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Binging but not Purging: How to Tell Bulimia Nervosa and Binge Eating Disorder Apart

While multiple similarities exist between the signs and symptoms of binge eating disorder and bulimia nervosa, there are distinct differences that separate these two common eating disorders. The most obvious difference is that people diagnosed with binge eating disorder do not force themselves to throw up (purge) the food they have just eaten. Alternately, people struggling with bulimia nervosa will eat and immediately empty the contents of their stomach.

Binge eating disorder and bulimia nervosa affect between two and three percent of girls and women in the United States, according to the National Association of Anorexia Nervosa and Associated Disorders. In addition, ANAD reports at least half of bulimia nervosa nervosa and binge eating disorder clients have mood and/or anxiety disorders that need to be psychiatrically addressed. One in ten bulimia nervosa and binge eating disorder clients suffer from a substance addiction. Surprisingly, ANAD further states binge eating incidents in post-bariatric clients may exceed 25 percent.

Signs and Symptoms of Binge Eating Disorder

Most of us have eaten too much at one time and regretted it later. However, people with binge eating disorder (BED) cannot stop themselves from repeatedly overeating, even though they feel miserable and ashamed afterward. Other signs of BED include:

  • Eating quickly and without being aware of how much or what you have eaten
  • Eating large quantities of food when you are not hungry
  • Binge eating alone because you are embarrassed to allow others to see you eat
  • Feeling extremely depressed, guilty and may be disassociated from reality after a binge eating episode

The American Psychiatric Association states people with BED engage in binge eating episodes at least once a week for three consecutive months. Individuals with BED may be obese or overweight. Unlike people with bulimia nervosa, those with binge eating disorder may not obsess about their weight, but may be ashamed of the way they look.Signs and symptoms of binge eating disorder may be misdiagnosed by well-meaning family members or friends who are not aware the person is eating large amounts of food in private. Only licensed eating disorder counselors can accurately diagnose a binge eating disorder.

Signs and Symptoms of Bulimia Nervosa

A potentially life-threatening disorder characterized by continuing episodes of binge eating and self-induced vomiting. In many cases, people with bulimia nervosa may indulge in harmful compensatory behaviors to prevent gaining weight. These behaviors include but are not limited to exercising hours a day, abusing diuretics and laxatives and abusing stimulants to increase metabolism and energy. Distorted views of their bodies is also a sign someone may have bulimia nervosa. Although they may be severely underweight, individuals with bulimia nervosa will often see themselves as overweight and fat.

One similarity between binge eating disorder and bulimia nervosa involves feeling uncomfortable around others when eating or simply refusing to eat with anyone. Bulimia nervosa can also compel a person to develop odd food rituals (eating only certain foods, chewing food excessively, not eating food someone else prepares) or hoarding food for future binge eating episodes.

People with bulimia nervosa may go to the bathroom immediately after meals (to throw up), drink large amounts of non-caloric beverages (Diet Coke, water) and avoid eating in public. Wearing baggy clothes may also be a common method people with bulimia nervosa use to hide their weight loss.

Self-induced vomiting occurring several times a day will lead to visible signs of the disorder, such as swelling of the jaw or cheek, knuckle calluses from trying to make themselves vomit, stained teeth, bloated appearance and suffering illnesses due to reduced immune system functioning. People with bulimia nervosa may worry about the way they look and will obsessively inspect themselves in mirrors for flaws that do not exist.

Binge Eating Disorder and Bulimia Nervosa Health Risks

Although BED and bulimia nervosa health risks differ slightly, anyone with either of these eating disorders is at a high risk of suffering medical complications which might require extensive hospitalization. Some medical complications could result in chronic problems demanding lifelong treatment.

Many people with binge eating disorder may be overweight because they do not force themselves to vomit or exercise obsessively to keep weight off. Obesity is known to contribute to Type 2 diabetes, high blood pressure, heart disease, high cholesterol, some kinds of cancer, joint degeneration, gallbladder disease and infertility.

Alternately, people with bulimia nervosa often experience medical issues emerging from malnutrition, repetitive vomiting and a compromised immune system. Specific health problems of bulimia nervosa clients include:

  • Acid reflux
  • Constipation
  • Dizziness/fainting
  • Heart arrhythmia
  • Muscle weakness
  • Feeling cold in warm weather/wearing winter clothing in warm weather
  • Tooth decay, gingivitis
  • Brittle nails
  • Flaky, dry skin
  • Thinning of hair/bald spots
  • Hirsuteness (abnormal hair growth on the body caused by malnutrition and extreme weight loss)
  • Wounds that are slow to heal

Mental health issues affecting people with bulimia nervosa and binge-eating disorder are similar and involve major depression, panic disorder, self-injury behaviors, substance abuse and lack of impulse control (shoplifting, gambling, sexual promiscuity).

People with type I diabetes and bulimia nervosa may also be diagnosed with diabulimia nervosa, a relatively new symptom of bulimia nervosa where someone deliberately restricts their insulin dosage to lose weight. Sometimes called Eating Disorder Diabetes Mellitus Type I, diabulimia nervosa develops because a person with bulimia nervosa and type I diabetes thinks insulin will make them gain weight. They may also restrict their intake of certain foods to decrease insulin dosage and withdraw from family and friends to avoid being confronted with neglecting to take their insulin.

How Are Binge Eating Disorder and Bulimia Nervosa Treated?

A binge eating disorder or bulimia nervosa treatment plan includes corresponding psychotherapies and medication regimens created by therapists, psychiatrists, and nutritionists specializing in treating all eating disorders.

Cognitive behavioral therapy and dialectical behavioral therapy are two psychotherapies proven to be successful in helping people understand and control their bulimia nervosa or BED. Both teach skills involving regulation of emotions and the ability of clients to stop negative thoughts and feelings from escalating. Clients also learn how not getting enough sleep, overeating, vomiting repeatedly and abusing drugs may impact their physical and mental health. While counseling eating disorder clients, therapists provide instructions on how to consciously incorporate life-affirming, positive experiences into their lives to help overcome their particular eating disorder.

Specific DBT and CBT skills that support regulating emotions include:

  • Identifying negative and positive thoughts and emotions
  • Identifying triggers and obstacles that prevent stopping and changing negative emotions and thoughts
  • Improving the ability to focus on objectively perceiving reality while recognizing and dismissing distorting thoughts
  • Enhancing mindfulness about spontaneous emotions that have no basis in fact

Radical Acceptance

Radical acceptance in psychotherapy means accepting something for what it may be or is instead of fighting, often irrationally, to transform it into something the client wants it to be. In other words, people with bulimia nervosa or binge eating disorder are taught by therapists not to jump to conclusions about something they perceive as hostile or detrimental to their wellbeing. Radical acceptance is the ability to accept reality as it truly is and not what someone thinks it should be. However, it does not encourage passive behavior but instead, encourages clients to think clearly and assert themselves in a confident, rational manner. By doing so, people with bulimia nervosa and binge eating disorder can start taking control of their thoughts, emotions and behaviors maybe for the first time in their lives.

Lacking the coping skills to accept and deal rationally with past and current traumas is one of the reasons people with bulimia nervosa, binge eating disorder and other eating disorders find it overwhelmingly difficult to defeat their negative emotions and thoughts without professional help. CBT and DBT not only teaches clients about radical acceptance and distress tolerance coping techniques but also combines emotion regulation, interpersonal effectiveness and mindfulness to overcome the eating disorder self and discover their healthy self.

Distress Tolerance

Learning methods of distress tolerance through CBT and DBT allows bulimia nervosa and binge eating disorder clients to experience a particularly difficult moment without escalating the situation. People with eating disorders especially need to master distress tolerance techniques since engaging in self-destructive behavior often results from ineffectively dealing with conflict. Through the use of distress tolerance, radical acceptance and other mindful alternatives supported by CBT and DBT, clients can modify harmful, unproductive ways of coping with their eating disorder by learning how to tolerate distress so it can be objectively and rationally evaluated.

Life Skills

Learning to cope with everyday situations that create a sense of panic and fear in people with eating disorders, such as binge eating disorder or bulimia nervosa is a large part of any eating disorder treatment program. In many cases, clients do not know how to deal with stress and anxiety simply because they have never been supplied with the tools necessary to deal with conflict in a positive manner. Situations that may be considered challenging by someone with bulimia nervosa or BED may not be challenging to others. As clients work on decision-making skills by participating in psychotherapy, cognitive behavioral therapy and group therapy sessions with eating disorder counselors, their ability to make rational decisions improves as does their self-esteem and overall sense of self.

By providing clients with psychologists and counselors experienced with implementing cognitive behavioral therapy, dialectical behavioral therapy and other psychotherapies, Monte Nido helps individuals with bulimia nervosa and binge eating disorder understand their mental and physical problems by teaching them how to develop different sets of coping skills and strategies to facilitate the recovery process and make recovery a successful and rewarding experience.

At Monte Nido, we have a deep, compassionate understanding of how difficult it can be for an individual with bulimia nervosa or binge eating disorder to begin on the path to recovery. We provide long-term, empathetic, client-oriented care for clients with anorexia nervosa, bulimia nervosa and binge eating disorder. Our highly educated and qualified counselors and therapists successfully help clients address any underlying causes and behaviors of the eating disorder. By entering a binge eating disorder or bulimia nervosa treatment program, clients learn why an eating disorder is dominating their lives, how to understand the disorder and begin on the path to true recovery.

If you are wondering “Is there eating disorder counseling near me?” contact Monte Nido online or call us for immediate assistance.