12 Differences Between Anorexia And Bulimia

Eating disorders (ED) are a group of mental disorders that include both anorexia and bulimia. These are characterized by pathological behaviors in the face of food intake and/or alteration in behaviors related to weight control. These diseases carry negative physical and mental consequences in the people who suffer from them, also affecting social functioning.

EDs have a high mortality rate, constituting a public health problem, as well as a tendency towards chronification. They are disorders of multifactorial origin, that is, multiple factors affect their appearance and maintenance. However, in the last fifty years or so there has been an increase in the incidence and prevalence of eating disorders, probably due to sociocultural factors of social pressure for image and prevailing beauty canons. Because of this, eating behavior problems are much more common. more prevalent in adolescent and young women than in the rest of the population, since, although not exclusively, a large part of these messages from society are focused on this population sector.

Anorexia and bulimia, categorized within the section of eating and eating disorders of the DSM-5, are described as follows:

anorexia nervosa

According to the DSM-5, anorexia nervosa is a psychological disorder characterized by intake restriction which leads to a significantly lower body weight than normal. In anorexia there is a distortion of the perception of one’s own body and weight to which, in addition, exaggerated importance is given. Anorexia nervosa also presents a disproportionate fear of gaining weight and behaviors to avoid it.

Bulimia nervosa

Bulimia nervosa appears in the DSM-5 as a psychological disorder characterized by episodes of binge eating, in which a greater than normal amount of food is eaten, together with actions to compensate the binge Self-evaluation is also influenced by the perception of one’s own body and weight.

Among the similarities between bulimia and anorexia we find that they are part of the same group of disorders, eating disorders, and that they present alterations in both eating patterns and concern about body image. However, both diseases have a series of characteristics that differentiate them. The 12 differences between anorexia and bulimia are:

1. Behavior before food: The basic difference between anorexia and bulimia is that in anorexia there is a controlled restriction of intake, leading to fasting, while in bulimia the affected person tries to restrict the amount of food or stop eating, but is not able to resist. the desire for food and ends up engaging in binge eating. These binges are normally compensated by purgative behaviors such as vomiting and, less frequently, by excessive physical exercise or ingestion of laxatives. Therefore, anorexia is characterized by restriction and bulimia by binge eating in terms of behavioral symptoms.
2. Control over eating behavior: In the case of anorexia there is a strict and methodical control of food restriction and in bulimia there is a loss of this in binge eating, there is a more emotional and impulsive component.
3. The weight: Another difference between anorexia and bulimia is the body mass index (BMI), which is a method used to estimate the amount of fat in a person’s body by dividing weight in kilos by height in meters squared. . The BMI is an indicative measure whose normal range is considered between 18.5 and 25. As for people with anorexia, they are underweight, normally a BMI less than 17, becoming less than 15 in cases of extreme severity. On the other hand, people who suffer from bulimia usually have a weight within the normal range. Furthermore, bulimia is characterized by large fluctuations in weight, so in seasons of binge eating, weight will tend to increase and in periods of calorie restriction, it will tend to decrease.
4. Psychological profile: The traits associated with each of the disorders vary from one another, since anorexia is characterized by control and order, and bulimia by emotionality and compulsivity. Therefore, in general terms, the profile of people with anorexia is usually marked by perfectionism, rigidity, introversion and self-demand, while that of those with bulimia is due to impulsivity, anxiety, emotional instability and a tendency to the adictions. Regarding the mental disorders associated with each of these diseases, anorexia is associated with obsessive-compulsive and avoidant personality disorders and bulimia with histrionic and borderline personality disorders.
5. Disease goal: Although in both disorders the goal is to achieve thinness, the goals that drive people with anorexia and bulimia are different; People with bulimia want to achieve thinness to achieve happiness, while people with anorexia want to achieve self-realization and identification with their own body.
6. Disease awareness: Another difference between anorexia and bulimia is that people with anorexia tend to have little or no awareness of the illness and present a denial of change, and people with bulimia tend to have greater awareness of the illness or insight although they do not usually consider the need of a treatment for it.
7. Distortion level: In both disorders there is body dissatisfaction and a search for thinness, yet the perceptual alteration and image distortion are greater in anorexia than in bulimia.
8. Consequences of the disease: There is a negative impact on health in both bulimia and anorexia, although the consequences are more serious in the latter. Another difference between anorexia and bulimia is the consequences of each of them: in anorexia, amenorrhea occurs, that is, loss of menstruation, bradycardia or lower heart rate, dry skin, loss of hair and bone mass, low tension and body temperature and the appearance of lanugo, a very fine body hair that appears in the absence of fat with the aim of protecting the body. On the other hand, in bulimia there is a reduction in potassium levels that can cause cardiac arrhythmias, dehydration, loss of tooth enamel and calluses on the hands due to the provocation of vomiting and an increase in salivary glands.
9. Mortality levels: Another difference between anorexia and bulimia is the crude mortality rate, which is higher in anorexia. Corresponding to 5% per decade, that of bulimia is 2%. Death can be due to complications associated with the disease or due to suicide in both.
10. Starting age: Although both diseases normally appear at an early age, anorexia usually develops in younger people than bulimia, during adolescence, between 14 and 18 years old, and bulimia later, in the youth stage, between 18 and 25. years.
11. Prevalence: Another difference between anorexia and bulimia is that the prevalence of bulimia is greater than that of anorexia; it is estimated that the prevalence of the former is between 1 and 1.5% and that of the latter is 0.4%.
12. Treatment goal: Finally, the treatment approach is also one of the differences between anorexia and bulimia. The main and initial goal of treatment for anorexia nervosa is weight regain to a healthy weight, while that of bulimia is the reduction of binge eating and subsequent compensatory behaviors. Intervention in anorexia in many cases requires hospitalization, while in bulimia at significantly lower levels.

Below is a summary table comparing the differences in anorexia and bulimia explained above.

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