Urge to diet, binge eat: Both are harmful eating disorders — here’s why

Do you have an inexplicable urge to control your diet in order to “get in shape” or like to binge eat? Does your body weight bother you and do you feel depressed? Well, if someone tries to pass any of it as just a behavioural pattern, they may be wrong. And it’s time we get serious about Anorexia Nervosa and Bulima Nervosa, the two common eating disorders found in people across the globe.

What is Anorexia Nervosa

Anorexia Nervosa is considered to be one of the most debilitating and deadly psychiatric disorders. While it is often linked to the prevalence of dieting among women in the late twentieth century, the first documented case of Anorexia Nervosa dates back 300 years. By 1874, the syndrome had already been extensively documented.

The illness has maintained its essential features unchanged since the initial descriptions. Anorexia nervosa is a condition where teenagers or young adults, mainly women, engage in a relentless and successful pursuit of thinness, leading to severe weight loss.

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Anorexia Nervosa is characterised by significant behavioural, psychological and physiological disturbances, such as increased physical activity, depression, obsessive preoccupation with food, decreased heart rate, blood pressure, and metabolic rate, elevated cortisol production and a significant decrease in estrogen (or testosterone in males) production.

The fluctuations in estrogen levels are accountable for the amenorrhea, a defining trait of Anorexia Nervosa in women. Amenorrhea is the absence of menstruation during a woman’s reproductive years.

What is Bulima Nervosa

Humans may have engaged in occasional episodes of excessive eating when food supplies were plentiful and the act of purging after overeating has been practiced for centuries.

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Nevertheless, the formal recognition of an eating disorder marked by uncontrollable food intake (binge eating) and by unhealthy methods to prevent weight gain (such as self-induced vomiting), did not occur until 1980, when the American Psychiatric Association established criteria for diagnosing Bulima Nervosa.

Eating disorders have traditionally been linked to individuals who are underweight or of normal weight, but issues among those who are obese have been observed for quite some time.

The extent to which they play a role in the development or perpetuation of obesity remains unclear. Binge Eating Disorder involves episodes of excessive eating, similar to those seen in Bulimia Nervosa (BN), but without subsequent purging or other compensatory behaviours.

So, are individuals with binge eating disorder truly distinct? Research in laboratory settings has shown that obese individuals with Binge Eating Disorder actually consume more food than their equally overweight peers without Binge Eating Disorder when instructed to binge.

This indicates that binge eating is not solely a matter of perception. Furthermore, binge eating seems to be linked, regardless of weight, to a higher prevalence of mental health issues like depression, more significant and frequent fluctuations in weight, and greater distress related to weight. These results suggest that the differentiation between obese individuals who binge eat and those who do not is a significant one.

Understanding Anorexia Nervosa and Bulima Nervosa

In the last 25 years, Anorexia Nervosa (AN) and Bulimia Nervosa (BN), the two officially recognised eating disorders, have garnered significant attention from both the research community and the general public.

These disorders collectively impact around 3 percent of women throughout their lives; with Bulima Nervosa, the more prevalent disorder, showing a potential increase in occurrence.

What causes Anorexia Nervosa and Bulima Nervosa

The causes of Anorexia Nervosa and Bulima Nervosa are still not fully understood.

Cultural and environmental factors are believed to contribute, with eating disorders being more prevalent in industrialised countries compared where food is abundant and thinness, especially in women, is associated with attractiveness.

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Even adolescent girls who perceive themselves as being at an ideal weight are still attempting to shed pounds, in contrast to less than 10 percent of adolescent boys.

The role of biological factors in the development of these disorders has been challenging to investigate due to their rarity and the lack of suitable animal models.

While progress has been made in developing effective treatments for Bulima Nervosa, Anorexia Nervosa remains a challenging condition to manage, particularly in the long term.

Is there any connection between Anorexia Nervosa and Bulima Nervosa

There are evident connections between Anorexia Nervosa and Bulima Nervosa. Both conditions are more common in young women, both involve an excessive preoccupation with body shape and weight, and approximately one-third of Bulima Nervosa patients seeking treatment have a history of Anorexia Nervosa.

However, unlike individuals with Anorexia Nervosa, who are typically severely underweight, most individuals with Bulima Nervosa have a normal body weight. 

Awareness on eating disorders

Despite the implementation of preventive programmes aimed at raising awareness about the dangers of unhealthy weight loss methods and promoting resistance to societal pressures for thinness, these initiatives have not been very successful.

Some even argue that these programmes could be counterproductive, sparking debate within the field. By better understanding how cultural and biological factors interact in the onset and perpetuation of eating disorders, more precise and efficient interventions can hopefully be developed.

The way forward

There are grounds for hope. Progress in molecular genetics could potentially enable the discovery of genes that make individuals more susceptible to developing Anorexia Nervosa or Bulima Nervosa.

A deeper understanding of the pathophysiology of eating disorders is expected to pave the way for novel strategies in treatment and prevention. Specifically, by gaining a clearer comprehension of the commonalities and distinctions between these disorders, it may be possible to expand the application of effective treatments for Anorexia Nervosa and Bulima Nervosa and Binge Eating Disorder.