How is Bulimia Different from Binge Eating? The Distinction

It is usual for us to be concerned about our health, weight, or appearance occasionally. After all, we are social beings and care about how we present ourselves to others. However, some people become fixated on losing weight, obsessed with body size and shape, and controlling their food intake. If these symptoms sound familiar to you, they are characteristics of an eating disorder. 

In this discussion, Twilight Recovery helps you recognize an eating disorder and how bulimia nervosa is different from binge-eating disorder. 

What are Eating Disorders?

Eating disorders are a group of serious, biologically influenced mental conditions marked by severe disturbances in feeding and eating behaviors – either eating too much or too little and concern over one’s body shape and size. 

Specifically, people with these conditions have abnormal or disordered eating and exercise patterns that interfere with daily life functions. Some may eat extremely small amounts of food, while others may eat uncontrollably. Most of the time, they feel distressed, anxious, or have apprehensions about the food they eat, their weight, and their appearance. 

Although clinical practice shows that these conditions frequently appear during adolescence or young adulthood, there are some reports that eating disorders can develop during later adulthood or even in childhood. Apart from the psychological impact that these conditions can bring, people also suffer from several physical health problems, such as cardiovascular, respiratory, or digestive problems, which can be life-threatening. 

Despite having a collective label for ‘eating’ disorders, these conditions are not simply about food. These are problems associated with one’s way of coping with a stressor or problem that an individual finds too difficult to deal with directly. They are complex illnesses that signal challenges with one’s identity, self-concept, and self-esteem, affecting equally men and women. 

What is Bulimia Nervosa?

Bulimia nervosa, usually referred to as bulimia, is a type of eating disorder where people experience recurrent episodes of eating vast amounts of food because of a lack of control over their eating habits. These binge eating behaviors are followed by ‘purging’ or behaviors that are used to compensate for overeating, such as forced vomiting, use of laxatives or diuretics, fasting, or excessive exercise to prevent weight gain. Unlike anorexia nervosa, people with this condition maintain average weight or may be overweight. 

Symptoms of Bulimia

According to the Diagnostic and Statistical Manual for Mental Disorders (DSM), to be diagnosed with Bulimia Nervosa, people should manifest the following symptoms:

• Recurrent episodes of binge eating. They eat a more considerable amount of food than most people would eat in a similar period (e.g., 2 hours) under similar circumstances. They also have a sense of lack of control over eating during the binge episode.
• They experience recurrent inappropriate compensatory behaviors to prevent weight gain. These may include either self-induced vomiting, misuse of laxatives, diuretics, and other medications, fasting, or excessive exercise. 
• Those binge eating and compensatory behaviors occur at least once a week for three months.
• Their self-evaluation is unduly influenced by body shape and weight.
• The disturbance does not occur exclusively during an episode of another eating disorder, particularly anorexia nervosa. 

What is a Binge Eating Disorder? 

This disorder is another form of feeding and eating disorder cluster characterized by loss of control over eating and having reoccurring episodes of eating substantial amounts of food. But unlike people who are suffering from bulimia nervosa, they do not manifest compensatory behaviors to prevent weight gain.  

Symptoms of Binge Eating Disorder

Some of the most common symptoms of binge eating disorder may include:

• Recurrent episodes of binge eating where people have a lack of control over eating, and they eat an amount of food that is larger than what most people would eat under similar circumstances.
• They have binge-eating episodes, either eating much more rapidly than expected, eating until feeling uncomfortably full, consuming large amounts of food even when not feeling hungry, eating alone because they feel embarrassed by how much they eat, or feeling disgusted with themselves, depressed, or very guilty after eating. 
• They experience marked distress about binge eating.
• The binge eating episodes occur at least once a week for three months.
• Binge eating is not associated with inappropriate compensatory behaviors, as in bulimia.

Similarities Between Bulimia Nervosa and Binge Eating Disorder 

Both bulimia nervosa and binge-eating can sometimes be misidentified because they share similarities in terms of symptom presentations. Specifically, people who have bulimia nervosa and binge-eating disorder both experience recurrent binging episodes where they have a lack of control in eating, and they eat a large amount of food that is significantly larger than what most individuals typically eat over a short period or under other similar circumstances.

In addition, people with binge eating disorder or bulimia have a desire to lose weight and have similar tendencies to comorbid with other mental illnesses such as anxiety and depression. 

Differences Between Bulimia Nervosa and Binge Eating Disorder

Although there are multiple areas where both bulimia and binge eating disorder are similar, several factors are also identified as to what sets them apart from each other. These include:

• Onset: The age of onset where binge eating disorder symptoms manifest is relatively earlier than those with bulimia nervosa. 
• Inappropriate Compensatory Behaviors: Unlike bulimia nervosa, people who have binge eating disorder have binge eating episodes that are not followed by compensatory behaviors (purge) to prevent weight gain.
• Weight: Considering that people with binge eating disorder do not perform inappropriate compensatory behaviors, they are usually more overweight or obese than those with bulimia nervosa. 
• Risk of Anorexia Nervosa: People with bulimia nervosa are more prone to developing anorexia nervosa than those with binge-eating disorder.

How Are Binge Eating Disorder and Bulimia Nervosa Treated?

Early detection and seeking professional help are essential for a full recovery for both binge eating disorder and bulimia nervosa. With the appropriate intervention, both these conditions can be treated successfully, and individuals grappling with these illnesses can regain their wellness. Some of the most recommended treatments include the following:

Medical Treatment 

Considering that people with these two disorders may be suffering from physical severe health-related problems that can be life-threatening if left untreated, one of the most important interventions is to carefully monitor the individual’s weight, fluid and electrolyte balance, cardiovascular health status, bone growth and development, nutrition status, and vital signs. In some cases, healthcare providers may recommend injecting intravenous fluids or may force-feed the individual to restore nutritional balance. 

Nutritional Counseling 

The primary goal of this intervention is to focus on health rather than weight. The individual may be referred to a nutritionist or a dietician to help them understand adequate nutritional needs and the importance of changing their eating behaviors. Typically, people with eating disorders are given the task of creating a food diary to track their dietary intake and become aware of triggers for bingeing. 

Psychotherapy

Psychotherapy is a form of talk therapy that helps individuals identify what causes their eating problems and what factors maintain them. It also teaches them some practical skills to help them deal effectively with triggers and stressors. Typically, therapies attempt to change the individual’s irrational thought patterns and change their unhealthy behaviors associated with binge-eating disorder and bulimia nervosa.

Healthy attitudes toward food, weight, and overall body shape and size are also emphasized in the treatment. Some of the commonly utilized types of psychotherapy for feeding- and eating-related disorders are cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT).

Medication

Although the effects of medication as a treatment for eating disorders are limited, some doctors may recommend selective serotonin reuptake inhibitors (SSRIs) medication, which are believed to reduce symptoms of eating disorders. In some cases, SSRIs can also treat co-occurring mental disorders such as anxiety and depression. 

We Treat People with Eating Disorders at Twilight Recovery

Our empathy goes to those people who are grappling with eating disorders. These conditions can be extremely overwhelming and exhausting to deal with. But know that treatments are available and recovery is possible. If you suspect or someone you know is suffering from feeding- and eating-related disorders, it is essential to seek early professional help because these conditions do not usually go away by themselves. 

To learn more about how we can help you overcome these conditions, connect with us at Twilight Recovery. Our compassionate staff is ready to assist you every step of the way.