Dr. David Herzog discusses the various reasons why bulimia is harder to diagnose than anorexia.

1. Why Bulimia is Harder to Diagnose than Anorexia!
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Dr. David Herzog, Boston-based founder of the Harvard Eating Disorders Center and the Harris
Center for Education and Advocacy in Eating Disorders, holds that bulimia nervosa is
exceedingly more difficult to properly diagnose than anorexia. This is due to several factors, all
of which he details in a post for the website, along with methods of treatment.!
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What is Bulimia!
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Bulimia is the process of binge eating
large amounts of food, only to purge the
body of it later through inducing vomit
or the use of laxatives. The underlying
cause for bulimia is very similar to that
of anorexia—often a coupling of
biological and social factors, involving
genetic predisposition and pressure
from popular culture and peers. In
regards to pressure from popular
culture, in a study conducted amongst
teenage girls in a rural province of Fiji
on the cusp of acquiring television,
bulimia went from being non-existent to
affecting more than ten percent of the
female adolescent population.!
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Men and Women of All Ages!
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Teenagers are not the only group susceptible to starting the course of binge eating and purging.
Individuals can start the process really at any time in life, although research has shown that the
disorder is most common in adolescents or those who are just post-adolescence. Women are
most common, but ten percent of those who suffer from bulimia are men. Traumatic events can
set off the disorder, such as physical abuse or being bullied at school. There is also some
research that indicates an imbalance in serotonin—a crucial neurotransmitter—could be behind
the start of the disorder.!
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Bulimia vs. Anorexia!
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As opposed to patients who suffer from anorexia, who are often notably below the average body
weight, those who struggle with bulimia tend to be of average weight or even slightly above.
Doctors must then look to other signs and symptoms to complete diagnosis. Evidence of
scarred fingers or hands and decaying teeth can be signs of forcing oneself to vomit. Internal
complications can show symptoms as well—unexplained pain in the stomach or the throat can
be a physical manifestation of the disruption to the processes of digestion. Noting behavior is
also important; friends and family must remain wary of an individual who carries around pockets
of supplies for binge eating and unnecessary enema kits or laxatives.!
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2. Dangers of Bulimia!
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Discovering the behavior speedily is incredibly crucial. Bulimia can bring on long-term
problems, including injuries to the digestive tract and damage to the stomach or esophagus;
overuse of laxatives can also result in an electrolyte imbalance.!
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Dr. David Herzog, Harvard Eating Disorder Specialist!