Anorexia Nervosa and Bulimia
• Anorexia Nervosa: commonly referred to as
anorexia, is an eating disorder characterized
by low body weight, distorted body image,
and obsessive fear of gaining weight.
• Bulimia: is an illness in which a person binges
on food or has regular episodes of significant
overeating and feels a loss of control.
Commonly binges, then vomits.
Symptoms and Indications of Bulimia
• Abuse of laxatives, diuretics, or enemas to
prevent weight gain
• Binge eating
• Frequent weighing
• Self-induced vomiting
• Overachieving behavior
• Eating binges may occur as often as several
times a day for many months.
Symptoms and Indications of Anorexia
• Behaviors include:
• Cutting food into small pieces
• Exercising compulsively
• Going to the bathroom right after
• Quickly eating large amounts of
• Restricting the amount of food
• Using laxatives, enemas, or
diuretics inappropriately in an
effort to lose weight
• Symptoms include:
• Blotchy or yellow skin
• Confused or slow thinking
• Cavities due to self-induced
• Dry mouth
• Extreme sensitivity to cold
(wearing several layers of clothing
to stay warm)
• Fine hair
• No menstruation
• Poor memory or poor judgment
• Wasting away of muscle and loss
of body fat
Causes of Anorexia
• Being a perfectionist
• Being female
• Experiencing childhood anxiety
• Feeling increased concern or attention to
weight and shape
• Having eating and gastrointestinal
problems during early childhood
• Having a family history of addictions or
• Having parents who are concerned about
weight and weight loss
• Having a negative self-image
Causes of Bulimia
• Cultural factors
• Bulimia is likely due to more
than one factor.
• Cognitive therapy: Explores the critical and unhealthy
thoughts underlying anorexia. The focus is on increasing self-
awareness, challenging distorted beliefs, and improving self-
esteem and sense of control. Cognitive therapy also involves
education about anorexia.
– it is not the best, but it is most often used. Treatment
often lasts from six weeks to six months.
• Behavior therapy: Promotes healthy eating behaviors through
the use of rewards, reinforcements, self-monitoring, and goal
setting. Teaches the patient to recognize anorexia triggers and
deal with them using relaxation techniques and coping
– Very effective
Anorexia Therapies Cont.
• Family therapy: Examines the family dynamics that may contribute to anorexia or
interfere with recovery. Often includes some therapy sessions without the anorexic
patient—a particularly important element when the person with anorexia denies
having an eating disorder.
– Most effective, and does not take a very long time.
• Group therapy: Allows people with anorexia to talk with each other in a supervised
setting. Helps to reduce the isolation many anorexics may feel. Group members
support each other through recovery and share their experiences and advice.
– Also very effective; not costly
• Antidepressants are often given to reduce suicidal thoughts, if any. Antipsychotics
are used for weight gain; chlorpromazine, sometimes in combination with insulin
to further stimulate hunger, produced more rapid weight gain and earlier hospital
discharge; unwanted side effects included the onset of binge eating and seizures
and can lead to the development of tardive dyskinesia, or facial spasms.
– Least effective, but it is the most costly
• Interpersonal psychotherapy helps people with bulimia solve relationship issues and
interpersonal problems that are contributing to their eating disorder. Interpersonal
psychotherapy also treats the depression and low self-esteem that goes along with bulimia
• Group therapy for bulimia involves education about the eating disorder and strategies for
overcoming it. It can also help bulimics feel less alone in their suffering. ~Cognitive
• cognitive-behavioral therapy focuses on Breaking the binge-and-purge cycle and Changing
unhealthy thoughts and patterns
• Antidepressants are often used in the treatment of bulimia. When combined with therapy,
antidepressant medications can help reduce binge eating. They can also improve
preoccupation with weight and body image, as well as the depression that often
– Biomedical perspective
Cultural and Gender Considerations
• Promotion of thinness in western culture—
”the ideal female form”
• The media emphasizes the ideal weight/form.
• Most women in wealthy, white families are
more susceptible to anorexia.
• Many more women than men have bulimia,
and the disorder is most common in
• Which eating disorder binges then vomits?
• What culture emphasizes the “ideal female
• Which kind of therapy is most effective for
• Name one behavioral symptom of Anorexia.
• Is Bulimia more common among men or
• Slide 4