Anorexia nervosa and bulimia nervosa are the most common clinically recognized eating disorders. Those with anorexia have a tendency to skip meals, adopt highly restrictive and unhealthy diets, obsess over thinness and food, and present abnormal eating habits or rituals. Bulimia presents itself in the form of binging, or overeating, followed by purging, often either by vomiting or using laxatives. It is possible for a person to suffer from both disorders, simultaneously; one may also suffer from body dysmorphia and see herself as being "fat," even when extremely underweight. There is no clear cure for either disorder, both of which primarily affect young women, but treatment is available and can result in full recovery for some. Ongoing treatment efforts and awareness are necessary to maintain health.

Comparison chart

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Anorexia Nervosa

Bulimia Nervosa

About Eating disorder wherein sufferers fear weight gain and avoid eating as a result. Mainly affects young women. Eating disorder wherein sufferers go through a cycle of binging (overeating) followed by purging, due to a fear of weight gain. Mainly affects young women.
Typical Age of Onset Early teen years Late teen years
Behavioral and Psychological Symptoms Obsession with food, weight, and a "thin" body image; extreme fear of weight gain; compulsive exercise; depression and anxiety; low self-esteem; body dysmorphic disorder. Obsession with food, weight, and a "thin" body image; extreme fear of weight gain; compulsive exercise; depression and anxiety; low self-esteem; body dysmorphic disorder.
Physical Symptoms Usually extremely underweight and unhealthy figure; physical weakness, deterioration, and organ dysfunction; absent menstruation; memory loss, feeling faint, etc. Many within "normal" weight range for height/age, but can be underweight; physical weakness, deterioration, and organ dysfunction; absent menstruation; memory loss, feeling faint, etc. Noticeable oral/dental deterioration.
Relationship to Food Avoids eating, frequently goes on fasts or restrictive diets, tendency to be secretive about eating habits and rituals. Goes through periods of binging — overeating — and purging, usually by vomiting or heavy use of laxatives, diuretics, etc.
Causes No official cause. Can be related to culture, family life/history, stressful situations, and/or biology. No official cause. Can be related to culture, family life/history, stressful situations, and/or biology.
Treatment May require hospitalization. Outpatient or inpatient treatment options. Dietitians, doctors, therapists, and psychiatrists often part of treatment. Unlikely to require hospitalization. Outpatient or inpatient treatment options. Dietitians, doctors, therapists, and psychiatrists often part of treatment.
Prognosis Varies. Slight majority who seek treatment report full recovery in years to come; up to one third still affected or struggle with relapses. One of the deadliest mental disorders. Varies. Slight majority who seek treatment report full recovery in years to come; up to one third still affected or struggle with relapses.
Prevalence in Women 0.3-0.5% 1-3%

edit Signs and Symptoms

In many cases, the behavioral, psychological, and physical characteristics of anorexia are more obvious to outsiders than the characteristics of bulimia, which are often subtle. However, it is common for there to be overlapping symptoms between the two disorders.

edit Behavioral and Psychological Characteristics

Anorexia and bulimia share numerous psychological symptoms:

Symptoms for anorexia and bulimia differ in terms of how those with these conditions relate to food and what ritualistic behaviors they exhibit.

edit Physical Characteristics

When it comes to those who suffer from one, rather than both, of these illnesses, there are markedly different associated physical characteristics.

Comparing the different physical symptoms of anorexia and bulimia. Images from WomensHealth.gov.
Comparing the different physical symptoms of anorexia and bulimia. Images from WomensHealth.gov.

edit What Causes Eating Disorders?

Doctors do not yet know what causes eating disorders. However, anorexia and bulimia have known associated risk factors.

edit Diagnosis

As weight loss is common to numerous other illnesses, diagnosing anorexia and bulimia can be difficult in some cases. For this reason, doctors will often need to thoroughly examine patients and run a series of blood tests to properly diagnose these disorders and figure out a course of treatment.

Diagnosing anorexia in cases of extreme weight loss is easier than in cases where only slight weight loss has occurred. Bulimia is easier to diagnose due to the obvious oral/dental symptoms associated with the disorder.

edit Treating Anorexia and Bulimia

Due to bulimia being associated with average body weight, it is rare for this disorder to call for hospitalization. Anorexia, however, frequently lands sufferers in the hospital over time, as organs are prone to malfunction or fail as one loses abnormal amounts of weight.

Treating bulimia and anorexia can be difficult and, in some cases, impossible, and it appears that the age of onset and diagnosis is important.[2] Many who have an eating disorder will not acknowledge and admit that they have an eating disorder. This makes anorexia and bulimia difficult not only for those suffering from the disorder, but also for their friends and family.

In cases where a person is open to receiving treatment, there is hope to be found in a variety of outpatient and inpatient care facilities. Treatment teams consist of dietitians, doctors and psychotherapists who specialize in eating disorders, and occasionally psychiatrists who may prescribe antidepressants or antianxiety medications.

Cognitive-behavioral therapy is a popular method of therapy for treating these disorders, as changing how one thinks about weight and food is a primary goal. Treatment tends to also include more healthful coping mechanisms for handling stress and triggering subjects.

edit Long-Term Outcomes

The long-term prognosis for both disorders varies. While the majority of those who have sought treatment report moderate to complete recovery a number of years later, a significant minority (~10-30%) still struggle with symptoms and even relapses. Among those who struggle the most, suicide is common.[3]

Anorexia is harder to treat than bulimia. Roughly 20% of those who diagnosed with anorexia are dependent on social services.[4] Worse, it is a very deadly disease, with one of the highest mortality rates among mental disorders. In a 21-year follow-up study, nearly 16% of the study's participants "died from causes related to anorexia nervosa."

edit Statistics

While both eating disorders can affect both sexes and all ages and races, they are more commonly diagnosed in young Caucasian women. At least one study has suggested racial differences have had more to do with racial prejudices affecting diagnosis, but further research is required.

90-95% of all those first diagnosed with anorexia or bulimia are young women between the ages of 15 and 24. Bulimia, affecting around 1% of young women in the U.S., is more common than anorexia, which affects 0.3%.[5]

Body dysmorphic disorder, which is sometimes coupled with one or both of these disorders, is nearly as common in men (2.2%) as it is in women (2.5%).[6]


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