The 6 differences between Anorexia and Bulimia

We analyze the main differences between these two eating disorders.

In today's society, enormous importance is given to physical appearance. From the media to the most private forms of interaction, few areas of life allow us to move away from the general conception that equates thinness and physical attractiveness with perfection and success.

Anorexia and bulimia are two eating disorders in the development of which the social pressure to in the development of which social pressure to achieve an ideal physique plays a fundamental role. The closeness between these two diagnoses sometimes causes some confusion regarding their definition.

Defining anorexia and bulimia: characteristics of both disorders

Anorexia nervosa is characterized by the restriction of food intake. The patient's body image is distorted, i.e. people with anorexia see themselves as thicker than they are. Also, there is a distortion of the body image; this means that people with anorexia see themselves thicker than they are.

Anorexia has two subtypes: restrictive, in which weight is lost mainly through fasting and physical exercise, and compulsive/purging, in which binge eating and purging occur.

In bulimia, on the other hand, emotional discomfort or stress emotional discomfort or stress triggers binge eating, usually of foods with a highBinge eating, usually of high-calorie foods, followed by purging behaviors (vomiting, use of laxatives) or compensatory behaviors (fasting, intense exercise) that are a consequence of feelings of guilt or shame. During binge eating, a feeling of loss of control over intake is experienced.

Bulimia is also classified according to two types, one purging and one non-purging, which corresponds more to compensatory behaviors such as fasting.

Other psychological problems with a similar profile are orthorexia nervosa, which is characterized by the obsession to eat only healthy food, body dysmorphic disorder, which consists of an excessive preoccupation with some physical defect, and vigorexia or muscular dysmorphia, a subtype of the previous one.

The main differences between anorexia and bulimia.

Even bearing in mind that the diagnoses are only indicative tools and that the symptoms of anorexia and bulimia may overlap, it is worth reviewing the main differences between these two disorders as they are understood by psychology manuals.

1. The main symptoms: restriction or binge eating

Behavioral symptoms are one of the one of the fundamental differences between bulimia and anorexia. In general, in anorexia there is strict control over behavior, while bulimia has a more compulsive and emotional component.

In the case of bulimia the presence of frequent binge eating is necessary for diagnosis. Although these episodes can also occur in anorexia, they are basic only in the compulsive/purging subtype, and tend to be much less intense than in bulimia.

Purging and compensatory behaviors can occur in both disorders. disorders. However, in the case of bulimia one or both will always occur, as the person feels the need to lose the weight gained through binge eating, whereas in anorexia these behaviors may be unnecessary if caloric restriction is sufficient to satisfy weight loss goals.

Binge eating disorder is another diagnostic entity characterized exclusively by recurrent episodes of uncontrolled eating. Unlike those found in bulimia and anorexia, in this case binge eating is not followed by purging or compensatory behaviors.

2. Weight loss: underweight or fluctuating weight

The diagnosis of anorexia nervosa requires a persistent urge to lose weight and being significantly below the minimum weight that you should be according to your biology. This is usually measured by Body Mass Index or BMI, which is calculated by dividing weight (in kilograms) by height (in meters) squared.

In anorexia the BMI tends to be below 17.5, which is considered underweight, while the normal range is between 18.5 and 25. People with a BMI of more than 30 are considered to be obese. It should be borne in mind, however, that BMI is an indicative measure that does not differentiate between Muscle mass and fat tissue and that it is particularly inaccurate in very tall or very short people.

In bulimia the weight is usually within the range considered healthy.. However, there are important fluctuations, so that in periods in which binge eating predominates the person can put on a lot of weight, and when the restriction is maintained for a long time the opposite can occur.

3. The psychological profile: obsessive or impulsive

Anorexia tends to be related to control and order, while bulimia tends to be related to control and order, while bulimia tends to be related to control and order.whereas bulimia is more associated with impulsivity and emotionality.

Although these are only general tendencies, if we wanted to make a psychological profile of a "stereotypically anorexic" person, we could describe them as introverted, socially isolated, with low self-esteem, perfectionist and self-demanding. Conversely, bulimic people tend to be more emotionally unstable. tend to be more emotionally unstable, depressive and impulsivedepressive and impulsive, and more prone to addictions.

It is interesting to relate these diagnoses to the personality disorders most commonly associated with each of them. While obsessive-compulsive and avoidant personalities predominate in anorexia, in bulimia there are usually cases of histrionic and borderline disorders.

Additionally, in anorexia there is more often a denial of the problem, which is more easily assumed in people with bulimia.

4. Physical consequences: severe or moderate

The physical alterations resulting from anorexia are more severe than those caused by bulimia, as the former can lead to death by starvation. In fact, in many cases of anorexia hospitalization is used in many cases to bring the person back to an acceptable weight, whereas in bulimia this is significantly less frequent.

In anorexia, it is much more common to have amenorrhea, that is to say, the disappearance of menstruation or its non-appearance in cases that begin at a very early age. Dry skin, capillary weakness and the appearance of lanugo (a very fine hair, like that of newborns), hypotension, feeling cold, dehydration and even osteoporosis are also often detected. Most symptoms are attributable to starvation.

Some common physical consequences of bulimia are swelling of the parotid gland and face, reduced potassium levels (hypokalemia) and the appearance of dental caries due to the dissolution of enamel caused by recurrent vomiting. Vomiting can also cause the so-called "Russell's sign", calluses on the hand (callus).calluses on the hand (on the knuckle area) due to rubbing against the teeth.

These physical alterations depend more on the specific behaviors of each person than on the disorder itself. Thus, although vomiting may be more frequent in bulimia, an anorexic person who vomits recurrently will also damage his or her dental enamel.

5. Age of onset: adolescence or young adulthood

Although these eating disorders can occur at any age, it is most common for each of them to begin at a certain period of life.

Bulimia typically begins in young adulthood, between the ages of 18 and 25.between the ages of 18 and 25. Since bulimia is related to psychosocial stress, its frequency of onset increases at about the same age when responsibilities and the need for independence gain strength.

In contrast, anorexia tends to start at an earlier age, mainly in adolescencemainly in adolescence, between 14 and 18 years of age. In general, the development of anorexia has been associated with the social pressures derived from sexual maturation and the adoption of gender roles, specifically feminine, since for men the demand for thinness is usually lower.

6. The type of obsessive thoughts

The cognitive component is also different between anorexia and bulimia. In anorexia there is a constant discomfort about one's appearance.This leads the person to avoid gaining weight at all costs, and to try to approach a very thin ideal of beauty (perceived as less thin than it really is).

On the other hand, in bulimia, the thoughts behind the disorder have to do with the feeling of guilt caused by binge eatingwhich leads the person to want to restore the balance. There is no distorted view of one's own body.

"Bulimia" and "anorexia" are just labels.

Although in this article we have tried to clarify what are the fundamental differences between the diagnosis of bulimia and anorexia, the fact is that both behavior patterns are close in many ways. in many ways. As we have seen, many of the characteristic behaviors of these two disorders, such as recurrent vomiting or the practice of intense exercise, are as characteristic of one as of the other, and in some cases only their frequency or their centrality in the problem allow differentiation between anorexia and bulimia.

Moreover, it is quite common for both diagnoses to be it is not uncommon for the two diagnoses to overlap, either successively oreither successively or in alternation. For example, a case of anorexia with occasional binge eating could eventually lead to bulimia. In addition, if the same person were to regain his or her previous patterns, he or she would again fit the diagnosis of anorexia. In general, if the conditions for a diagnosis of anorexia are met, anorexia is given priority over bulimia.

This makes us reflect on the rigidity with which we generally conceptualize the disorders, whose names are labels with the function of helping clinicians to have an overview of the most advisable intervention tools when dealing with each of their cases.

The treatment of these types of eating disorders

Both anorexia and bulimia are severe pathologies that must be treated urgently by mental health professionals, given that their mortality rate is high (and very high in the case of the former). In this sense, psychotherapeutic intervention is necessary, psychotherapeutic and medical intervention is necessary..

In the consultation, professionals will be guided by the differences between bulimia and anorexia to know what type of disorder the patient suffers from and will apply an intervention plan adapted to each case.