Anorexia vs Bulimia
Anorexia and bulimia are two common eating disorders. They both result in poor calorie intake. In anorexia, the poor caloric intake is due to inadequate eating. In bulimia, the patient vomits soon after a meal without allowing for digestion and absorption. There are many similarities as well as differences between anorexia nervosa and bulimia nervosa, and which is discussed here in detail.
Anorexia nervosa is characterized by fear of weight gain, unreasonable and unhealthy restriction of food, most commonly associated with rapid weight loss. Due to abnormal perception of body image, they are obsessed at having a thin figure. The incidence of anorexia nervosa is 1% in females and 0.1% in males. It affects mostly young adult females between 15 and 20 year of age. Anorexia nervosa is actually a misnomer. Anorexia means a loss of appetite while patients diagnosed with anorexia nervosa do not have a loss of appetite, but they limit the food intake excessively in fear of weight gain. They only appear to have no appetite.
Bulimia nervosa is characterized by episodes of eating large amounts of food rapidly and trying to rid oneself of the food they consumed, by vomiting, laxatives, exercise, stimulants or diuretics. This condition was first described and recorded by a British psychiatrist. There is a lack of data on the prevalence of bulimia because of the difficulty in detecting cases. Studies available thus far have produced the wide range of figures. According to available data, female of low income families are at a higher risk of having bulimia. Individuals who love dancing, gymnastics, ballet, and athletics have a higher risk of getting bulimia.
Similarities Between Anorexia and Bulimia
• Anorexia nervosa and bulimia nervosa are both commoner in females than in males.
• Individuals with both anorexia and bulimia may complain of feeling very cold. This is due to loss of body fat. The fat tissue in the skin helps regulate the body temperature by insulating the body against heat loss.
• Severe anorexia nervosa may cause a drastic drop in blood pressure.
• Due to poor circulation in hands and feet they feel cold to touch.
• There is poor nail and hair growth in both anorexia nervosa and bulimia. Nails are rapidly growing skin appendages. Considerable amount of energy and nutrients are required in the nail and hair growth due to the associated rapid cell divisions and maturation. Due to restriction of food the daily requirements of these micronutrients and macronutrients are not met. Therefore, nails and hair grow slowly.
• The excessive strain in the body due to long standing lack of adequate caloric intake in both anorexia and bulimia may be the earliest cause of irregular menstruation. Because menstrual cycle has a cerebral cortical control, stress, emotional upheaval may also cause menstrual irregularities. Chronic malnutrition will cause disruptions of follicle maturation in the ovaries. This leads to irregularities in plasma oestrogen and progesterone levels throughout the menstrual cycle.
• There are a number of skin features associated with anorexia and bulimia, caused by severe chronic inadequate nutrition. They can get fungal infections on finger webs (inter-digital intertrigo), red slightly elevated (popular) rash, early loss of hair and lack of hair growth (telogen effluivium), bluish discoloration of fingers, toes and sometimes face (acrocyanosis), painful and tender nail condition called paronychia, yellowish or orange discoloration of palms and soles (carotenoderma), itching all over the body (pruritus), acne, stretch marks on the skin (striea distensea), darkening of skin (hyperpigmentation), purplish reticular mottled appearance of skin (livedo reticularis), wounds on corners of the mouth (angular stomatitis), dermatitis around mouth, eyes, ears, anus and limbs (acrodermatitis enteropathica).
• Bad breath is a common complication of both anorexia nervosa and bulimia nervosa, although the mechanism is different.
• Depression is the most commonly encountered psychiatric condition in both anorexia nervosa and bulimia nervosa.
Differences Between Anorexia and Bulimia
• Anorexic patients do not eat while bulimic patients eat, but try to purge using various methods.
• Anorexic patients have a distorted body image perception while bulimics do not. They just use extreme methods to stay thin.
• Anorexic patients do not use purging methods while bulimics do. There are many purging methods in use. Most commonly used method is vomiting. Mostly, people just insert a finger into the throat to trigger the gag reflex and induce vomiting. Some use salt water. Excessive unsafe use of laxatives is another method. Rigorous exercise is also a known method of purging.