Anorexia vs. Bulimia: What’s the Difference?
Eating disorders are complex mental health conditions that deeply affect an individual’s relationship with food and body image. Anorexia nervosa and bulimia nervosa are two of the most well-known eating disorders, each with distinct behaviors, health consequences, and challenges.Â
Understanding what is the difference between bulimia and anorexia? As well as the different side effects and health concerns associated with each, can help you or a loved one recognize the signs and seek the best available treatment for anorexia and bulimia.
An eating disorder is a serious mental health condition characterized by significant disruptions to a person’s eating patterns and behavior towards food. It often involves extreme actions, such as restriction, overeating, or intense preoccupation with body weight, which can impact a person’s physical and emotional well-being.Â
Common eating disorders include anorexia nervosa and bulimia nervosa. Many eating disorders are life-threatening and can feel incredibly overwhelming, but with support and therapy, healing is possible.Â
Anorexia nervosa, often called anorexia, is arguably the most dangerous and prevalent diagnosed eating disorder [4]. It is a condition where a person fails to consume enough food to maintain a healthy body weight. Individuals with anorexia frequently avoid food; they may fear eating or weight gain and are often highly restrictive with their eating habits. Despite visibly low body weight and the severe health risks involved, those with anorexia are often unable to change their eating patterns.
Approximately 2% of women are diagnosed with anorexia nervosa, making it more common in women than men, although men are also affected. That said, the disorder is about ten times more prevalent in women, typically emerging in adolescence (ages 16–17) but often not officially diagnosed until the 20s [4].
Anorexia’s mortality rate is 12 times higher than that of any other psychiatric condition [8]. This is due to the devastating effects of starvation and the associated risks of suicide, underscoring the severity of this life-threatening disorder.
Anorexia Nervous leads to many health complications, including:
These are just some of the health consequences of anorexia. Physical symptoms that may be readily identifiable for someone who has anorexia include extreme weight loss, a thin appearance, fatigue, dizziness, thinning hair, and always feeling cold [1].
Along with these physical signs are some behavioral indicators, including preoccupation with food, unusual eating habits, excessive exercise, and a refusal to eat food, particularly food with high fat or caloric intake.Â
Bulimia Nervosa, commonly referred to as Bulimia, is an eating disorder characterized by binge eating – eating vast amounts of calories in a short period – followed by purging, which can include self-induced vomiting, use of laxatives, extreme physical activity, and fasting [2].
While binge eating varies in intensity, a bulimia diagnosis involves specific patterns and behaviors. A person with bulimia may consume 10-30 times their daily caloric needs in a span of two hours, overriding natural bodily signals of fullness [4]. This means their brain and body no longer signal caution to stop eating, making the onset of a binge feel entirely uncontrollable.
Approximately 25% of those diagnosed with anorexia are also cross-diagnosed with bulimia [8]. Though bulimia is more common in females, it is still present in males, typically beginning around age 12 (which is slightly younger than anorexia). An estimated 1.5% of women and 0.5% of men are diagnosed with bulimia.
There are a variety of adverse effects associated with Bulimia, including:
Some of the physical signs and symptoms that may indicate someone has bulimia are weight fluctuations, swollen cheeks, and discolored teeth due to stomach acid exposure (from frequent vomiting) [2]. Individuals with bulimia may also experience sore throat, digestive problems, and dehydration, which can be dangerous.
Along with these physical signs are behavioral concerns, such as secretive eating, preoccupation with weight or body image, and evidence of purging, such as self-induced vomiting, laxative use, or excessive exercise. Bulimia is often riddled with feelings of shame, so individuals may be highly secretive and good at hiding these signs.
While both are eating disorders, the major difference between anorexia vs. bulimia lies in the neuropathic signals that fire or don’t fire. Many of these conditions depend on the individual’s impulse control or lack thereof. This isn’t to suggest that people with eating disorders need to muster up more self-control. Quite the opposite, science shows us that specific neuromodulators influence decision-making and provide rewards through positive hormonal changes [4].
For most people, our prefrontal cortex saves us from making impulsive decisions. This is called “inhibitory control”. In the case of eating disorders, this function can either be overactive or underactive.
For someone with anorexia, inhibitory control is very overactive as they develop deeply rooted habits of extreme food aversion and consistently choose low-fat, low-calorie foods. These habits then rewire the brain and deliver a positive hormonal chemical (such as serotonin or dopamine) to the body. The habit of not eating or eating very few calories is then ingrained into the mind of a person with anorexia as a positive event despite its pronounced negative effects on their health.
For those with bulimia, inhibitory control in the prefrontal cortex is underactive, making individuals more prone to impulsive behaviors, such as binge eating. If there’s a hormonal imbalance, particularly with leptin, the brain may misinterpret hunger signals, causing a person to feel compelled to eat large amounts of food. If leptin levels fail to signal fullness correctly, and inhibitory control is unleashed to impulsive behavior, a binge can occur. For those with bulimia, this can lead to feelings of shame and a desire to “undo” the binge, often resulting in purging behaviors, such as self-induced vomiting [4].
Eating disorders are diagnosed through a combination of medical assessments, psychological evaluations, and self-reported behaviors. While we may gain a lot of information online, the only people who can diagnose an eating disorder are clinicians using the criteria detailed within the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders).
This manual specifically identifies symptoms of anorexia, bulimia, and a range of other eating disorders. A doctor will evaluate their patient for symptoms including extreme food restriction, preoccupation with body weight or shape, binge eating, and behaviors like purging. Physical exams are conducted to assess the individual’s health, such as weight fluctuations, electrolyte imbalances, or organ damage from these severe mental health conditions.
Comprehensive diagnosis and treatment for anorexia and bulimia often involve a multidisciplinary team, including psychiatrists, dietitians, and therapists. It’s best to resist the urge to self-diagnose or diagnose someone you know. Always consult medical health professionals if you have concerns.
Some of the treatments for eating disorders include:
While some of these therapies do prove to be beneficial, they are most effective if they occur early on. Prolonged eating disorders may require more invasive therapy. Research and testing have recently begun on individuals willing to undergo neurological brain stimulation. This approach has shown positive results in helping those with anorexia vs. bulimia rewire specific brain pathways [4].
As we now know, eating disorders like anorexia and bulimia are not simply behavioral choices. Genetic and hormonal factors influence them, and therapeutic and medical resources may be required to address the underlying biological causes of these life-threatening disorders.
Supporting someone with an eating disorder will be unique to their condition. However, everyone can benefit from a patient, empathic, and nonjudgmental approach to mental health conditions.
Avoid giving advice or focusing on food and body image, as these can be sensitive subjects that drive the individual to more negative behaviors. Instead, offer reassurance that you care for them, be quick to listen, and encourage open communication.
Learning about specific eating disorders can help you understand their experience and offer compassionate support. Eating disorders require professional advice and treatment, especially if you or a loved one are facing life-threaten symptoms. Remember, recovery is a gradual process, but it is possible with the right help.
While media and culture often suggest that eating disorders stem from societal pressures, “diet culture,” and other behavioral influences, statistics don’t fully support this assumption. Diagnoses of anorexia and bulimia have remained relatively stable over the past decade despite a major increase in social media use among children and adolescents [4].
Eating disorders are not solely driven by harmful cultural ideals but are largely influenced by genetic predispositions and hormonal imbalances. Though unrealistic body standards may worsen these disorders, they are treatable with the right interventions.
Anorexia involves severe food restriction, leading to dangerous weight loss and physical health issues, while bulimia nervosa is marked by cycles of binge eating followed by purging behaviors. These eating disorders and many other types can be life-threatening but are treatable with proper support and intervention.
If you or someone else is struggling with an eating disorder, Connections offers personalized treatment administered by knowledgeable clinicians. Our treatments include:
We also treat a wid range of mental health conditions, including:
Find compassionate treatment for eating disorders today by calling our team at844-759-0999
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