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Similarities and Differences Between Anorexia and Bulimia

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Talya G

on 1 December 2013

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Transcript of Similarities and Differences Between Anorexia and Bulimia

Similarities and Differences Between Anorexia and Bulimia
General Information:
Diagnostic Criteria
Refuse to maintain body weight at or above minimally normal weight for age and height
Intense fear of gaining weight or getting fat, even though they are underweight
Disturbance in the way in which one's body weigh or shape is experienced, undue influence of body weight or shape on self evaluation, or denial of the seriousness of current low weight (Distorted body weight
In postmenarchal females, the absence of 3 consecutive menstrual cycles
Types of Anorexia:
Restricting Type: Individual severely restricts their intake but is not involved in binge-eating or purging behavior
Most commonly known type of anorexia
Restriction can take many forms and may follow obsessive and rigid rules
Binge-Eating/Purging Type: The individual severely restricts food intake and is regularly involved in binge-eating or purging behavior
Some anorexics view themselves as being overweight while others understand that they are underweight but view body parts associated with sexual maturity as being fat
View weight loss as a success (a sign of outstanding self discipline and control over life) and therefore view weight gain as a personal failure
View weight loss as a way to achieve happiness
General Information:
Diagnostic Criteria
Recurrent episodes of binge eating
Recurrent inappropriate compensatory behaviors to prevent weight gain (regular use of one or more of self induced vomiting, use of laxatives or diuretics, strict dieting or fasting, vigorous exercise
Binge eating and inappropriate compensatory behaviors occur on average, twice a week for two months
Self- evaluation is unduly influenced by body shape and weight
The disturbance does not occur exclusively during episodes of anorexia nervosa
Types of Bulimia:
Purging Type: Individual is regularly involved in self-induced vomiting of the misuse of laxatives diuretics or enemas
Nonpurging type: Individual has used other inappropriate compensatory behaviors such as fasting or excessive exercise but isn't regularly involved in self induced vomiting or the misuse of laxatives, diuretics, or enemas.
Over time, methods of purging become less effective
Bulimia does not necessarily involve purging (physically eliminating food from one's body throwing up or using laxatives, enemas, or diuretics). If an individual uses fasting, excess excercising or going on crash diets to compensate for binges, it also qualifies as bulimia
General Information:
Individuals with Anorexia and Bulimia are both too concerned with being fat and attempt to restrict eating
They are both eating disorders
individuals with the disorders have a fear of weight gain
Patients self worth and self evaluation is mainly based on weight and appearance
Affects approximately 1% of adolescent girls and young women
Majority of patients are female however 5-10% are male
Mainly in wealthy societies with Western Culture
more common in teenagers
Most fatal of all psychiatric illnesses: it causes starvation, malnutrition and dangerously low body weight-all of which lead to severe health problems and sometimes death
40% of individuals with Anorexia later develop Bulimia
Prevalence in women: 0.5%
Binge eating 25-50%
Mortality: 5%
Behavior (These are behaviors that some anorexics have but do not necessarily apply to all individuals with the disease)
Frequently check body size through frequent weighing, measuring, pinching, or trying clothes on and looking in the mirror
Willful Starvation
Dieting despite being thin (follow severely restricted diet, eat only low calorie foods, ban "bad" foods)
Pretending to eat or lying about eating (hiding, playing or throwing away food to avoid eating it or making excuses to get out of meals)
Avoids eating most foods, especially carbohydrates and fats
Strange or secretive food rituals( refusing to eat in the company of others, cut food into small pieces to control intake, or eating in rigid, ritualistic ways)
Weigh food and count calories
Obsession with calories, fat grams and nutrition (Reading food labels, measuring and weighing portions, keeping a food diary, reading diet books etc.)
Wear baggy clothes
In the first stages of anorexia, anorexics tend to become increasingly concerned with dieting, isolate themselves, and focus on work or studies
After a while may become irritable and develop obsessional rituals
Eventually decreased alertness and concentration
Secretive behavior surrounding eating or exercising
Sometimes: Obsessive interest in cooking or preparing food for others
Aggressive if forced to eat forbidden foods
Sensitive to references about appearance
Anorexics often deny that they have the disorder
Effect on health
Dry or chapped lips
Languo ( Growth of fine hair all over the body to promote warmth
Brittle fingernails
Bruising easily
Muscle loss
Reduction of bone density
Constantly feels cold
Headaches or fainting
Possible kidney failure due to dehydration
Kidney stones
Poor circulation resulting in pins and needles and/or purple extremities
Decreased libido, Impotence in males
Anaemia (Iron deficiency)
Oedma (Retention of fluid that may give a "puffy appearance
Stunting of height and growth
Zinc Deficiency
Reduction in white blood cell count
Reduction in immune system function
Vitamin Deficiency and altered thyroid metabolism
Weight Gain: Due to the effects of starvation it is important to ensure that the patient maintains a healthy weight
Nutritional counseling on how to eat regular and balanced meals
Hospitalization may be needed to monitor food intake
Allows the patient to examine the possible causes of their disease
Attempts to help patient eliminate dissatisfaction with their body
Attempt to teach patient how to deal with difficult emotions, relationship problems and stress in a a productive way instead of a self destructive way
Most effective form of psychotherapy for Anorexia Nervosa is family therapy in which the family members of the patients re consulted by the psychiatrist along with the patient
There are some anti-depressants that can be used to control patients preoccupation with body weight, however the use of anti-depressants should only be considered after weight gain has been established
Important to adress and stabilize any serious heath issues. Hospitalization may be necessary if patient is seriously malnourished or no longer wants to live
Behavior(These are behaviors that some bulimics have but do not necessarily apply to all individuals with the disease)
Because of prolonged dieting, patients may begin to experience intense hunger or craving for food (usually food that is sweet or high in fat)
This is because when a person starves themselves their body reacts with powerful cravings as a way to ask for needed nutrition
Begin to eat an find it hard to stop
After eating for up to several hours, patients begin to feel guilty or uncomfortable so they use self-induced vomiting, laxative or diuretic abuse, or self starvation to attempt to rid their body of the food they have consumed.
Repeat this cycle from several times a week to several times a day
In most cases patients are secretive about their illness
Patients can become dependent on the chemicals they use in the binge cycle (e.g. laxatives, diuretics, and diet pills). Some are also dependent on alcohol.
Goes to the bathroom a lot after eating to purge
Food avoidance or dieting behavior
Excessive exercise
Secretive with things related to their disease
Mood swings
Can use vomiting, laxative abuse, insulin abuse, or diuretic abuse (individuals with Anorexia use these methods to control food intake and individuals with bulimia use these methods for compensatory behavior)
Self harm
Substance abuse
Suicide attempts
Overly sensitive to references about weight or appearance
Become obsessed with weight and shape of their bodies
compulsive behaviors to check weight like repeatedly weighing themselves, pinching themselves or looking in the mirror
Effect on health
Hair loss
Dry Skin
Irregular heart rate, leading to possible heart failure
Affect electrolyte levels
Tooth Decay
Amenorrhea (cessation of menstrual cycles)
Abdominal pain
Low blood pressure
Mood Swings
Low self esteem
Fear of gaining weight
Often leads to social withdrawal or isolation
Effect on health
Damages digestive system
Potassium loss
Damage to the throat, esophagus and stomach
Stomach and intestinal ulcers
Inflammation and rupture of the esophagus
Possibility of ruptured stomach
Erosion of dental enamel from vomiting
Swollen salivary glands and cheeks
Chronic sore throat and gullet
Dental decay
Back pain
Puffy face and swollen fingers and feet
Chronic sore throat, hoarseness
Broken blood vessels in the eyes
Calluses or scars on knuckles or hands from sticking fingers down the throat to induce vomiting
Fluctuation in weight, however an individual with Bulimia usually keeps an average weight or slightly above or below average weight (This makes the disease harder to recognize than Anorexia)
Stomach pains
Many patients resist treatment becuase they fear weight gain
Involves a team of specialists including doctors, dieticians, and therapists
Nutritional counseling to teach patients how to eat healthy meals in order to maintain body weight
Psychotherapy: Aims to treat the psychological problems associated with eating disorders such as low self esteem, isolation, perfetionism and depression
Patients should stay away from people, places and activities that trigger old habbits
Breaking the binging and purging cycle
Nutritional counseling:
Prescribe a nutritional diet
Encourage healthy not exessive exercise
Treatment is more likely to succeed if the patient agrees to stop dieting. Once patient stops trying to restrict calories and follow strict dietary rules, they will no longer be overwhelmed with cravings ant thoughts of food.
Helps patient understand destructive nature of symptoms
Helps patient develop healthier thoughts and behaviors
There are some antidepressants that can be used tocontrol depressive symptoms and the urge to binge
Most effective form of treatment for Bulimia Nervosa is cognitive and behavioral therapy along with antidepresants
More common than Anorexia
Affects about 5% of females in Western countries between the ags of 15-35
More common in women in their twenties
About 1-4% of people in the United States suffer from Bulimia
Mortality is very low and often sudden due to arrythmias induced by electrolyte abnormalities
Prevalence in women: 1-3%
Binge eating is required for diagnostic
Can be developed at any age for both males and females
In the United states 2-6% of people (5-16 million people) are affected with anorexia or bulimia
Possible Causes
Begins with a desire to loose weight that turns into a preoccupation with weight loss
Anorexics often have a history of being a perfectionist, over achiever, introverted, having poor peer relations, and battling with low self esteem
Anorexia is a complex condition that arises from a combination of various social emotional and biological factors
Emotional difficulties
Traumatic experiences from the past
Family and social pressures
Family environment-having parents who are overly controlling, put a lot of emphasis on looks, diet themselves or criticize their children's bodies and appearance
Stressful life events such as a breakup or going away to school
Research suggests that a genetic predisposition to anorexia runs in the family (individuals with a sibling with anorexia are 10-20 times more likely to develop anorexia
Brain chemistry-people with Anorexia tend
Individuals are concerned about their weight and resort to extreme methods in order to lose weight
May develop disorder as a way of dealing with difficult emotions
Low self esteem
Concerns about weight and body image
Poor body image: Our culture's emphasis on thinness and beauty can lead to body dissatisfaction, especially in young women who are constantly exposed to media images with and unrealistic physical ideal
Major life changes that can be stressful such as the physical changes of puberty, going away to college or the break up of a relationship
Participation in activities that demand slenderness or are appearance oriented (e.g. ballet, gymnastics, modeling, acting)
Patients are preoccupied with a feeling of being fat and begin to diet
May develop this behavior as a way of dealing with feelings of anxiety, stress or anger or as a way of dealing with happy times
Triggers for bulimia include
dissatisfaction with body
Prolonged dieting
Dysmorphic mood such as depression,, anxiety, irritability, sadness and restlessness
Familial and interpersonal stress
History of trauma or abuse (wmen with bulimia have a higher incidence of sexual abuse
Distorted body image
Pre-occupation or obsessive thoughts about food
Refusal to accept that weight is dangerously low
Thoughts about dieting, food and your body dominate most of the day, leaving little time for friends, family and other activities patients used to enjoy
Difficulties with activities which involve food
Deceptive behaviors relating to food
Fear of disapproval of others if they find out about the illness
Guilt, shame, self disgust, self losing
Reluctance to develop personal relationships

How to help an anorexic person
Encouraging a family member or friend to get tretement is the most caring and supportive thing you can do
Waving articles about the serious effects of anorexia or exclaiming that the anorexic will die if they don't eat probably wont work so instead you should gently express your concerns and let them know that you are there to listen to them
Don't act like the food police: a person who has anorexia needs compassion and support, not an authority figure standing over the table with a calorie counter
Avoid threats, angry outbursts, and put downs
How to help
Think of yourself as an "outsider." You are not someone suffering from and eating disorder so you can't do anything to "solve your loved one's anorexia, it is ultimately the individuals choice to decide when they are ready
Avoid insults or scare tacticts
Be a role model for healthy eating, exercising and body image
Listen to the person with the disorder without judgement and let them know you care
Don't make negative comments about your own body or anyone elses
How to help
Offer compassion and support
Avoid guilt trips and patronizing comments
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