Anorexia Vs. Bulimia: What Are The Differences?

Medically reviewed by Melissa Guarnaccia, LCSW
Updated October 10, 2024by BetterHelp Editorial Team

Anorexia and bulimia may be used in social conversation without understanding their meaning. Some people might be confused about the differences between these two disorders or have misconceptions based on myths they've seen in the media. Although anorexia and bulimia can overlap in symptoms, they are distinct conditions with unique manifestations. Consider learning more about both conditions to reduce the chances of unhelpful symptoms.

This article explores the differences between anorexia and bulimia in addition to similar symptoms like poor body image and an intense fear of weight gain. We’ll also cover resources to help individuals seek mental health support for diagnosis and treatment of anorexia, bulimia, and other eating disorders. 

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Understanding eating disorders 

Anorexia and bulimia are both eating disorders listed in the DSM-5, the current diagnostic manual by the American Psychological Association (APA). Each can affect an individual's eating habits in unique ways, and both are serious conditions that can have potentially dangerous symptoms. Eating disorders often involve mental and physical health concerns. While a doctor may help with the physical effects or hospitalization, a therapist might be called to support an eating disorder's psychological aspects. 

Though many associate eating disorders with people of a specific age or gender, anorexia, bulimia, and other eating disorders can affect anyone of any gender or age. Though these conditions may be more common in teens and young adults, someone can develop or be diagnosed with an eating disorder at any point. In addition, once an eating disorder occurs, it could return at any point in the individual's life.

It can also be common for an eating disorder to occur alongside another mental illness, like an anxiety disorder, substance use disorder, or depressive disorder. One resource found that 50% to 75% of people with an eating disorder also live with depression. However, outside of this connection, other factors may also impact the development of an eating disorder. Genetics, a dysfunctional family dynamic, pressure to maintain a certain body weight or shape, past trauma, peer pressure, and media exposure can also cause eating disorders.

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

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Signs of an eating disorder 

The signs of an eating disorder can differ depending on the condition. However, not everyone with an eating disorder may lose or gain weight while experiencing one. People with any eating disorder can have a larger body size or remain at an "average" weight. Keeping an eye out for other factors besides body shape can be beneficial in recognizing an eating disorder before it potentially progresses.

Visible signs of an eating disorder may include visible weight changes for some people. Whether those weight changes are an increase or a decrease in weight, they may be associated with health risks. In addition, continuous dieting, counting calories and fat content, and weight tracking could be signs of an eating disorder. 

Someone who eats ritualistically by cutting their food into tiny bites, eating by themselves, or hiding the food they eat, may be showing signs of an eating disorder. Some people cook elaborate or expansive meals for others but won't eat them themselves. Consider seeking support if you notice these behaviors in yourself or someone else. 

Other potential signs of an eating disorder could include the following: 

  • Periods of fasting

  • Periods of overeating or binge eating

  • Fluctuations in weight 

  • Depression

  • Lethargy 

  • Withdrawal from social situations

  • Wearing loose and baggy clothing 

  • Hiding body parts

  • Expressing shame about one's body

  • Asking for reassurance about one's loss of weight 

Note that someone may exhibit a mixture of these symptoms or experience other symptoms entirely. Consult a doctor or mental health professional if you or someone you love might be living with an eating disorder. 

Anorexia vs. bulimia

Below are a few differences between anorexia and bulimia and their symptoms and impacts. 

What is anorexia? 

Anorexia nervosa is often one of the most well-known eating disorders in the public eye. However, the condition involves more than "being thin" or dieting. Those with anorexia nervosa severely limit their food consumption to lose weight. These individuals might believe they are overweight or unattractive, including when they are underweight. They might use dieting, exercise, and other means to reduce their need to eat. 

People with anorexia may develop an obsession with their body or ritual to cope with a fear of gaining weight. As a result, they may partake in any possible activity they believe will stop them from gaining weight. Someone with anorexia can become dangerously underweight and may experience brain damage, organ failure, bone loss, infertility, heart problems, and death. 

Note that anorexia can present in unique ways, and many people with this condition may partake in food-restrictive behaviors but not lose weight or initially show signs of a medical emergency. Looking at someone's weight may not be the first symptom used in diagnosis, as the mindset behind the condition can be more telling. 

What is bulimia? 

Bulimia nervosa is like anorexia because it can involve an obsession with weight and a desire to lose weight to achieve a specific body size. However, with bulimia, there are periods of binging and purging, which means that the person may go through a period where they eat excessive food and purge by using exercise, medications, or vomiting to expel the food from their body. 

People with bulimia may keep these behaviors a secret, binging and purging when they believe it will not be noticed. This behavior can increase their guilt and shame about the disorder and their actions. Because of excessive binging and purging, these individuals can be any weight, like those with anorexia. For this reason, other symptoms might be considered first. 

For those with bulimia, health problems can also occur, including gastrointestinal distress (due to forced vomiting or self-medication), heart problems, and dehydration.

How to receive support for an eating disorder 

No matter the eating disorder you or a loved one may be living with, reaching out for support can be essential to reduce the risk of serious symptoms. Even someone who has only recently started purging or skipping meals could be damaging their body, and getting help quickly could offer prevention to these risks. Early on, damage may be reversible, but eating disorders may cause irreversible harm as they progress.

Several forms of treatment may benefit those with an eating disorder, including but not limited to the following:

  • Inpatient eating disorder rehabilitation 

  • Inpatient hospitalization

  • Outpatient eating disorder clinics

  • An eating disorder support group, online or in person

  • A therapist specializing in eating disorders

  • Nutritionists with experience working with eating disorders

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Alternative support options 

A physician or your family doctor can start treatment for physical symptoms or impacts of an eating disorder. However, a therapist may offer the most effective support for the underlying psychological concerns. If you're nervous about seeking in-person guidance or want cost-effective eating disorder treatment, alternative forms of therapy like online counseling through a platform like BetterHelp may be beneficial. 

Online therapy can have unique benefits compared to in-person options. You can connect with someone from wherever you are and whenever you need them, which might reduce embarrassment or shame for some individuals. Research indicates that people with anorexia and bulimia are more likely to have other mental health conditions like anxiety, depression, and mood disorders.

Studies show that online therapy can lead to a 50% improvement in symptoms of generalized anxiety disorder, depression, and other mental health conditions. Although more research is needed, some studies show that online therapy can effectively treat bulimia

Takeaway

Anorexia and bulimia are two different eating disorders, though some symptoms overlap. If you or someone you know shows signs of an eating disorder, consider reaching out for support. Treatment often focuses on both mental and physical symptoms. You can contact a therapist online or in your area for further guidance and support.
Healing from eating disorders is possible
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