Anorexia & Bulimia: Symptoms and Differences

What is Anorexia?

Anorexia, otherwise known as anorexia nervosa, is an eating disorder characterized by an intentional, abnormally low body weight caused by an intense fear of gaining weight.

People who suffer from anorexia nervosa have a distorted perception of their physical size and structure and will place a high value on maintaining their weight. Some people with anorexia will partake in rigorous exercise, while the majority dangerously restricts the amount of food they consume.

Anorexia is a life-threatening disorder as it is defined by physically starving yourself. According to Google, approximately 200,000 to 3 million people suffer from anorexia nervosa in the United States alone.

Diagnostic Guidelines

For a definite diagnosis, all the following are required:

1. Body weight is maintained at least 15% below that expected (either lost or never achieved), or Quetelet’s body-mass index is 17.5 or less. Prepubertal patients may show failure to make the expected weight gain during the period of growth.
2. The weight loss is self-induced by avoidance of “fattening foods” and one or more of the following: self-induced vomiting; self-induced purging; excessive exercise; use of appetite suppressants and/or diuretics.
3. There is body-image distortion in the form of a specific psychopathology whereby a dread of fatness persists as an intrusive, overvalued idea and the patient imposes a low weight threshold on himself or herself.
4. A widespread endocrine disorder involving the hypothalamic-pituitary-gonadal axis is manifest in women as amenorrhoea and in men as a loss of sexual interest and potency. (An apparent exception is the persistence of vaginal bleeds in anorexic women who are receiving replacement hormonal therapy, most commonly taken as a contraceptive pill.) There may also be elevated levels of growth hormone, raised levels of cortisol, changes in the peripheral metabolism of the thyroid hormone, and abnormalities of insulin secretion.
5. If onset is prepubertal, the sequence of pubertal events is delayed or even arrested (growth ceases; in girls the breasts do not develop and there is a primary amenorrhoea; in boys the genitals remain juvenile). With recovery, puberty is often completed normally, but the menarche is late.

What is Bulimia?

Bulimia, or bulimia nervosa, is a very serious eating disorder in which someone eats a large amount of food and then purges, (induces vomiting) in order to get rid of the calories they just consumed. This is usually followed by strenuous and unhealthy methods of avoiding weight gain.

Bulimia can be life-threatening as it leaves the body confused and starved for proper nutrients. According to Google, bulimia affects 3 million people in the United States per year between ages 14 and 60.

For a definite diagnosis, all the following are required:

There is a persistent preoccupation with eating, and an irresistible craving for food; the patient succumbs to episodes of overeating in which large amounts of food are consumed in short periods of time.

The patient attempts to counteract the “fattening” effects of food by one or more of the following: self-induced vomiting; purgative abuse, alternating periods of starvation; use of drugs such as appetite suppressants, thyroid preparations or diuretics. When bulimia occurs in diabetic patients they may choose to neglect their insulin treatment.

The psychopathology consists of a morbid dread of fatness and the patient sets herself or himself a sharply defined weight threshold, well below the premorbid weight that constitutes the optimum or healthy weight in the opinion of the physician. There is often, but not always, a history of an earlier episode of anorexia nervosa, the interval between the two disorders ranging from a few months to several years. This earlier episode may have been fully expressed, or may have assumed a minor cryptic form with a moderate loss of weight and/or a transient phase of amenorrhoea.

Anorexia & Bulimia Symptoms and Causes

The causes of anorexia and bulimia are often psychological, including genetic as well as environmental and social factors that may also contribute to the onset and development of anorexia.

Anorexia symptoms are very noticeable and often severe. Some of the most common anorexia symptoms include:

• Psychological: Anxiety, depression, and fear of gaining weight
• Physical: Dehydration, dizziness, fainting, fatigue, low blood pressure, low body temperature, osteoporosis, water-electrolyte imbalance, or feeling cold
• Behavioral: binge eating, compulsive behavior, hyperactivity, impulsivity, refusing to eat, eating too little, social isolation
• Weight: underweight, weight loss, or extreme weight loss and thinness
• Menstrual: irregular menstruation or absence of menstruation
• Developmental: delayed puberty or slow growth
• Gastrointestinal: constipation or vomiting
• Mood: apprehension or guilt
• Also common: brittle nails, bruising, dieting, dry hair, dry skin, headache, laxative abuse, sensitivity to cold, or slow heart rate

What causes bulimia is unknown. The disorder is usually tied back to low self-esteem and body image issues. In most cases, people who suffer with bulimia are unaware of how to positively handle their emotions.

Symptoms of bulimia include:

• Behavioral: binge eating, compulsive behavior, impulsivity, self-harm, vomiting after overeating, or lack of restraint
• Gastrointestinal: constipation, heartburn, inflamed esophagus, or stomach doesn’t empty itself of food
• Whole body: dehydration, fatigue, food aversion, hunger, or water-electrolyte imbalance
• Sensory: abnormality of taste, reduced sense of taste, or sensitivity to cold
• Menstrual: absence of menstruation or irregular menstruation
• Mood: anger, general discontent, guilt, or mood swings
• Weight: body weight changes or weight loss
• Mouth: bad breath, cavities, or dryness
• Psychological: anxiety, depression, or fear
• Also common: sore throat, starvation, or stomach ulcer

When and Where to Get Help

Both anorexia nervosa and bulimia are very serious conditions that should be acted on and treated once diagnosed. If you believe you are  suffering from either of these disorders, please contact me, and we will work through a healthy solution, together.

You can reach me directly at (610) 645-6300.

Sources: Mayoclinic.org via Google Medical search