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The distinctions between eating disorders can be confusing. While anorexia and bulimia may have some issues in common, other factors make them distinct. For parents, understanding the differences can be crucial, as early detection and proper treatment significantly improve the chances a child will recover. Following is information to help distinguish between the two.
Definition:
Anorexia is more common in teenagers, while bulimia is more often seen in women in their 20's. However, don't make the mistake of thinking there is a set age for either of these diseases. Here are differences between anorexia and bulimia based on the American Psychiatric Association's definition:
Bulimia Nervosa
• Recurrent episodes of binge eating (minimum average of two binge-eating episodes a week for at least three months).
• A feeling of lack of control over eating during the binges.
• Regular use of one or more of the following to prevent weight gain: self-induced vomiting, use of laxatives or diuretics, strict dieting or fasting, or vigorous exercise.
• Persistent over-concern with body shape and weight.
Anorexia Nervosa
• Refusal to maintain weight that's over the lowest weight considered normal for age and height.
• Intense fear of gaining weight or becoming fat, even though underweight.
• Distorted body image.
• In women, three consecutive missed menstrual periods without pregnancy.
Signs & Symptoms:
While both disorders focus on an obsession with thinness, anorexics display noticeable, often severe weight loss while bulimics usually maintain a healthy weight. Here are other signs and symptoms of these two eating disorders:
Anorexia
• Avoids eating
• Exercises excessively
• Weighs food and counts calories
• Wears baggy clothes
• Takes diet pills
• Has dry skin and thinning hair
• Has fine hair on other parts of body
• Acts moody or depressed
• Feels cold
• Has frequent sensation of dizziness
Bulimia
• Has a puffy face
• Exercises excessively
• Has swollen fingers
• Has cuts and calluses on the back of the hands and knuckles
• Discoloring or staining of teeth
• Goes to the bathroom a lot after eating (to purge)
Health Issues:
Both disorders can cause severe health issues. Bulimia damages the digestive system and can affect electrolyte balances, which in turn damages organs. The starvation of anorexia causes the body to slow down to preserve energy, which in turn has adverse consequences. In extreme cases, both can lead to death. Other health issues include:
Anorexia
• Reduction of bone density
• Cessation of menstrual periods
• Fatigue
• Depression
• Irregular heart rate, leading to possible heart failure
• Mild anemia
• Muscle loss
• Possible kidney failure due to dehydration
• Low blood pressure
Bulimia
• Possible rupture of the esophagus due to frequent vomiting
• Fatigue
• Depression
• Stomach pains
• Irregular heart rate, leading to possible heart failure
• Constipation
• Tooth decay from stomach acid
Treatment:
When seeking treatment, parents may find their child resists admitting they are ill. In dealing with a child suffering from an eating disorder, treatment for involves a team of specialists: doctors, dieticians, and therapists. Self-help groups and treatment centers are also effective. Following are treatment goals and options for anorexia and bulimia, based on recommendations from the National Institute of Mental Health:
Anorexia: The treatment of anorexia has three main phases:
• Restore weight loss
• Treat psychological issues such as depression, self-esteem, and interpersonal conflicts
• Achieve long-term recovery and remission
The use of anti-depressants for treating anorexia should be considered only after weight gain has been established.
Bulimia: The main goal in the treatment of bulimia is to eliminate binging and purging.
• Establish healthy and consistent eating habits, i.e. three meals a day at regular times
• Encourage healthy, not excessive, exercise
• Treat psychological issues such as mood or anxiety disorders
The use of anti-depressants for treating bulimia has been shown to be helpful for those with bulimia and may help prevent relapse.
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