What is Anorexia? What is Bulimia?

If a person has a compulsion to eat, or not to eat - a compulsion that has a negative effect on his/her mental and physical health, he/she probably has an eating disorder. The two most common types of eating disorders are Anorexia Nervosa and Bulimia Nervosa. Some estimates say that approximately 5-7% of American females suffer from either disorder at some time during their lives.

What is Anorexia Nervosa?

Anorexia Nervosa is defined as a psychological disorder. The patient has a distorted body image and an irrational fear of becoming overweight - so he/she deliberately attempts to lose weight. Even though the majority of patients are female, men can also suffer from Anorexia Nervosa.

* Anorexia = A general loss of appetite or no interest in food. Not to be confused with Anorexia Nervosa.

According to DSM-IV-TR® Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, a person with Anorexia Nervosa:

• weighs much less than he/she should - 15% or more below their ideal weight
• normally has a BMI of 17.5 or less
• has missed three consecutive menstrual periods
• has a preoccupation with body shape and weight
• has a severe fear of putting on weight

76% of reported Anorexia Nervosa onsets start between the ages 11-20. About 6% of patients diagnosed with Anorexia Nervosa die - approximately half of deaths are the result of suicide. It has the highest mortality rate for any mental illness.

A person who suffers from Anorexia Nervosa is often a perfectionist who sets herself/himself targets beyond his/her reach. When they are not achieved the patient begins to control parts of his/her life that he feels he/she can, such as food intake and weight.

An exaggerated fear of losing control is mainly driven by low self-esteem and constant self-criticism. It is not uncommon for a patient to feel he/she has lost control after consuming a tiny amount of food.

What is Bulimia Nervosa?

Bulimia Nervosa is defined as a psychological disorder. The patient experiences regular bouts of serious overeating, which are always followed by a feeling of guilt, which can then lead to extreme reactions such as crash dieting, doing lots of exercise, and purging (deliberately vomiting).

According to DSM-IV-TR® Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, for patients to be diagnosed with bulimia nervosa (as opposed to anorexia nervosa), they must be showing the following 4 symptoms:

• Binge-eating "repeatedly" - eating much more than most people normally do, together with a feeling that they can't stop or control their eating


• Repeatedly and inappropriately compensating for the over-eating, such as over-medicating with laxatives, fasting, exercising to exhaustion, or making themselves vomit


• Been doing these two things (binge-eating and inappropriately compensating) repeatedly at least twice a week for the last 3 months


• Overly judging themselves in terms of the weight and shape of their bodies

Unlike anorexia nervosa, bulimia nervosa is difficult to identify. The sufferer is not usually underweight. Because of the shame and guilt associated with the illness, patients are skilled in masking the symptoms.

Long-term, the patient may experience malnutrition - a symptom which often brings the patient to the attention of the doctor.

Help and information on coping with eating disorders can be found by visiting one of the following national websites:

• National Eating Disorders Association (USA)
• BEAT - beating eating disorders (UK)
• National Eating Disorder Information Centre (Canada)
• Eating Disorders Association (Australia)
• Eating Disorders Association (Republic of Ireland)
• Eating Disorders Services (New Zealand)