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What Is Anorexia? What Is Bulimia? How Are the Two Similare, If They Are, and How Do They Differ?

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In this essay similarities and the differences between anorexia nervosa and bulimia nervosa are considered. Similarities in the explanations of the two eating disorders are discussed through psychodynamic, behavioural, genetic and biochemical explanations.

Anorexia nervosa is a complex emotional problem characterized by an obsession with food, weight, and thinness. Victims actually starve themselves, eating fewer calories than their bodies need to function.

According to the current diagnostic manual of the American Psychiatric Association (DSM-IV), a woman is suffering from clinical anorexia, not just dieting or fasting, when her weight has fallen to 15% below the normal range and she has not menstruated for at least three months. Sometimes the diagnosis is made because of drowsiness and lethargy that are affecting her work. Other symptoms are dry skin, brittle nails and hair, lanugo (fine downy hair on the limbs), constipation, anemia, and swollen joints. The level of female hormones in the blood of an anorectic woman falls drastically, and her sexual development may be delayed. Her heart rate and blood pressure can become dangerously low, and loss of potassium in the blood may cause irregular heart rhythms. Over a 10-year period, about 5% of women diagnosed as anorectic die, mainly from infections or cardiac failure.

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The differences and the similarities in the symptoms of the two eating disorders are plain to see, but what are far more difficult to distinguish between are the explanations and the causes of these two disorders.

Unfortunately because of the way that these two disorders overlap each other most research that has gone into this area, places them both under one umbrella called eating disorders. Most explanations are applied to both making none or very little distinction between them. This to be fair is not for no good reason and without reasonable basis.  T Van Der Ham et al studied variations and differences in the path of illness in a 4-yr follow-up study of 25 anorexic and 24 bulimic teenagers. Participants were evaluated on the Morgan and Russell Outcome Schedule (H. G. Morgan and A. E. Haywood, 1988). 47% of the participants had good, 43% midway, and 10% bad outcome scores after 4 yrs. The groups differed as to the severity and type of eating disorder, but were similar in mental, psychosocial, and psychological symptoms during the sickness. Eight percent of the anorexic participants became bulimic. The author concluded that the 2 illnesses could be considered different symptom patterns of 1 basic eating disorder in which the obsession with food and a distorted body image are the core symptoms.

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All of the above explanations have highlighted how similar the two disorders are but there is one explanation, which shows that the causes of bulimia may be slightly different to anorexia.  This is the role of Serotonin.  Walsh et al has shown that the neurotransmitter serotonin might be the cause of bulimia.  Low levels of serotonin were found to be associated with binge eating.

Information and previous studies show that in so many ways anorexia and bulimia are very similar but there are a few differences between the symptoms and the causes.


  • www.ce5.com/anorexia.
  • www.findarticles.com
  • van der Ham, T; van Strien, Din C; van Engeland, H (1994).  A four-year prospective follow-up study of 49 eating-disordered adolescents: Differences in course of illness.  Acta-Psychiatrica-Scandinavica. Vol 90(3): 229-235.
  • Andersen, Arnold E; Hay, Andy (1985). Racial and socioeconomic influences in anorexia nervosa and bulimia. International Journal of Eating Disorders, Vol 4(4): 479-487.
  • Diaz Marsa, Marina; Carrasco, Jose Luis; Saiz, Jeronimo, (2000).  A study of temperament and personality in anorexia and bulimia nervosa. Journal of Personality Disorders, Vol 14(4): 352-359.

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