Difference Between Anorexia Nervosa and Bulimia Nervosa

What is the difference between anorexia nervosa and bulimia nervosa?

At least 30 million people suffer from eating disorders in the US, and anorexia nervosa and bulimia nervosa are perhaps the most well known. Understand the difference between anorexia nervosa and bulimia nervosa, and although the conditions share many similarities there are some clear differences between the two.

Symptoms of anorexia nervosa

People with anorexia strive to deliberately lose lots of weight.

Processes of losing weight include:

  • Skip meals, eat very small amounts or cut out particular types of food
  • Lie to others about what they have eaten
  • Obsessively count calories of the food they eat
  • Lie about their weight or try to disguise their body shape
  • Exercise to excessive levels
  • Use diet pills or appetite suppressants
  • Force themselves to vomit, or use laxative or diuretics in an attempt to purge food from the body.

Individuals with anorexia often have very low self-confidence or self-esteem and place a great deal of self-worth in their weight. They might believe that being thinner will make them happy, and they may experience body dysmorphia where they see themselves as bigger than what they are.

It's also common for individuals to frequently weigh themselves, check their body measures and examine their body in the mirror. Fear of gaining weight is very common in individuals with anorexia.

Anorexia can cause a wide range of problematic effects on the body, and sufferers may experience many physical symptoms.

Physical symptoms include:

  • Frequent headaches
  • Dizziness
  • Extreme fatigue
  • Feeling cold
  • Discolored feet and hands due to bad circulation
  • Bloating and constipation
  • Dry skin
  • Brittle nails
  • Hair loss on the scalp
  • Insomnia
  • Growth of fine, downy hair on the body
  • Abdominal pain
  • Loss of monthly period

Symptoms of bulimia nervosa

With bulimia nervosa, the main symptom is routinely binge eating and subsequently purging - by vomiting or taking laxatives - to rid food from the body. Like anorexia, bulimia tends to cause sufferers to develop obsessive behaviors around foods, and they often feel low self-esteem in regards to their body weight.

However, while people with anorexia tend to try to eat very small amounts, those with bulimia often eat large quantities of food even if they do not feel hungry. Often it is very calorie-dense foods that they choose, and it's not uncommon to feel out of control over the quantity of what is eaten. Sometimes binges are planned and others are spontaneous.

After episodes of overeating, individuals with bulimia purge the food from their body in an attempt to redeem feelings of guilt or regret and to avoid gaining weight. Like those with anorexia, people with bulimia tend to suffer from an intense fear of putting on weight.

Purging may occur in the form of vomiting or using laxatives to try to force food to move through the body quickly. These are the most common methods, but some may use diet pills, excessively exercise, adopt strict diet regimes or fast.

Although some of these techniques are also used by those with anorexia, the key difference with bulimia is that binges and purges or restrictions tend to be cyclical rather than ongoing. Individuals tend to worry that they are overweight and may set strict rules about their diet or exercise regime which they struggle to maintain. This leads to a compulsion to binge eat foods which have been restricted. Then, feelings of guilt, shame or self-hatred instigate the urge to purge and return to restricting to avoid weight gain.

Complications of anorexia and bulimia

Long-term anorexia can cause significant and sometimes permanent physical effects on the body.

Significant and permanent effects on body:

  • Muscle weakness and bone fragility (osteoporosis)
  • Restricted physical development and growth in children and adolescents
  • Absent periods and infertility in women
  • Loss of sex drive and erectile dysfunction in men
  • Poor circulation throughout the body
  • Irregular heartbeat, low blood pressure, heart disease and heart failure
  • Swelling, feet, hands and face (edema)
  • Anemia
  • Hypoglycemia (low blood sugar)
  • Kidney and liver damage
  • Seizures
  • Problems with memory and concentration

Bulimia shares some long term complications with anorexia, namely absent or irregular periods, hair loss and poor skin health, and an increased risk of heart problems.

Routine purging, particularly vomiting, can also lead to complications.

Complications include:

  • Dental problems due to acid on teeth
  • Swollen saliva glands in the face
  • Damage to bowel muscles leading to chronic constipation
  • Chemical imbalances in the body, leading to fatigue, kidney damage, muscle spasms and convulsions
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Last Reviewed:
September 03, 2017
Last Updated:
October 05, 2017