Is there a difference?

厌食症and bulimia are both eating disorders. They can have similar symptoms, such as distorted body image. However, they’re characterized by different food-related behaviors.

For example, people who have anorexia severely reduce their food intake to lose weight. People who have bulimia eat an excessive amount of food in a short period of time, then purge or use other methods to prevent weight gain.

Although eating disorders aren’t specific to age or gender, women are不成比例地affected by them. About 1 percent of all American women will develop anorexia, and 1.5 percent will develop bulimia, according to theNational Association of Anorexia Nervosa and Associated Disorders (ANAD).

全面的，一个广告估计至少有3000万美国人与厌食症或贪食症等饮食障碍一起生活。

Keep reading to learn more about how these conditions present, how they’re diagnosed, available treatment options, and more.

Eating disorders are usually characterized by an intense preoccupation with food. Many people who have an eating disorder also express dissatisfaction with their body image.

Other symptoms are often specific to the individual condition.

厌食症

厌食症often stems from a distorted body image, which may result from emotional trauma,depression, oranxiety. Some people may view extreme dieting or weight loss as a way to regain control in their lives.

There are many different emotional, behavioral, and physical symptoms that can signal anorexia.

The physical symptoms can be severe and life-threatening. They include:

  • severe weight loss
  • insomnia
  • dehydration
  • 便秘
  • 弱点和疲劳
  • dizziness and fainting
  • thinning and breaking hair
  • bluish tinge to the fingers
  • 干燥，淡黄色皮肤
  • inability to tolerate cold
  • amenorrhea, or absence of menstruation
  • downy hair on the body, arms, and face
  • arrhythmia, or irregular heartbeat

Someone with anorexia may exhibit certain behavioral changes before physical symptoms are noticeable. This includes:

  • skipping meals
  • 躺在他们吃过多少食物
  • eating only certain “safe” — usually low-calorie — foods
  • adopting unusual eating habits, like sorting food on the plate or cutting food into tiny pieces
  • talking badly about their body
  • trying to hide their body with baggy clothes
  • avoiding situations that could involve eating in front of other people, which can result in social withdrawal
  • avoiding situations where their body would be revealed, like the beach
  • extreme exercising, which may take the form of exercising for too long or too intensely, like an hour-long jog after eating a salad

Emotional symptoms of anorexia may increase as the disorder progresses. They include:

  • 自尊和身体形象差
  • irritability, agitation, or other mood changes
  • social isolation
  • depression
  • anxiety

Bulimia

Someone with bulimia may develop an unhealthy relationship to food over time. They may get caught up in damaging cycles of binge eating and then panic about the calories they’ve consumed. This may lead to extreme behaviors to prevent weight gain.

There are two different types of bulimia. The attempts to purge are used to differentiate them. The new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) now refers to attempts to purge as “inappropriate compensatory behaviors”:

  • 清除bulimia.Someone with this type will regularly induce vomiting after binge eating. They may also misuse diuretics, laxatives, or enemas.
  • Non-purging bulimia.Instead of purging, someone with this type may fast or engage in extreme exercise to prevent weight gain after a binge.

Many people with bulimia will experience anxiety because their eating behavior is out of control.

As with anorexia, there are many different emotional, behavioral, and physical symptoms that can signal bulimia.

The physical symptoms can be severe and life-threatening. They include:

  • weight that increases and decreases in significant amounts, between 5 and 20 pounds in a week
  • 由于脱水而堵塞或破裂的嘴唇
  • bloodshot eyes, or eyes with busted blood vessels
  • callouses, sores, or scars on the knuckles from inducing vomiting
  • mouth sensitivity, likely due to eroding tooth enamel and receding gums
  • 淋巴结肿大

Someone with bulimia may exhibit certain behavioral changes before physical symptoms are noticeable. This includes:

  • 不断担心重量或外观
  • 吃到不适的点
  • going to the bathroom immediately after eating
  • 锻炼太多，特别是在一个坐着的时候吃了很多
  • restricting calories or avoiding certain foods
  • not wanting to eat in front of others

Emotional symptoms may increase as the disorder progresses. They include:

  • 自尊和身体形象差
  • irritability, agitation, or other mood changes
  • social isolation
  • depression
  • anxiety

It isn’t clear what causes anorexia or bulimia to develop. Many medical experts believe it may be due to a combination of complex biological, psychological, and environmental factors.

这些包括：

  • Genetics.According to a 2011 study , you may be more likely to develop an eating disorder if you have a family member who has one. This may be because of a遗传易感性to traits associated with eating disorders, such as perfectionism. More research is needed to determine whether there’s truly a genetic link.
  • Emotional well-being.People who have experienced trauma or have mental health conditions, such as anxiety or depression, may bemore likelyto develop an eating disorder. Feelings of stress and low self-esteem也可能有助于这些行为。
  • Societal pressures.The current Western ideal of body image, self-worth, and success equated with thinness can perpetuate the desire to achieve this body type. This may be emphasized further by pressure from the media and peers.

如果您的医生怀疑您有饮食障碍，他们会运行几次测试以帮助诊断。这些测试还可以评估任何相关的并发症。

The first step will be a physical exam. Your doctor will weigh you to determine your body mass index (BMI). They’ll likely look at your past history to see how your weight has fluctuated over time. Your doctor will likely ask about your eating and exercise habits. They may also ask you to complete a mental health questionnaire.

在这个阶段，您的医生可能会订购实验室测试。这有助于排除减肥的其他原因。它还可以监测您的整体健康，以确保不会发生可能的饮食障碍的并发症。

If the tests reveal no other medical causes for your symptoms, your doctor may refer you to a therapist for outpatient treatment. They may also refer you to a nutritionist to help you get your diet back on track.

If severe complications have occurred, your doctor may recommend that you get inpatient treatment instead. This will allow your doctor or another medical professional to monitor your progress. They can also watch for signs of further complications.

在任何一种情况下，你的治疗师都可以是在谈论与食物和体重的关系之后实际诊断特定饮食失调的治疗师。

Diagnostic criteria

There are different criteria that the DSM-5 uses to diagnose anorexia or bulimia.

The标准required to diagnose anorexia is:

  • restricting food intake to maintain a weight below the average weight for your age, height, and overall build
  • an intense fear of gaining weight or becoming fat
  • connecting your weight with your worth or other distorted perceptions about body image

The标准required to diagnose bulimia is:

  • recurrent episodes of binge eating
  • recurrent inappropriate compensatory behaviors — like excessive exercise, self-induced vomiting, fasting, or misuse of laxatives — to prevent weight gain
  • 狂犬病和不恰当的补偿行为都是平均每周至少一次，至少三个月
  • connecting your weight with your worth or other distorted perceptions about body image

饮食障碍没有快速治愈。但有许多治疗方法可治疗厌食症和贪食症。

您的医生可能建议谈话疗法，处方药和康复组合，以治疗任何一种病症。

The overall goal of treatment is to:

  • 解决条件的基本原因
  • improve your relationship with food
  • modify any unhealthy behaviors

如果您关注您的饮食行为，并且尚未拥有精神医疗保健提供者，您可以通过此处查看您所在地区的医生雷竞技app官网Healthline FindCare工具.

药物

According to a 2005 study , medication has shown little efficacy for the treatment of anorexia.

然而，在进行的少数审判中，有证据表明：

Medicinal options for bulimia appear to be a little more promising. The 2005 study indicates a number of medications may be effective in treating this disorder.

它们包括：

  • 选择性血清素再吸收抑制剂like fluoxetine (Prozac) can help treat underlying depression, anxiety, or OCD, and reduce bingeing-purging cycles.
  • 单胺氧化酶抑制剂likebuspirone(Buspar) can help decrease anxiety and reduce bingeing-purging cycles.
  • 三环抗抑郁药像丙酰胺（TOFRANIL）和DESIPRAMINE（NORPRAMIN）一样，可以帮助减少吹入吹扫循环。
  • Antiemetic medicationslikeondansetron（Zofran）可以帮助减少吹扫。

Therapy

Cognitivebehavioral therapy(CBT) uses a combination of talk therapy and behavioral modification techniques. It may involve addressing past trauma, which could have caused a need for control or low self-esteem. CBT can also involve questioning your motivations for extreme weight loss. Your therapist will also help you develop practical, healthy ways to deal with your triggers.

Family therapy may be recommended for adolescents and children. It aims to improve communication between you and your parents, as well as teach your parents how to best support you in your recovery.

Your therapist or doctor may also recommend support groups. In these groups, you can talk with others who have experienced eating disorders. This can provide you with a community of people who understand your experience and can offer helpful insight.

Outpatient vs. inpatient

饮食障碍在门诊或住院环境中进行治疗。

对于许多人来说，门诊是优选的方法。你会定期看到你的医生，治疗师和营养学家，但你可以恢复日常生活。您不必错过大量的工作或学校。您可以享用自己家的舒适。

Sometimes, inpatient treatment is required. In these cases, you’ll be hospitalized or placed in a live-in treatment program designed to help you overcome your disorder.

Inpatient treatment may be necessary if:

  • You haven’t complied with outpatient treatment.
  • Outpatient treatment hasn’t been effective.
  • You show signs of excessively misusing diet pills, laxatives, or diuretics.
  • Your weight is less than or equal to 70 percent of your healthy body weight, putting you at risk for severe complications.
  • You’re experiencing severe depression or anxiety.
  • You’re demonstrating suicidal behaviors.

如果没有治疗，厌食症和贪食症会导致危及生命的并发症。

厌食症

Over time, anorexia can cause:

在严重的情况下，可能会发生死亡。即使你还没有体重，这是可能的。它可能是由于心律失常或电解质的不平衡。

Bulimia

Over time, bulimia can cause:

  • 蛀牙
  • inflamed or damaged esophagus
  • 脸颊附近的发炎腺
  • 溃疡
  • pancreatitis
  • arrhythmia
  • 肾功能衰竭
  • heart failure

在严重的情况下，可能会发生死亡。即使你不超过重量，这也是可能的。它可能来自心律失常或器官衰竭。

饮食障碍可以通过行为修饰，治疗和药物组合治疗。恢复是一个持续的过程。

Because eating disorders revolve around food — which is impossible to avoid — recovery can be difficult. Relapsing is possible.

Your therapist may recommend “maintenance” appointments every few months. These appointments can help reduce your risk for relapse and help you stay on track with your treatment plan. They also allow your therapist or doctor to adjust treatment as needed.

朋友和家人可能很难接近他们喜欢饮食失调的人。他们可能不知道该说些什么，或担心隔离这个人。

If you notice that someone you love is exhibiting signs of an eating disorder, however, speak up. Sometimes people with eating disorders are afraid or unable to ask for help, so you’ll need to extend the olive branch.

When approaching a loved one, you should:

  • Pick a private location where you can both talk openly without distractions.
  • Choose a time when neither of you will be rushed.
  • Come from a loving place instead of an accusatory one.
  • 解释为什么你担心，不判断或批评。如果可能，请参阅具体情况，并详细说明为什么它引起关注。
  • Share that you love them and want to help however they may need.
  • Be prepared for some denial, defensiveness, or resistance. Some people may get mad and lash out. If this is the case, try to stay calm and focused.
  • 要耐心，让他们知道，如果他们现在不想要帮助，如果有任何改变，你会在那里。
  • 了解一些解决方案的对话，但不要建议他们离开蝙蝠。如果他们开放以接下来的步骤，只能共享资源。
  • Encourage them to get help. Offer to help them find a therapist or go with them to the doctor if they’re scared. A doctor’s visit is crucial to help someone with an eating disorder get on track and to make sure they’re getting the treatment they need.
  • 专注于他们的感受而不是物理描述。

There are also a few things that you should avoid doing:

  • Don’t comment on their appearance, especially as it relates to weight.
  • Don’t shame someone about their potential disorder. To avoid this, use “I” statements like “I worry about you” instead of “you” statements like “You’re making yourself sick for no reason.”
  • Don’t give medical advice you aren’t equipped to give. Saying things like, “Your life is great, you have no reason to be depressed” or “You’re gorgeous, you don’t need to lose weight,” do nothing to address the problem.
  • Don’t try to force someone into treatment. Ultimatums and added pressure don’t work. Unless you’re the parent of a minor, you can’t make someone go into treatment. By doing so, you’ll only strain the relationship and take away a stem of support when they need it most.

If you’re a minor and you have a friend who you believe has an eating disorder, you can go to their parents to express your concern. Sometimes peers can pick up on things that parents don’t, or see behaviors that they hide from their parents. Their parents may be able to get your friend the help they need.

For support, contact the National Eating Disorders Association’s Helpline at 800-931-2237. For 24-hour support, text “NEDA” to 741741.