While there are a handful of different eating disorders, bulimia and anorexia are the two most common. This article will explore the physical and mental differences between anorexia and bulimia, examining how each disorder affects the body and mind.
What is Anorexia Nervosa?
Anorexia Nervosa is where an individual restricts their energy intake to the point that they experience significantly low body weight. They also have an intense fear of gaining weight with behaviors that interfere with weight gain as a result. Someone with anorexia also experiences a disturbance in their perceived weight or shape.
What is Bulimia Nervosa?
Bulimia is an eating disorder characterized by recurrent episodes of binge eating where an individual eats significantly more than what someone should eat under similar circumstances in a small time frame, and feels that they have no control over how much they are eating.
Following the excessive consumption of food they will use inappropriate measures to compensate for how much they ate in order to prevent weight gain. These measures often include self-induced vomiting, laxatives, medication, fasting, or excessive exercise.
The Physical Difference Between Anorexia and Bulimia
What is the difference between anorexia and bulimia? Physically, the difference has to do with weight, nutritional deficiency, and organ damage.
A. Weight and Body Composition
The biggest difference between anorexia and bulimia is that someone with anorexia is often severely underweight whereas someone with bulimia might be a normal weight or even overweight. The body composition will look slightly different as well since body shape and weight can fluctuate severely with bulimia compared to anorexia.
B. Nutritional Deficiency and Health Risks
Those with binge eating disorder are at a high risk of nutritional deficiencies because their body doesn’t absorb nutrients due to the binging activities. There are similar risks of nutritional deficiencies from malnutrition associated with anorexia.
C. Organ Damage and Long-Term Effects
With anorexia, the long term effects have to do with severe malnutrition. Many people with anorexia also struggle with excessive levels of physical activity and this can be difficult on long-term health as well.
Those who have anorexia are 18 times more likely to be at risk of suicide with studies finding that between one quarter and one third of individuals with anorexia have attempted suicide.
Those with bulimia are at a higher risk of being overweight and dealing with significant damage to their body as a result of binging and purging including things like:
- Problems stimulating bowel movements
- Fractal prolapse
- Gastrointestinal issues
- Cardiac and skeletal myopathies
- Cardiac arrhythmias
- Gastric rupture
- Esophageal tears
- Fluid and electrolyte disturbances
- Emotional distress
- Nutritional deficiencies
Some of the symptoms happen over the course of several years while others can be fatal.
The Mental Difference Between Anorexia and Bulimia
What is the difference between bulimia and anorexia mentally?
A. Control and Food Behaviors
One difference between anorexia and bulimia is that anorexia control and food behaviors have to do with restricting food intake to start. There are also regular techniques used to evaluate size like:
- Frequent weighing
- Obsessively measuring different parts
- Using a mirror to obsessively check the parts they believe are “too fat”
In most cases someone with anorexia will work to restrict calories by starvation.
That said, the biggest difference between anorexia and bulimia as far as control is concerned is that someone with bulimia will often use a binge-purge cycle where they control weight by overeating and then purging with things like:
- Vomiting
- Laxatives
- Excessive exercise
Those who have bulimia focus more on overeating and then purging the excess calories.
B. Body Image and Self-Perception
Individuals with anorexia are consumed with distorted self-perception. So when they look in the mirror, they feel they are entirely overweight, or that certain parts of them like their thighs, abdomen, or buttocks are “too fat.”
Someone with bulimia may feel like they have a lack of control over their eating and in many cases they are ashamed and try to hide the patterns.
C. Emotional Patterns and Triggers
One big difference between bulimia and anorexia is that people with bulimia struggle with triggers that are interpersonal like negative feelings related to their body weight, stress, depression, boredom, among others.
Can You Have Anorexia and Bulimia at the Same Time?
Yes, you can have anorexia and bulimia at the same time. However, the more likely diagnosis is someone with anorexia who also has binge-purging behaviors.
Co-Occurring Disorders
There are several co-occurring disorders for each. Those with anorexia are more likely to develop co-occurring disorders including anxiety, depression, and bipolar disorders. They are also at a higher risk of alcohol use disorder and substance abuse disorder.
Those with bulimia nervosa are more likely to experience frequent symptoms of depression or bipolar disorder as well as anxiety disorders. The lifetime prevalence of substance abuse disorders reaches 30% of those with bulimia. There’s also a higher risk of substance abuse as individuals use stimulants to control their weight.
Mental Health Risks of Co-Occurring Disorders
For those who are seriously underweight with anorexia, there is a risk of depression including:
- Irritability
- Insomnia
- Social withdrawal
- Social withdrawal
There is also a risk of OCD features, often related to food such as preoccupation with thoughts of food, hoarding food, or collecting recipes.
It is important to note that those with anorexia and binge-purging behaviors are more likely to have issues with impulsivity, including substance abuse.
Those who have bulimia are also more likely to develop frequent depressive symptoms like low self-esteem and bipolar and depressive disorders. This often starts as mood disorders which develop around the same time as bulimia.
Treatment Options for Anorexia and Bulimia
The right type of treatment for anorexia and bulimia will include a combination of psychotherapy or talk therapy, medical interventions in some situations, and support systems for long-term recovery.
Medical Interventions
At first, medical interventions might be required to prevent the disorder from getting worse or to tackle related physical health issues.
Psychotherapy for Anorexia and Bulimia
The most common therapies for anorexia and bulimia are CBT and DBT, geared toward eating behaviors.
Support Systems and Recovery
From there, the best type of support systems for long-term recovery involve family members as well as eating disorder specific support groups.
Conclusion
Can you have anorexia and bulimia at the same time? Yes, people with anorexia can present with binge purge behavior similar to bulimia. If you are struggling with either, it’s important to understand the differences between the two and to seek proper treatment after a professional diagnosis. It is important to seek treatment early and remember that recovery is possible with the right support and medical care.