There are several differences between anorexia and bulimia: in anorexia the person eats too little and in bulimia tries it but ends up binge eating. Anorexic people have a weight below normal, while bulimics have a normal weight. Bulimic people lack self-control, while anorexics do not. In this article we will list the main differences.
Those who suffer from anorexia or bulimia are usually young women and even adolescents or girls, although anyone can suffer from them.
They have in common that they feel that their own value is determined by the shape and size of their body, seeing thinness as the highest goal they can achieve. But sadly, the perception of one's own body is completely altered and they never find the perfect thinness they are seeking.
They always want to lose more and more weight, depending their happiness on their physical appearance. These people make life-threatening efforts to achieve their goals . These people can lose weight until they reach a certain goal that they consider acceptable. But even when they get the desired weight they can not stop their obsession and still think that there are more pounds to lose.
In general, people with anorexy They will try to achieve their goals by eating as little as possible. While those who have bulimia , They will not be able to control their binges and will opt for purge behavior.
All this process accompanies great discomfort, obsessions, anxiety, low self-esteem , Isolation, feeling misunderstood... although normally they will not admit that they have a problem.
Despite the good intelligence they present, they both believe they are doing the right thing and that no one understands what they regard as"their philosophy of life." They even defend themselves from the world by creating"pro-mia"and"pro-ana"internet networks and groups where advice is given and supported.
Differences Between Anorexia and Bulimia
As we see, these two disorders have many things in common. Now we are going to detail what the differences are.
1- Different ways of achieving the same goal
In both anorexia and bulimia, what is desired is Lose Weight . For this, people with anorexia are dedicated to virtually eliminate all food from the diet little by little. Above all, those who consider that they have more calories; Until finally they try to spend as much time as possible without eating anything (fasting).
They can accompany the process with physical exercise to try to decrease weight faster, developing all possible strategies to stay without eating. That is, anorexia is characterized by restriction.
On the other hand, in bulimia, the person tries to keep fasting as in anorexia, but without success. There comes a time when hunger invades, loses control and prepares to devour immense amounts of high-calorie food in a short time.
In addition, after these periods known as binge eating, the bulimic person will try to compensate in some way for all that he has eaten (what is called a purge). They usually resort to self-induced vomiting, although other alternatives are physical exercise or the use of laxatives and diuretics.
However, according to DSM-V diagnostic criteria, anorexia may be restrictive (involving avoidance of food as we have mentioned) or binge / purge subtype.
That way there is a group of people with anorexia who resort to purging behaviors after having ingested food. But to diagnose bulimia, on the contrary, the indispensable requirements are: to be binge eating, and purges or compensation behaviors to avoid gaining weight after the large intake.
The difference of the diagnoses here resides in criteria of corporal weight, self-control and conducts that employ.
This makes the diagnosis more complicated and the same patient can go through several different diagnoses as the disease progresses.
During the article we will explain this in more detail.
2- The weight
According to established diagnostic criteria, to indicate that a person has anorexia should be classified as low weight. This means you must have lost 15% or more of your ideal body weight based on your age and height.
In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), there is indicated for anorexia:"body weight significantly low in relation to age, gender, course of development and physical health. Significantly low weight is defined as a weight that is below the normal minimum or, in children and adolescents, below the expected minimum."
However, this criterion is not taken into account in patients with bulimia. In fact, many have a weight that is normal and even overweight.
It is typical of this last condition that there are important oscillations in the weight. While anorexia remains low or decreasing more and more.
3- Self-control
People with bulimia often experience a marked lack of control, in the face of binge eating and purging, as well as shame and guilt .
However, in anorexia the feeling of control is much stronger, as the patient naively believes that she can restrict the food she eats at her whim. The more you manage to restrict, the more control you feel about your life.
This is observed in the following aspects. In bulimia, after a time of fasting, the simple fact of trying a bite of food can trigger a great loss of control that ends in binge eating. Over time, the affected person knows when the binge will come and has a large amount of food stored in the house especially reserved for those moments.
In anorexia, on the other hand, these binges do not appear, but they try to eat very little or nothing. You can try some small amounts of food that will"compensate"you with more days of fasting or exercise.
4- Impulsiveness
Anorexics are people who fit in with the ideas of total control, austerity, inhibition, restraint, avoidance, and isolation.
On the other hand, the profile of the bulimics is associated more with impulsivity, exigencies, descontrol, instability, etc. In fact, there is an important relationship between bulimia and Borderline personality disorder , Which has many of these characteristics.
5- Awareness of the problem
Coupled with the above, as people with bulimia will feel more discomfort and feeling of loss of control, it is more usual to admit that they have a problem. But anorexia may not feel the existence of that problem and on the contrary the patient believes that he is acting correctly regarding his diet.
6- Thoughts
The difference between bulimia and anorexia is also reflected in the ruminating thoughts.
People with bulimia may be constantly thinking about food, what recipes they will cook or what food they will buy for the next binge. They may be planning it for a long time, and even following an order of the meals that will follow or how you will combine the foods.
On the other hand, anorexics devote their thoughts to meals that are going to skip, what excuses to invent not to eat or what tricks will use so friends and family do not realize.
7- Behavior and rituals with food
People with anorexia often have typical eating behaviors. They will avoid these situations at all costs, but when they have no choice but to be in them will try to pretend to eat.
In addition, they develop refined techniques like discreetly introducing food into a napkin. It is also usual to break the food into very small pieces, order them or play with them.
On the other hand, in bulimia behavior on the table is usually normal. The people around you may not notice anything as they seem to eat without problems. Then, purge behaviors will be secretly performed.
8- Age of onset
Both conditions occur in young women generally, between the pre-adolescent stage and early adulthood. Although each time the onset is earlier, it can be between 8 and 10 years of age.
It seems that anorexia appears at an earlier age than bulimia. Anorexia has an average age of about 14 or 15 years, while in bulimia it is about 19 years.
However, it is important to know that any eating disorder can begin at any age and in both men and women.
9- Prevalence
These disorders occur 15 times more in women than in men, and the prevalence is between 0.3% and 0.5% in women with anorexia. However, in bulimia this percentage rises, ranging from 1-3% of the population.
That is, bulimia is more frequent than anorexia. And it could still be more in the figures, but it is more difficult to detect because there are no significant reductions in weight.
10- Physical symptoms
In anorexia the most characteristic symptoms are a low weight and a weak and sick appearance. In addition to deterioration and dysfunction of the organs, fatigue, fainting, loss of concentration and memory. It can also occur Amenorrhea Or lack of menstruation.
On the other hand, in bulimia there are no evident changes in weight, being within normal. The remaining symptoms may be very similar to those of anorexia, although there are others that indicate recurrent self-induced vomiting.
Some of them are calluses on the fingers, mouth and esophagus with wounds, stains on the teeth, gum problems, etc.
The symptoms of anorexia are seen more clearly from the outside and one can more easily suspect that someone has the disease. However, bulimia manifests itself in a very subtle way and the people around you may not notice.
- In this article You can know the consequences of anorexia.
- In this article You can know the consequences of bulimia.
11- Treatment
Frequently in patients with anorexia comes the time of hospitalization. In bulimia it does not happen as usual, but it can take a long time for the problem to start to show.
When there are differences between anorexia and bulimia, to intervene must be taken into account. For example, for anorexia it is intended that the affected patient values the achievements he has achieved in his life. For patients with bulimia, the intervention will be focused on helping them maintain order and control.
12- Forecast
These two types of eating disorders often have a good recovery a few years later. Although there is a 10-30% who continue to struggle with their symptoms and have frequent relapses. Among those with more complications, the risk of suicide is much higher.
Anorexia is much more difficult to treat than bulimia, so it will have a worse prognosis. In addition, it is linked to high mortality rates in the field of mental disorders.
This was manifested in a 2000 year study of 21 years of follow-up, which analyzed 84 patients with anorexia nervosa. It was found that 15.6% died for reasons associated with this disease.
References
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- Husain, A. (2002). Anorexia and Bulimia Nervosa. Retrieved on August 04, 2016, from Serendip.
- Paz, M., Fernandez P., Soberon F., Álvarez Z., Rubín Gómez, A. E. (2004). Anorexia occurs at any age and sex (Research work). IES Ría del Carmen.
- Zipfel, S., Löwe, B., Reas, D., Herzog, W., & Deter, H. (2000). Long-term prognosis in anorexia nervosa: Lessons from a 21-year follow-up study. Lancet, 355 (9205), 721-722.