Anorexia nervosa is diagnosed when patients weigh at least 15 percent less than the normal healthy weight expected for their height. Hallmarks of anorexia include:
- Limited food intake
- Fear of being “fat”
- Problems with body image or denial of low body weight
People with anorexia nervosa don’t maintain a normal weight because they refuse to eat enough, often exercise obsessively, and sometimes force themselves to vomit or use laxatives to lose weight. Over time, the following symptoms may develop as the body goes into starvation:
- Menstrual periods cease
- Osteopenia or osteoporosis (thinning of the bones) through loss of calcium
- Hair/nails become brittle
- Skin dries and can take on a yellowish cast
- Mild anemia; and muscles, including the heart muscle, waste away
- Severe constipation
- Drop in blood pressure, slowed breathing and pulse rates
- Internal body temperature falls, causing person to feel cold all the time
- Depression and lethargy
Although they may frequently diet and vigorously exercise, individuals with bulimia nervosa can be slightly underweight, normal weight, overweight or even obese. But they are not as underweight as people with anorexia nervosa. Patients with bulimia nervosa binge eat frequently, and during these times sufferers may eat an astounding amount of food in a short time, often consuming thousands of calories that are high in sugars, carbohydrates and fat. They can eat very rapidly, sometimes gulping down food without even tasting it.
Their binges often end only when they are interrupted by another person, or they fall asleep or their stomach hurts from being stretched beyond normal capacity. During an eating binge sufferers feel out of control. After a binge, stomach pains and the fear of weight gain are common reasons that those with bulimia nervosa purge by throwing up or using a laxative. This cycle is usually repeated at least several times a week or, in serious cases, several times a day.
Many people don’t know when a family member or friend has bulimia nervosa because people almost always hide their binges. Since they don’t become drastically thin, their behaviors may go unnoticed by those closest to them. But bulimia nervosa does have symptoms that should raise red flags:
- Chronically inflamed and sore throat
- Salivary glands in the neck and below the jaw become swollen; cheeks and face often become puffy, causing sufferers to develop a “chipmunk” looking face
- Tooth enamel wears off; teeth begin to decay from exposure to stomach acids
- Constant vomiting causes gastroesophageal reflux disorder
- Laxative abuse causes irritation, leading to intestinal problems
- Diuretics (water pills) cause kidney problems
- Severe dehydration from purging of fluids
Bulimia can lead to rare but potentially fatal complications including esophageal tears, gastric rupture, and cardiac arrhythmias.
Binge Eating Disorder
People with binge eating disorder have episodes of binge eating in which they consume very large quantities of food in a brief period and feel out of control during the binge. Unlike people with bulimia nervosa, they do not try to get rid of the food by inducing vomiting or by using other unsafe practices such as fasting or laxative abuse. The binge eating is chronic and can lead to serious health complications, particularly severe obesity, diabetes, hypertension and cardiovascular diseases.
Binge eating disorder involves frequent overeating during a discreet period of time (at least once a week for three months), combined with lack of control and associated with three or more of the following:
- Eating more rapidly than normal
- Eating until feeling uncomfortably full
- Eating large amounts of food when not feeling physically hungry
- Eating alone because of feeling embarrassed by how much one is eating
- Feeling disgusted with oneself, depressed or very guilty afterward
Binge Eating Disorder also causes significant distress.