Anorexia Nervosa vs Bulimia Nervosa

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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

Improve this chart	Anorexia Nervosa	Bulimia Nervosa
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
LH and FSH level:	low	usually normal
Thyroxine levels:	low normal	usually normal
Cortisol levels:	increased	usually normal
Onset:	mid adolescence	late adolescence

Contents 1 Diagnostic criteria 2 Clinical characteristics 3 Physical and laboratory findings 4 Treatment 5 See Also 6 References

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:

• Eating, in a discrete period of time an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
• Sense of lack of control over eating during the episode. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self induced vomiting, misuse of laxatives or diuretics, enemas, or other medications; fasting; or excessive exercise.

edit Clinical characteristics

• Anorexia nervosa has onset in mid adolescence whereas Bulimia usually starts in late adolescence or adulthood.
• Weight at diagnosis is markedly decreased in Anorexia Nervosa while it is usually normal in Bulimia.
• Amenorrhea (absence of menstrual period) is usually present in patients with Anorexia Nervosa while it is usually normal in the other group of patients.
• Binge eating is present in 25-50 % of patients with anorexia nervosa while it is present in 100 % of patients with Bulimia nervosa.
• Mortality is around 5% in 10 years for Anorexia nervosa while it is very low in Bulimia nervosa.
• Antisocial behavior can be found in patients with Bulimia Nervosa while it is rare in patients with Anorexia nervosa.

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 See Also

• Difference between burning calories and burning fat
• Obese vs Overweight

edit References

• Harrison's principles of internal medicine volume 1
• Current medical diagnosis and treatment

Comments: Anorexia Nervosa vs Bulimia Nervosa

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Anonymous comments

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 on 2013-03-14 13:41:01

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 on 2013-03-12 20:44:58

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 on 2012-10-25 11:20:02