Introduction
Eating disorders are serious mental health conditions characterized by abnormal or disturbed eating habits. Two common eating disorders are Anorexia Nervosa (AN) and Bulimia Nervosa (BN). While both share certain characteristics—such as distorted body image—they differ significantly in behaviors, weight patterns, and treatment approaches.
Core Features
| Feature | Anorexia Nervosa (AN) | Bulimia Nervosa (BN) |
|---|---|---|
| Primary Behavior | Severe restriction of food intake, leading to significantly low body weight | Binge eating followed by compensatory behaviors (e.g., purging, excessive exercise) |
| Body Weight | Typically underweight (BMI < 18.5) | Usually normal weight or overweight |
| Compensatory Behaviors | Excessive restriction, exercise, sometimes purging | Purging (vomiting, laxatives, diuretics) or non-purging (fasting, excessive exercise) |
| Binge Eating Episodes | Rare or absent | Frequent (at least once a week for 3 months) |
Psychological Differences
| Psychological Feature | Anorexia Nervosa (AN) | Bulimia Nervosa (BN) |
|---|---|---|
| Body Image Distortion | Severe; often denies low weight as a problem | Significant distortion; more aware of disordered behaviors |
| Sense of Control | Feels “in control” through restriction | Feels loss of control during binges |
| Self-Esteem Impact | Almost entirely tied to weight/control over food | Strongly influenced by weight, but also affected by binge-purge cycle |
Physical Consequences
| System Affected | Anorexia Nervosa (AN) | Bulimia Nervosa (BN) |
|---|---|---|
| Cardiovascular | Bradycardia, hypotension, increased risk of heart failure | Electrolyte imbalances (e.g., hypokalemia), arrhythmias |
| Gastrointestinal | Delayed gastric emptying, constipation | Esophageal tears, acid reflux, possible gastric rupture from binging |
| Endocrine | Amenorrhea, osteoporosis, lanugo (fine hair growth) | Menstrual irregularities but not always amenorrhea |
| Oral Health | Brittle nails, dry skin, hair loss | Tooth erosion, swollen salivary glands (parotid hypertrophy) |
| Neurological | Brain atrophy, potential cognitive decline | Seizures (often due to electrolyte disturbances) |
Treatment Differences
Anorexia Nervosa (AN): Treatment is often more urgent due to the high mortality risk and severe underweight status. Key components include:
- Weight restoration and careful medical monitoring
- Psychotherapy (e.g., cognitive-behavioral therapy, family-based therapy)
- Possible inpatient or residential treatment for medical stabilization
Bulimia Nervosa (BN): Treatment focuses on interrupting the binge-purge cycle and stabilizing eating patterns. Common approaches include:
- Psychotherapy (e.g., cognitive-behavioral therapy)
- SSRIs (e.g., fluoxetine) to reduce binge-purge frequency
- Nutritional counseling and support
Overlap
Note: Both disorders can involve purging behaviors and distorted body image. Individuals with the binge-purge subtype of Anorexia Nervosa display behaviors similar to Bulimia Nervosa but maintain an underweight status.