Bulimia Vs. Binge-Eating Disorder: What Is the Difference?

What Is Bulimia Nervosa?

Bulimia nervosa refers to repeated episodes of uncontrolled overeating and extreme measures to counteract the effects of binging. Purging behavior often includes vomiting, excessive exercise, laxative misuse, or a combination. Individuals with this eating disorder typically experience a preoccupation with body weight and size, sometimes leading to anxiety after eating and body dysmorphia.

Symptoms of bulimia may include:

• Dehydration
• Teeth decay
• Loss of menstrual cycle
• Sleep apnea
• Body dysmorphia
• Poor body image 
• Excessive exercise
• Unhealthy use of laxatives
• Restrictive eating patterns
• Chronically inflamed sore throat’
• Gastrointestinal issues
• Electrolyte imbalances

What Is Binge-Eating Disorder?

Binge-eating disorder occurs when an individual eats large quantities of food accompanied by a loss of control over consumption.¹ Those in a binge-eating episode may eat to the point of discomfort, often despite not feeling hungry. They also typically eat alone due to embarrassment and negative feelings about their behavior.²

Symptoms of binge-eating disorder may include:

• Symptoms of depression
• Suicidal ideation in severe cases
• Regular episodes of excessive food intake in a certain period
• An obsession with food and planning for the next binge
• Emotional eating
• Guilt after eating
• Hiding food and amount of intake from others
• Often skipping meals to binge later in the day
• Covering the body with clothes that conceal weight fluctuations

Bulimia Vs. Binge-Eating Disorder

Many people may ask, “What is the primary distinction between bulimia nervosa and binge eating disorder?” In short, the difference between bulimia and binge eating is the presence or absence of purging. Those with bulimia engage in self-induced vomiting, laxative misuse, or excessive exercise, while individuals with binge-eating disorder do not exhibit compensatory behavior.

Can I Have Both Bulimia & Binge-Eating Disorder?

Because of the primary difference between bulimia and binge-eating disorder, an individual cannot have both disorders at the same time. However, both conditions result in physical and mental health complications that typically require professional intervention and support.

What Causes Bulimia & Binge-Eating Disorder?

Eating disorders do not have one shared cause. Many factors can contribute to the development of disordered eating habits, including genetics, trauma, and societal expectations. Additionally, multiple failed diet attempts may increase the risk of bulimia or binge-eating disorder, especially in those who struggle with poor self-esteem or body image.

Possible causes of bulimia and binge-eating disorder include:

• History of failed dieting: Restricting specific foods can lead an individual to binge and develop other disordered eating habits.³
• Sexual, verbal, or emotional abuse: Incidences of sexual abuse in eating disorder patients appear prevalent.⁴
• Low self-esteem: Individuals with low self-esteem may resort to extreme measures to improve their body image, including purging behavior.
• Societal/cultural expectations: Many individuals can fall prey to societal expectations around thinness and conventional attractiveness. Social media often promotes images of idealized bodies, healthy foods, diets, and exercise, sometimes contributing to body image concerns.⁵
• Traumatic life events: Bullying, teasing, loss, and abuse are common risk factors for eating disorders like bulimia and binge-eating disorder.⁶
• Genetics: Recent findings suggest a substantial genetic link to eating disorders.⁷
• Family history: Individuals can develop healthy or unhealthy relationships with food based on familial and cultural norms.⁸
• Anxiety:  Binge-eating can be a method of cognitive avoidance to reduce or hide anxiety.⁹

Impacts of Binge-Eating Disorder & Bulimia

Binge-eating disorder and bulimia come with various risks, including obesity, hypertension, depression, and anxiety. Prolonged purging behavior can lead to acid reflux, tooth decay, and kidney malfunction. For these reasons, seeking mental and medical help may be necessary to repair the impacts of these disorders.

How Are Binge-Eating Disorder & Bulimia Diagnosed?

Individuals should seek assistance from a licensed mental health professional to receive an accurate diagnosis. These providers can recognize the differences between bulimia and binge-eating disorder to ensure you receive appropriate care. A typical assessment may include physical exams, labwork, psychological evaluations, and a medical/mental health history review.

Treatment for Bulimia & Binge-Eating Disorder

Various methods are available to treat binge eating and bulimia. A combination of therapy and medication may benefit those who experience co-occurring anxiety, depression, or other mental health conditions. Your care team will work with you to determine the best approaches for your needs.

Therapy

Individuals struggling with bulimia or binge eating disorder can improve their well-being and self-esteem with therapy. Finding the right therapist specializing in eating disorders is the first step toward recovery and establishing a healthy relationship with food. In severe cases, a professional may recommend in-patient eating disorder treatment to help individuals regain medical stability or reduce the risk of self-harm. While seeking support can be scary, you do not have to recover alone.

Therapy options for binge-eating disorder and bulimia may include:

• Enhanced cognitive behavior therapy (CBT-E): CBT-E focuses on how thoughts, feelings, and behaviors relate to disordered eating. Recognizing these factors and replacing unhealthy habits can reduce the urge to binge or purge.
• Dialectical behavior therapy (DBT): DBT focuses on building emotional regulation, mindfulness, and distress tolerance skills to aid in treating disordered eating and other problematic behaviors.¹⁰
• Interpersonal therapy (IPT): IPT can help reduce binge and purge behavior by addressing dysfunctional interpersonal relationships that contribute to disordered eating.²
• Group therapy: Group therapy provides community support from peers struggling with similar issues.

Medications

When appropriate, a psychotherapist or medical practitioner may recommend medication to treat binge-eating disorder or bulimia. Those with binge-eating disorder may benefit from appetite suppressants, such as Alli, Topiramate, and Liraglutide. Some antidepressants have shown promising results when treating bulimia. Consult your physicians to learn more about the risks and benefits of pharmaceutical treatment.

How to Cope With Bulimia or Binge-Eating Disorder

Dealing with an eating disorder comes with challenges, but you can improve your relationship with food. Seeking therapy and developing healthy coping mechanisms can help you overcome the urge to binge or purge. Additionally, learning to love yourself is a crucial part of recovery. Spend time cultivating self-acceptance, compassion, and validation as you navigate challenges.

Below are ways to cope with an eating disorder:

• Journal your thoughts: Journaling for your mental health allows you to process your thoughts and feelings, allowing space for reflection and identifying areas for self-improvement.
• Practice mindfulness: Mindfulness increases self-awareness of unhealthy behavior and thoughts. Focusing on the present can help those with bulimia or binge-eating disorder recognize when they feel triggered and implement strategies to prevent binging or purging.
• Try meditation: Meditation allows individuals to create a safe mental space to accept and release unhealthy food-related thoughts.
• Develop a support system: Your support network will keep you accountable to your goals during recovery. They can also provide redirection when faced with challenges.
• Learn a new skill: Exploring new hobbies or activities can be a positive distraction from disordered eating thoughts. Consider painting, dancing, making music, or trying a new sport. Any activity that promotes self-improvement, confidence, and happiness is beneficial.
• Use affirmations: How we speak to ourselves can create a space for growth and change. Utilizing positive affirmations is one way for individuals with eating disorders to reprogram negative body or food-related thoughts and beliefs.