder, as individuals search for new coping or control mechanisms.

This shift often results in unhealthy behaviors, reflecting a complex psychological journey from substance dependency to disordered eating, driven by underlying mental health challenges.

Being a perfectionist

Perfectionism often leads to setting unattainable standards for one's physical appearance, resulting in an obsessive focus on food intake, excessive exercise, and body weight.

This pursuit of an ideal body image can create a relentless cycle of strict dieting and intense fitness routines, causing considerable mental and physical strain.

Social factors

Social pressures

The drive to meet societal beauty standards plays a critical role in the onset of anorexia nervosa and bulimia nervosa.

This pursuit often damages self-esteem and distorts body image, pushing individuals toward the extreme behaviors seen in these disorders.

The constant exposure to idealized body images in the media further intensifies these pressures, leading to unhealthy attitudes toward food and body weight.

Weight stigma

Societal bias against those who are overweight often leads to assumptions of poor health and laziness, creating a stigma around weight gain.

This fear of societal judgment can be a significant factor in the development of eating disorders, as individuals may resort to extreme dieting to avoid weight gain.

Such misconceptions contribute to the stigma and misunderstandings around weight and eating disorders, while overlooking the complexities of individual health.

Previous trauma

Studies reveal a significant link between past trauma, including physical, sexual, or verbal abuse, and the development of eating disorders.

One survey revealed that both men and women with anorexia and bulimia have encountered trauma.

Trauma survivors are more susceptible to these mental disorders, sometimes adopting behaviors like self-induced vomiting as a way to cope with emotional distress or regain control.

Biological factors

Family history of eating disorders

Research suggests that individuals with a family history of eating disorders, including both anorexia nervosa and bulimia nervosa, are more likely to develop similar unhealthy eating habits and other eating disorders themselves.

This increased risk is due to genetic factors and the influence of the family environment, where behaviors related to eating disorders are often modeled and normalized.

Additionally, a family history of eating disorders can also predispose individuals to a broader spectrum of mental health issues.

Family history of mental illness

Mental health disorders can have a genetic component, making them potentially hereditary.

This genetic predisposition increases the risk of developing mental illnesses, including eating disorders, as they are often interlinked.

Recognizing this genetic connection is vital for early intervention and effective treatment, especially for those with a family history of mental health issues.

A long history of dieting

Engaging in what may seem like insignificant diets can inadvertently pave the way to unhealthy eating habits and disorders. While trying to maintain a healthy body weight, individuals often adopt harmful behaviors.

What are the Symptoms of Anorexia and Bulimia?

While eating disorders can affect anyone, research has shown that they are two times more common in females than in males. Eating disorders also typically develop during an individual’s teenage years or early adulthood.

It’s not always easy to identify someone who’s developing anorexia or bulimia nervosa. Here are a few signs to look out for:

  • An intense focus on losing weight, even when the individual is not overweight

  • Perceiving any type of weight gain as a personal failure

  • A preoccupation with food, which may include researching diets, counting calories, or even preparing elaborate meals for others

  • A distorted body image

Symptoms of anorexia nervosa and bulimia nervosa: A comparison

Eating Disorder Symptom

Anorexia Nervosa

Underweight for age, sex, and height

Exhibiting restrictive eating patterns and behaviors, such as limiting food and energy intake Distorted perception of body weight and image, poor insight into destructive behavior, and denial of being underweight Intense fear of gaining weight and seeing weight gain as a sign of failurePreoccupation with food (calorie counting, making meals for others, etc.)

Bulimia Nervosa

Often within normal body weight range

Episodes of binge eating followed by compensatory purging to balance out excessive food consumption

Diagnosing Eating Disorders

An eating disorder is generally classified as a condition that negatively impacts an individual's eating habits and behavior.

These conditions affect how individuals function at work and school and pose several health risks.

These disorders often have overlapping symptoms and it’s common for an individual's diagnosis to shift over time.

All eating disorders are diagnosed using the DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision).

How is anorexia diagnosed?

Anorexia nervosa is diagnosed by a medical professional after they’ve ruled out other medical conditions that could be causing an individual’s behavioral or weight changes.

As outlined by the DSM-5-TR, the following three criteria must be met to make an anorexia nervosa diagnosis:

  • Restrictive behavior with regards to food and energy intake resulting in insufficient nutrients needed by the body

  • Severe fear of gaining weight, even when within normal body weight ranges

  • Distorted image of body and inability to recognize unhealthy weight loss

How is bulimia diagnosed?

As with anorexia, a medical professional will also assess an individual to rule out other medical conditions before diagnosing bulimia.

An individual with bulimia will meet the following criteria as outlined in the DSM-5-TR:

  • Regular episodes of uncontrollable binge eating

  • Inappropriate and compensatory methods to “correct” or “balance out” their previous binge episode (self-induced vomiting, using laxatives or diuretics, or exercising excessively)

  • Poor insight into unhealthy eating habits and behavior, as well as an inaccurate perception of one’s body weight and shape

Treatment for Anorexia and Bulimia

Treatment for eating disorders like anorexia and bulimia involves a combination of nutritional, psychological, and, in some cases, medical interventions, without relying solely on specific medications.

  • Nutritional therapy: This involves a calculated increase in caloric intake to promote healthy weight gain, often overseen by a dietician.

  • Cognitive behavioral therapy (CBT): This is a key psychological approach, focusing on altering negative attitudes toward food and body perception, and preventing relapse.

Is medication used for treating anorexia and bulimia?

Medication can be a component of treatment for both bulimia and anorexia, though it's more commonly used for bulimia.

Selective serotonin reuptake inhibitors (SSRIs), particularly Fluoxetine (Prozac®), are FDA-approved for bulimia to help reduce binge-purge behaviors.

In contrast, anorexia treatment initially focuses on psychotherapy and nutritional therapy.

If necessary, antipsychotic medications such as Olanzapine (Zyprexa®) may be introduced for their weight-gain side effects. Sometimes, antidepressants can be prescribed for co-occurring mental health issues like anxiety and depression, rather than directly for anorexia.

Can I be hospitalized for anorexia or bulimia?

Losing 75% or more of one's recommended body weight constitutes a medical emergency that requires immediate hospitalization.

This level of urgency is also applied if a patient experiences rapid, significant weight loss.

In such cases, nutritional supplementation is crucial. Patients are often fed through a nasogastric tube to replenish essential nutrients, especially when they’re too weak for oral intake or show resistance to eating.

This method ensures safe and effective nutritional restoration under critical conditions.

Where Can I Learn More About Eating Disorders Like Anorexia and Bulimia Nervosa?

If you experience any of the symptoms mentioned above and are struggling with eating disorders , LifeMD can help.

LifeMD can connect you to a team of healthcare professionals who can support you in your recovery and guide you to healthier ways to lose weight and reach your goals.

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This article is intended for informational purposes only and should not be considered medical advice. Consult a healthcare professional or call a doctor in the case of a medical emergency.

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