by Jengy Pie

Created on: December 06, 2008

Broadly speaking there are two types on eating disorders: Anorexia nervosa and Bulimia Nervosa. Those that do not fit into either category are deemed to have 'Eating disorder not otherwise specified'. It is important to mention that we all diet or exercise, and have variable degrees of comfort or discomfort about our body image. The point at which it becomes a disorder, as outlined by the American Psychiatry Association, is when these thoughts and negative self-evaluations begin to cause significant distress and impact on social, occupational or other important areas of function. Each of the eating disorders will be described below to improve understanding of these mental illnesses.

Both anorexia nervosa (AN) and bulimia nervosa (BN) is characterized by an excessive importance of body shape and weight into self-evaluation. Sufferers believe that their body shape and weight are more controllable than other aspects of their lives, such as stresses at home or in relationships. They judge their self worth based on how they look, rather than how well they relate to others and their other achievements in life.

As outlined in the DSM-IV TR (2000), AN is characterized by refusal to maintain a body weight at or above the minimum normal range for the persons age and height. Sufferers also experience an intense fear of being fat or gaining weight despite being underweight. Those with AN also have a degree of denial into their problem, and place undue influence on their body weight and shape on their self-evaluation. Consequently patient are usually dangerously skinny and experience a variety of health issues. AN is classified into two types: restricting type and binge-eating/purging type. In the restricting type patients excessively minimize caloric intake or exercise excessively to maintain or lose weight. The purging type is characterized by eating large amounts of food quickly and then either inducing vomiting or abusing medications, such as laxatives, diuretics or enemas to shed the extra pounds.

The DSM-IV TR (2000) describes BN as an eating disorder in which patients undertake recurrent binges and compensations (exercising, dieting, or medication abuse) to keep their weight within their control. To fit the exact criteria in the psychiatry handbook episodes of binges and purging need to occur at least two times per week for three consecutive months. Those with BN endure a vicious cycle in which binges result in feelings of self-disgust, 'bloating' or feeling like their will is weak. This leads to unrealistic rule setting with diet restriction and exercise, which leads to intense hunger and sets the stage for the next binge. BN is also divided into two types: purging type and non-purging type. A variant of BN, called binge eating disorder (BED), is characterized by recurrent binges without the compensation, such as self-induced vomiting or laxative abuse. These patients tend to be overweight.

There a a few key differences between AN and BN. AN sufferers tend to be underweight and wasted whereas those with BN tend to be normal weight or overweight. Also, AN is much more dangerous because of the lack on nutrition and treatment complexity. About 5% of AN sufferers die per year, either from suicide or malnutrition, and BN has a much better outlook. Some patients with BN can go on to develop AN.

This is the way eating disorders are divided and is a great way to think about them.

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