Anorexia's Sisters: Bulimia and BED, Part I - Page: 2

No discussion of anorexia nervosa can be complete without at least touching on the other two major eating disorders: bulimia nervosa and binge eating disorder (BED). While the focus of these pages is, and will continue to be, female anorexia, this overview is intended for those suffering from any of these disorders, or combination thereof, as well as interested researchers and medical providers.

In her article, "Eating Disorders: An Overview of Anorexia, Bulimia, and Compulsive Over-eating," Linda Ciotola, M.Ed., C.H.E.S. synthesizes a common profile of these conditions. All result from the complex interactions of biological, psychological, and social factors. All involve an obsession with food, weight, and physical appearance. Although they usually affect adolescent females, no age group or sex is immune.

According to Ciotola, the disorders are often the outgrowth of dieting among girls trying to attain a cultural ideal of slenderness. All respond to multi-disciplinary treatment with an emphasis on psychotherapy. On the biological side, research indicates that many sufferers have imbalances of brain chemicals known as neurotransmitters. This situation can often be corrected with anti-depressant or other medications. However, getting the person into treatment is a major stumbling block because the illnesses are defense mechanisms to avoid facing intensely painful emotional problems.

All of these illnesses are self-destructive behaviors which can, and do, result in death. The sooner the sufferer gets treatment, the greater her chances for recovery.

There are a variety of support groups on the internet for sufferers of all stripes. One of the most popular newsgroups for people with all types of eating disorders is alt.support.eating-disord.

Bulimia Nervosa

The American Anorexia Bulimia Association (AABA) notes that bulimia is usually characterized by frequent binge eating (enormous food consumption in one sitting) followed by purging. According to AABA, bulimics purge by vomiting and abusing laxatives, enemas or diuretics. The Academy for Eating Disorders calls these bulimics "purging types." According to the Academy, non-purging bulimics follow their binges with compulsive exercise or fasts.

Similarly, the Academy observes the existence of purging and non-purging subtypes in anorexia. The diagnosis of anorexia, binge/purging type, is problematical because of its resemblance to bulimia. According to the Academy, if a patient simultaneously meets criteria for both anorexia and bulimia, she is diagnosed as an anorexic, binge-purging type.

According to literature in an AABA press kit, 50% of anorexics are also bulimic, and 20% of bulimics have had a history of anorexic episodes. The National Eating Disorders Organization (NEDO), estimates that one-third of anorexics develop bulimia.

AABA estimates that 5% of American college women are bulimic. According to the Eating Disorders Resource Centre, 80-90% of all bulimics are female.

According to AABA, depression and tooth decay are hallmarks of both anorexia and bulimia. However, American WholeHealth observes it is easier for the bulimic to hide her condition because, unlike the skeletal anorexic, she is usually of normal or near-normal weight. And, according to AABA, only the bulimic will have characteristic swollen glands in the neck and face, giving her a chipmunk-like appearance.

AABA lists these medical consequences of bulimia, which are remarkably similar to those of anorexia:

• dehydration
• damage to bowels, liver and kidney
• electrolyte imbalance
• cardiac arrest

Like the anorexic, the bulimic often feels out of control. However, unlike the anorexic (who is usually in denial for a prolonged period), she quickly recognizes she has a problem. However, because the bulimic seeks to hide her condition, she can be as difficult as the anorexic to get into treatment.

The social behavior of anorexics and bulimics is very different. Ciotola notes that unlike the asexual, isolated anorexic, bulimics tend to be promiscuous. This trait reflects an inability of the sufferer to control her impulses.

According to The Eating Disorders Site, antidepressants such as fluoxetine (Prozac), is an effective treatment for bulimia. According to the Site, bulimics have abnormal amounts of serotonin, a neurotransmitter in the brain. As I noted in The Genetic Link, Prozac is also effective on anorexics.

While anorexics have excess serotonin, bulimics do not seem to have enough. According to a February 1999 UPI story reported on HealthNetwork.com, British researchers, writing in the American Medical Association's Archives of General Psychiatry, found that recovered bulimic females whose brain serotonin was lowered experienced recurrences of some symptoms.