Anorexia vs. Bulimia

Anorexia Nervosa
Bulimia Nervosa

Anorexia nervosa and Bulimia nervosa are psychiatric disorders characterized by severe disturbances in eating behaviors. Both occur primarily in previously healthy young women who become overly concerned with their body weight and shape. Many patients with Bulimia nervosa have past histories of anorexic behavior. On the other hand, many patients with Anorexia nervosa have histories of binge eating and purging behavior. Both of them are more prevalent in cultures where food is plentiful and in which being thin is associated with attractiveness.

In spite of having so many similarities there are certain differences in between the two which make them separate entities. Some of the major differences are:

Comparison chart

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Anorexia Nervosa

Bulimia Nervosa

LH and FSH level low usually normal
Thyroxine levels low normal usually normal
Cortisol levels increased usually normal
Onset mid adolescence late adolescence
Prevalence in women 0.5% 1-3%
Weight Markedly reduced usually normal
Menstruation Absent usually normal
Binge eating 25-50% required for diagnosis
Mortality ~5% per decade low - often sudden due to arrythmias induced by electrolyte abnormalities
Cardiovascular low BP, decreased heart rate dehydration, imbalanced electrolytes (esp. potassium), low BP, orthostatic hypotension, arrythmias d/t electrolyte imbalance
Skin / extremities dry skin, lanugo hair dry skin, hair loss, brittle nails
Glucose levels Hypoglycemia usually normal
Sex hormones level Low estrogen or testosterone usually normal

Contents: Anorexia vs Bulimia

An anorexic female before and after treatment.
An anorexic female before and after treatment.

edit Diagnostic criteria

In anorexia nervosa, there is refusal by the patient to maintain body weight at or above a minimally normal weight for age and height. There is intense fear of gaining weight or becoming fat even though they are underweight. In post-menarchal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles.

In Bulimia nervosa, there are recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

edit Clinical characteristics

edit Physical and laboratory findings

Cardiovascular changes are more common in patients with Anorexia nervosa like decreased heart rate and decreased blood pressure while these changes are rare with Bulimia Nervosa. Skin changes like lanugo hair, dryness etc. are common associates of patients with Anorexia Nervosa while they are rare in patients with Bulimia Nervosa. Hormonal imbalances like low estrogen or testosterone, low LH and FSH, low normal thyroxine etc. are common in patients with Anorexia Nervosa while they are rare in patients with Bulimia nervosa.

edit Treatment

For Anorexia Nervosa the most effective form of psychotherapy is family therapy in which the family members of the patients are also consulted by the psychiatrist along with the patient. For Bulimia Nervosa the most effective form of treatment is cognitive and behavioral therapy along with antidepressants.

edit References

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Comments: Anorexia Nervosa vs Bulimia Nervosa

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Anonymous comments (4)

December 29, 2013, 1:39pm

Good article. Very informative.

— 75.✗.✗.7

March 14, 2013, 1:41pm

Why are there so few references to Black Americans and struggles with Anorexia and/or Bulimia. At 42 I struggled most of my teen years with anorexia and was hospitalized for it, at 40 I crashed after my daughters went to college and the old problem reared its head along with all of the issues that made it appear in the beginning which had nothing to do with wanting to be thin, but invisible because of human trafficking that was and continues to be ignored in my community. Isolation leads to survival and a lack of understanding leads to exorcism where everyone thinks you have demons. Therapists are fine but awed with all of the personal accomplishments that mask the pain. I can only revert back to what helped as a child.

— 198.✗.✗.241

March 12, 2013, 8:44pm

Sure, as a guy, I find smaller/thinner girls more physically attractive. But that by no means I prefer them. Just one of those things in life that'd be kinda nice. Compared to personality, physical appearance doesn't matter much. So it's not really that big a deal to me. If you think that you have to wreck your body to be attractive, then you don't understand one of the most simple facts in life; the vast majority of guys don't really care.

— 71.✗.✗.171

October 25, 2012, 11:20am

It's devastating that our society today goes through these psychological disorders. Being thin is definitely not a sign of attractiveness. Please don't let these gruesome diseases rule your life.

— 101.✗.✗.108


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