Eating disorders have long come out of the shadows. The average person knows they exist but probably doesn’t recognize that there’s more than one kind of disordered eating. Take, for example, anorexia and bulimia. As you’re about to see, they share some symptoms, but there are crucial differences between them.
Some 30 million Americans are struggling with an eating disorder. The impact on their overall well-being can be devastating. Accurately identifying the disorder in question is crucial in getting treatment and managing the symptoms. With all that in mind, let’s compare anorexia and bulimia. Learning these differences can have life-or-death implications.
What is Anorexia?
Also known as anorexia nervosa, it presents with symptoms like:
- Skipping meals
- A skewed perception of one’s body, e.g., poor body image
- Intense focus on calories, diet, and getting fat
- Food restriction
- Social withdrawal
- Low self-esteem
- Problems at work or school
- Difficulty maintaining healthy relationships
As you can probably see, control (or the illusion thereof) is important to someone with anorexia. As the disorder progresses, the person can become quite precise and even ritualistic in their efforts. Left unaddressed, anorexia can produce visible physical side effects like extreme thinness, damaged hair and nails, and dry, yellowy skin. Over time, the impact can include dire outcomes like heart and brain damage, or even death.
A precise cause is not known, but some trends have been identified. People with anorexia often have a close family member with the same disorder, tend to be obsessive in general, and live in a culture or even just a family in which thinness is the ideal.
Whats is Atypical Anorexia?
To understand atypical anorexia, re-read everything in the above section on anorexia. All of it holds true, except for one big difference. There is no “dangerously low body weight.” Generally speaking, a person with atypical anorexia remains within or above the normal weight range for their height, weight, sex, etc.
About four out of 10 of those with atypical anorexia nervosa require hospitalization. They make up roughly one-third of the population in inpatient eating disorder treatment programs. Adolescents with atypical anorexia often present with abnormally low heart rate and an absence of menstruation. Unfortunately, despite the most obvious indicator—low body weight—people with atypical anorexia still experience all of the physical dangers associated with anorexia nervosa.
Treating Anorexia
This often involves the involvement of family members. Family therapy empowers everyone involved in helping to ease the symptoms of anorexia. Other modalities to consider:
- Individual therapy
- Nutritional counseling
- Short-term hospitalization
What is Bulimia?
Bulimia nervosa is more common than anorexia and is probably what most people associate with disordered eating. It involves many of the same controlling and restrictive symptoms as anorexia. Bulimia, however, is primarily associated with bingeing and purging behaviors. Bingeing involves losing control while eating to the point of consuming large amounts of food. Purging is the effort to prevent oneself from gaining weight due to bingeing, e.g.:
- Vomiting
- Excessive exercise and other physical activities
- Fasting
- Laxative abuse
Bulimia is measured on a scale regarding how often the bingeing and purging happen. Mild bulimia involves 1-3 episodes a week, while moderate bulimia is 4-7 episodes. Bulimia is severe at 8-13 episodes a week, and extreme cases exceed 14 episodes a week. Physical side effects of bulimia include acid reflux, sore throat, tooth decay, and dehydration. Bulimia can cause an electrolyte imbalance, possibly resulting in a heart attack or stroke. Additionally, the glands around the neck and jaw can enlarge over time.
The cause of bulimia is also not known. Like anorexia, it can be connected to family history and cultural norms. Other risk factors include childhood obesity and anxiety, childhood abuse, puberty at a young age, low self-esteem, social anxiety, and depression.
Treating Bulimia
Two psychotherapy have been shown to be most effective:
- Cognitive-Behavioral Therapy (CBT) can change negative thoughts about body image and thus, shift eating behaviors.
- Interpersonal Psychotherapy helps individuals develop a social support system to help address their disordered eating.
Obviously, each case of disordered eating involves some very unique elements and variables. A therapist with experience in this area can adapt any approach to the specifics of the people impacted. I worked with many individuals and families who have struggled with anorexia or bulimia. Recovery is possible, but, as stated above, the big first step is to recognize what’s going on.
If you or someone you know is struggling with an eating disorder, don’t wait to seek help. As a Certified Eating Disorder Specialist, I can help you take productive steps soon to feel better about food, your body, and yourself. If you have questions, you can contact me through this website or if you are ready to start your healing journey you can book an appointment.
