What Is The Difference Between Anorexia And Bulimia
Anorexia nervosa and bulimia nervosa are both eating disorders. They can have similar symptoms, such as distorted body image and an intense fear of gaining weight. The difference is that they have different food-related behaviors.
People who have anorexia severely reduce their calorie intake and/or purge to lose weight. People who have bulimia eat an excessive amount of food in a short period of time followed by certain behaviors to prevent weight gain. Such behaviors include:
- Intentional vomiting.
- Misuse of medications such as laxatives or thyroid hormones.
- Fasting or exercising excessively.
People with bulimia usually maintain their weight at optimal or slightly above optimal levels whereas people with anorexia typically have a body mass index that is below 18.45 kg/m2 .
Can Anorexia Nervosa Be Prevented
Experts don’t know how to prevent anorexia nervosa. It may help if family members have healthy attitudes and actions around weight, food, exercise, and appearance. Adults can help children and teens build self-esteem in various ways. This includes academics, hobbies, and volunteer work. Focus on activities that aren’t related to the way a person looks.
How Can I Care For A Loved One Who Has Anorexia
There are multiple things you can do to help and support someone with anorexia, including:
- Learn about anorexia: Educate yourself about anorexia to better understand what they are going through. Dont assume you know what they are experiencing.
- Be empathetic: Dont downplay or dismiss their feelings and experiences. Let them know that you are there to listen and support them. Try to put yourself in their shoes.
- Encourage them to seek help and/or treatment: While having an understanding and supportive friend or family member is helpful to a person with anorexia, anorexia is a medical condition. Because of this, people with anorexia need treatment such as therapy and nutritional counseling to manage their condition. Encourage them to talk to their healthcare provider if they are experiencing the signs and symptoms of anorexia.
- Be patient: It can take a while for someone with anorexia to get better once theyve started treatment. Know that it is a long and complex process and that their symptoms and behaviors will eventually improve.
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Who Do They Affect
Globally, anorexia affects 0.4 % to 4% of all people and bulimia affects about 1% of all people. Binge-eating disorder affects up to about 2% of all people. These illnesses are more likely to affect the following groups of people:
WomenUp to 90% of people diagnosed with anorexia and bulimia are women. However, more boys and men are being diagnosed with eating disorders, and it’s likely that experiences of boys and men aren’t caught in current statistics. Binge-eating disorder is diagnosed in men and women more equally.
Young peopleAnorexia, bulimia, and binge-eating disorder often start in the teenage and young adult years, though they can also start earlier or later in life, too.
Family membersEating disorders tend to run in families, so you have a higher risk of developing an eating disorder if a close family member also has an eating disorder.
People with other mental illnessesPeople who experience an eating disorder are more likely to be diagnosed with mood disorders like depression and bipolar disorder, an anxiety disorder, a substance use disorder, or a personality disorder.
People from certain cultures or careersAnorexia and bulimia are more common among people who have jobs that depend on the way their body looks. This may include some dancers, models and athletes. Eating disorders may also be more common in cultures with strong gender stereotypesfor example, ones that idealize thin women and lean, muscular men.
Damaging Mindsets That Fuel Anorexia
All-or-nothing thinking. Through this harshly critical lens, if youre not perfect, youre a total failure. You have a hard time seeing shades of gray, at least when it comes to yourself.
Emotional reasoning. You believe if you feel a certain way, it must be true. I feel fat means I am fat.I feel hopeless means youll never get better.
Musts, must-nots, and have-tos. You hold yourself to a rigid set of rules and beat yourself up if you break them.
Labeling. You call yourself names based on mistakes and perceived shortcomings. Im unhappy with how I look becomes Im disgusting. Slipping up becomes Im a failure.
Catastrophizing. You jump to the worst-case scenario. If you backslide in recovery, for example, you assume that theres no hope youll ever get better.
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Could I Have An Eating Disorder
I’m always thinking about food, dieting and my weight
I feel guilty and ashamed after I eat
I often feel out of control when I eat
I feel better when I don’t eat
I will never be happy unless I reach my ideal weight
I often try to “get rid” of food by purging
I experience physical signs that my body isnt getting enough nutrients, such as hair loss, dry skin, dizziness or lack of energy
If you answered yes to any of these questions, it’s best to talk to your doctor.
Are There Clinical Trials Studying Eating Disorders
NIMH supports a wide range of research, including clinical trials that look at new ways to prevent, detect, or treat diseases and conditions, including eating disorders. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.
Researchers at NIMH and around the country conduct clinical trials with patients and healthy volunteers. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information about clinical research and how to find clinical trials being conducted around the country, visit NIMH’s clinical trials webpage.
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Anorexia Focused Family Therapy
If you are under 18, it is likely that your parent or carer will be closely involved in this process. In the early stages of therapy, they will have more control over your eating choices. As you start to recover and become able to make rational and healthy decisions, more independence and control over what you eat is handed back to you. Sessions with your specialist will be regular and will include:
- Keeping an eating diary and advice surrounding food and eating.
- Weighing you regularly.
- Information about the ways in which anorexia damages your health.
- Help in motivating you to recover.
- Reassurance for you and your family that nobody is to blame for your anorexia. It is an illness and it is nobody’s fault that you have it. It is not your fault or the fault of anyone in your family.
Association Is Not Cause
There is no single cause for any eating disorder. This may shock some people who look for causes in childhood experiences or traumas. What we do know is that there are several known risk factors which make it more likely that a person will develop an eating disorder. And there are known risk factors for specific types of eating disorder. Someone with any kind of eating disorder is more likely to be sensitive, prone to anxiety, has high standards yet poor self-confidence. The reasons why these factors have come together in any one individual will be personal. Sometimes it is just an accident of birth and sometimes it is a build up of experiences.
Below are some of the known risk factors for eating disorders:
Eating disorders most commonly start off with dieting behaviour. You can read more about the effects and the psychology of dieting on our information page. Even though most eating disorders begin with a diet, not all dieters will get an eating disorder.
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How Are Eating Disorders Diagnosed
Health care providers and mental health professionals diagnose eating disorders based on history, symptoms, thought patterns, eating behaviors, and an exam.
The doctor will check weight and height and compare these to previous measurements on growth charts. The doctor may order tests to see if there is another reason for the eating problems and to check for problems caused by the eating disorder.
How To Create A Healthier Relationship With Food And Body Image
Experts find that its helpful to introduce and practice new thought patterns related to your body and your self-image. These could include:
- Appreciate all of the activities your body can do, and celebrate the amazingness of what your body does for you
- Practice seeing yourself as a whole person by keeping a list of things that you like about yourself that dont relate to your weight or body shape
- Remind yourself that confidence, self-acceptance, and openness make you beautiful
- Surround yourself with positive people who value you, and others, for personality and not appearance
- Look for, become critical of, and protest social media messages that make you feel bad about your body
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What Is The Treatment For Anorexia Nervosa
The aim of treatment is to:
- Reduce risk of harm which can be caused by anorexia.
- Encourage weight gain and healthy eating.
- Reduce other related symptoms and problems.
- Help people become both physically and mentally stronger.
If anorexia is suspected, you should be referred to a specialist eating disorders team, although unfortunately services in some parts of the UK are limited. This is a specialised mental health team which may include psychiatrists, psychologists, nurses, dieticians and other professionals. Usually this will involve outpatient appointments. Occasionally if you have very severe anorexia or medical complications, you may be admitted to a specialised eating disorder unit, or a medical ward in hospital. Medication is not usually necessary in treating anorexia.
The sorts of treatments that may be offered include the following:
Causes Of Negative Body Image
Sometimes body image is negatively impacted by one or more significant events. For example, a gymnast who is continually chided by her coach and fellow athletes to lose a little weight may develop a deeply ingrained and long-standing dissatisfaction with her body, no matter how thin she becomes.
If you are concerned about your body image, here are some questions to ask yourself:
- Is my perception of beauty distorted from years of media exposure that glorifies a very thin ideal that is unrealistic for most people to obtain in a healthy manner?
- Do I find myself regularly criticizing my own appearance?
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Seeking Treatment For An Eating Disorder
Eating disorders have the highest mortality rate of any mental illness. At least one person dies as a direct result of an eating disorder every 62 minutes.
It is important to know, however, that eating disorders are treatable. There is help available to those suffering from an eating disorder. You can visit the National Eating Disorders Association website for some useful tools. You can use this screening tool to determine if you or a loved one may be suffering from an eating disorder. You an also contact the NEDA helpline for support and resources.
National Eating Disorders Awareness Week is February 25 – March 3, 2019. Were changing the conversation around food, body image, and eating disorders! Join the movement and #ComeAsYouAre, not as you think you should be. www.nedawareness.org.
Rebecca Encao, MSMHC is both an instructor and a team lead for Southern New Hampshire University and has taught psychology and social science courses for SNHU since 2015. Prior to that she worked with eating disorder patients at Eating Recovery Center in Denver.
What Is An Eating Disorder
To understand why people get eating disorders, we first have to describe what an eating disorder actually is. Many people have odd eating habits but a true eating disorder is extreme shape and weight control behaviour which in turn is caused by excessive concerns about your weight. Most people with eating disorders have poor self worth and perfectionist opinions about how they should look and what they should weigh. Their need to be perfect often extends into other areas of their life. People with eating disorders also complain a great deal about feeling fat. Many people without an eating disorder have fat days too. In someone with eating distress, this is usually emotional experience such as anger or anxiety which is not being recognised.
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What Are Eating Disorders
Eating disorders are serious, biologically influenced medical illnesses marked by severe disturbances to ones eating behaviors. Although many people may be concerned about their health, weight, or appearance from time to time, some people become fixated or obsessed with weight loss, body weight or shape, and controlling their food intake. These may be signs of an eating disorder.
Eating disorders are not a choice. These disorders can affect a persons physical and mental health. In some cases, they can be life-threatening. With treatment, however, people can recover completely from eating disorders.
What Are The Signs And Symptoms Of Anorexia
You cannot tell if a person has anorexia just by their appearance because anorexia also involves mental and behavioral components not just physical. A person does not need to be underweight to have anorexia. Larger-bodied individuals can also have anorexia. However, they may be less likely to be diagnosed due to cultural stigma against fat and obesity. In addition, someone can be underweight without having anorexia. Remember, anorexia also includes psychological and behavioral components as well as physical.
There are several emotional, behavioral and physical signs and symptoms of anorexia. If you or someone you know experiences the signs and symptoms of anorexia below, its important to seek help.
Emotional and mental signs of anorexia
Emotional and mental signs of anorexia include:
- Having an intense fear of gaining weight.
- Being unable to realistically assess your body weight and shape .
- Having an obsessive interest in food, calories and dieting.
- Feeling overweight or fat, even if youre underweight.
- Fear of certain foods or food groups.
- Being very self-critical.
- Experiencing thoughts of self-harm or suicide.
Behavioral signs of anorexia
Behavioral signs of anorexia include:
Physical signs and symptoms of anorexia
Physical signs of anorexia include:
Physical symptoms of anorexia that are side effects of starvation and malnutrition include:
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‘thinning’ Of The Bones
Osteoporosis is caused by a lack of calcium and vitamin D and can lead to easily fractured bones. In addition, the risk of getting osteoporosis increases if you are a woman and your periods have stopped. This is because oestrogen in your body protects your bones from osteoporosis and the levels of oestrogen in your body reduce when your periods stop.
Tip : Develop A Healthier Relationship With Food
Even though anorexia isnt fundamentally about food, over time youve developed harmful food habits that can be tough to break. Developing a healthier relationship with food entails:
- Getting back to a healthy weight
- Starting to eat more food
- Changing how you think about yourself and food
Let go of rigid food rules. While following rigid rules may help you feel in control, its a temporary illusion. The truth is that these rules are controlling you, not the other way around. In order to get better, youll need to let go. This is a big change that will feel scary at first, but day by day, it will get easier.
Get back in touch with your body. If you have anorexia, youve learned to ignore your bodys hunger and fullness signals. You may not even recognize them anymore. The goal is to get back in touch with these internal cues, so you can eat based on your physiological needs.
Allow yourself to eat all foods. Instead of putting certain food off limits, eat whatever you want, but pay attention to how you feel physically after eating different foods. Ideally, what you eat should leave you feeling satisfied and energized.
Get rid of your scale. Instead of focusing on weight as a measurement of self-worth, focus on how you feel. Make health and vitality your goal, not a number on the scale.
Getting past your fear of gaining weight
Getting back to a normal weight is no easy task. The thought of gaining weight is probably extremely frightening, and you may be tempted to resist.
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What To Expect From Anorexia Treatment
Its important to start treatment as early as possible, especially if someone has already lost a lot of weight.
Treatment for anorexia usually includes:
- psychological treatment talking to a therapist or counsellor
- advice on eating and nutrition to help you gain weight safely
These treatments work better when combined, rather than on their own.
Your physical health will be monitored closely during your treatment. For example:
- your weight will be checked regularly
- you may have regular health checks with your GP or another healthcare professional
In children and young people with anorexia, their growth, development and weight will be monitored closely. Their height will also be checked regularly against the average for their age and sex.
Other health problems caused by anorexia will also be treated. For example, if you vomit regularly, youll be encouraged to stop. Youll be given advice on dental hygiene to help prevent stomach acid damaging the enamel on your teeth. Youll also be advised to visit a dentist regularly. If you take laxatives or diuretics, youll be advised to reduce them gradually so your body can adjust. Stopping them suddenly can cause side effects like nausea and constipation.
Other Specified Feeding Or Eating Disorder
The majority of those with eating disorders do not fall within the guidelines for anorexia, bulimia and binge eating disorder and are classified as OSFED. To be diagnosed as having OSFED a person must present with a feeding or eating behaviors that cause clinically significant distress and impairment in areas of functioning, but do not meet the full criteria for any of the other feeding and eating disorders.
A diagnosis might then be allocated that specifies a specific reason why the presentation does not meet the specifics of another disorder . The following are further examples for OSFED:
Medical Complications and Associated Features
Weight loss or faltering growth
Generalized emotional difficulties, sometimes referred to as food avoidance emotional disorder
Mirroring of medical complications and associated features of anorexia nervosa
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