Which is Worse – Bulimia or Anorexia?

The question of which is worse, bulimia or anorexia, is one that is often asked, particularly by those who believe they may have one of these eating disorders. The truth is that both bulimia and anorexia can have devastating consequences for those affected and for their family members. Both are serious mental health issues and while there are similarities between them, there are differences too. It is difficult to say which one is worse because both can be life-threatening if left untreated. Both conditions can cause harm to mental and physical health and both require professional treatment. The one good thing is that help is available and that both conditions can be overcome with the right programme of care and support.

It is extremely difficult to give a definitive answer to the question of which is worse, bulimia or anorexia because it really depends on the severity of the illness and the mental state of the affected individual. While most people might assume that anorexia is worse because it can lead to malnourishment and emaciation, when bulimia is severe it can also lead to severe harm for the individual. Below is an explanation of what each disorder is, and the negative consequences associated with both.

What is Bulimia?

Bulimia is a serious eating disorder that is characterised by episodes of binge eating followed by purging. Those affected by bulimia tend to cycle through bingeing on substantial amounts of food in a short space of time, and then purging themselves of the excess calories by vomiting, taking laxatives or exercising excessively.

These cycles of bingeing and purging tend to dominate daily life and can have a negative impact on the wellbeing of the individual. They can interfere with social interaction with others as well as with personal relationships.

However, because most bulimics tend to have a stable weight, it can be difficult for those close to them to spot the early signs of the illness. As such, bulimia can go unnoticed for a long time.

What is Anorexia?

Anorexia is also a serious eating disorder and one that is characterised by restriction of food intake in a bid to keep weight as low as possible. Individuals with anorexia may also purge themselves by taking laxatives and excessively exercising, but they tend not to binge eat as those with bulimia do. Many sufferers of anorexia have an innate fear of getting fat and tend to avoid foods that they perceive as fattening.

Anorexics tend to see themselves in a completely different way to how everyone else sees them. Their illness causes them to see themselves as needing to lose more weight, even when they are painfully thin and, to everyone else, in need of gaining weight.

Most anorexics will challenge any suggestion that they need to eat more or gain weight. Their distorted body image vision makes them believe that they are never thin enough; even when they know they have lost weight, they will need to lose more.

Spotting the Signs of Bulimia

As previously mentioned, family members and friends often do not spot the signs of bulimia in the early days. Nevertheless, if you are worried about someone you love, look closely at the eating habits and behaviours of this person and check for the following:

• Frequently checking his or her body shape or weight
• Comparing body shape or weight with other people’s
• Becoming obsessed with food, calorie counting and meal preparation
• Eating large amounts of food over a short space of time
• Disappearing to the bathroom shortly after eating
• Staying in the bathroom for a long time and flushing the toilet numerous times
• Having a fear of gaining weight
• Disguising the smell of vomit with perfume or mints
• Calluses on hands and fingers from making themselves vomit.

You may also notice that your loved one is suffering with mood swings and seems tired. You should look for signs of self-harming or evidence of laxative use. If you notice that food is disappearing, look for evidence of a binge; you may find a stash of empty food wrappers in bins or elsewhere in the home.

Spotting the Signs of Anorexia

As most anorexics do not binge on large quantities of food before purging, they tend to lose quite a bit of weight, making it easier for loved ones to notice the problem. Nonetheless, in the early days, family members and friends might miss some of the warning signs. If you are concerned about someone you love, you should look out for the following signs:

• A reluctance to eat with others
• Making excuses so as not to eat, such as saying they have already eaten or will eat later
• Becoming obsessed with calorie counting
• Avoiding foods that are deemed to be fattening
• Only eating low-calorie foods
• Restricting entire food groups
• Exercising excessively
• Being fearful of gaining weight
• Taking laxatives or diet pills
• Becoming obsessed with body weight and shape
• Having a distorted body image
• Extreme weight loss
• Fatigue
• Dizziness
• Stomach pains
• Hair loss
• Complaining of having no strength.

Anorexics may display signs of irritability and begin isolating themselves from others so that they do not have to eat with them. The affected person will strongly deny any suggestion that there is a problem and might become angry at the suggestion that he or she has lost too much weight.

The Impact of Bulimia on Health

Excessive vomiting can lead to problems that include permanent damage to teeth, vocal chords, and the throat. The cycle of bingeing and purging can cause heart and kidney damage as well as permanent damage to intestines and the stomach. Bulimics often struggle with abdominal pain, bloating and constipation. Tiredness and difficultly sleeping can eventually cause problems with mental and physical health.

The Impact of Anorexia on Health

Like bulimia, anorexia can lead to permanent damage that include erosion of tooth enamel, and damage to organs including the liver, kidney, and heart. It may also lead to infertility or difficulty conceiving. Anorexics are also more likely to suffer with osteoporosis, loss of muscle strength, and physical weakness.

Treatment for Bulimia and Anorexia

Bulimia and anorexia are complex mental health issues that require intervention from experienced counsellors and therapists. It is necessary for those who suffer with these eating disorders to learn how to develop a healthy attitude to eating.

For most people, this will involve an intensive programme of talking therapies such as cognitive behavioural therapy, individual counselling, group therapy, and family therapy.

Treating the mind, body and spirit is an essential part of recovery from eating disorders such as bulimia and anorexia. Most rehab providers will therefore incorporate traditional talking therapies and holistic treatments in a plan of care. The idea is that the whole person needs to be treated, rather than just the illness.

The aim of treatment is to help challenge negative thought processes and to assist with the development of new and healthy eating patterns. Education on nutrition and healthy exercising can help with this.

Where Does Treatment for Eating Disorders Take Place

For many people, an outpatient programme is sufficient for the treatment of an eating disorder such as bulimia or anorexia. However, if the illness is severe or if there is a physical or mental risk to the patient, an inpatient programme is often the best option.

In an inpatient facility, patients are given around-the-clock care and support from fully qualified, experienced staff members. They will receive an intensive and concentrated schedule of treatment designed to help them recover in the shortest amount of time.

Is Aftercare Available

As eating disorders are serious conditions, ongoing support is usually necessary. Most rehab providers will include up to a year of aftercare for patients, and there are self-help and support groups available within the local community where patients can meet with others who have experienced similar health problems.

As you can see, there is quite a lot to consider when thinking about which is worse, bulimia or anorexia. The issue is more to do with how the eating disorder has affected the individual than the eating disorder itself. Either condition when at its worst can be devastating.

If you would like to talk further about eating disorders or any other mental health or addiction problem, please call us today. We have a team of advisors who have been fully trained in all types of addiction and behavioural disorders. They can provide information, and advice or answer any queries you may have.