Eating Disorders: Anorexia and Bulimia

Description

Alternative Names

Symptoms

Possibly the most bewildering symptom of eating disorders is the distorted body image (body dysmorphia). Although people typically associate distorted body image with severe anorexia, one study indicated that distortion may be more prevalent in people with bulimia. People with bulimia were more likely than those with anorexia to overestimate their size. There was also a greater disparity between what they wanted to look like and what they believed they looked like. In another study, people with anorexia tended to have an accurate perception of their upper body, but overestimated the size of their abdominal and pelvic area.

Symptoms Specific to Bulimia without Anorexia

People with bulimia nearly always practice it in secret, and, although they may be underweight, they are not always anorexic. Symptoms or signs of bulimia may, therefore, be very subtle and go unnoticed. They may include the following:

• Evidence of discarded packaging for laxatives, diet pills, emetics (drugs that induce vomiting), or diuretics (medications that reduce fluids).
• Regularly going to the bathroom right after meals.
• Suddenly eating large amounts of food or buying large quantities that disappear right away.
• Compulsive exercising.
• Broken blood vessels in the eyes (from the strain of vomiting).
• Swollen salivary glands. These occur within days of vomiting in about 8% of people with bulimia. They often give a pouch-like appearance to areas below the corners of the mouth.
• Dry mouth
• Teeth develop cavities, diseased gums, and irreversible enamel erosion from excessive acid. (Gargling with baking soda after purging rather than using toothpaste may help neutralize the acid.)
• Rashes and pimples.
• Small cuts and calluses across the tops of finger joints. (These cuts can occur from repeated self-induced vomiting, in which a person thrusts the hand down the throat past the front teeth.)

Symptoms Specific to Anorexia

Weight Loss. The primary symptom of anorexia is major weight loss from excessive and continuous dieting, which may either be restrictive dieting or binge-eating and purging. Note. Young women who have both diabetes and eating disorders may have normal weight or even be overweight from the effects of insulin. However, they still are at high risk from the medical consequences of anorexia.

Other symptoms may include the following:

• Menstruation may be infrequent or absent.
• Often, compulsive exercising coupled with emaciation leads to orthopedic problems, particularly in dancers and athletes. Such problems, in fact, may be the first sign of trouble that forces these patients to seek medical help.
• Refusal to eat in front of others.
• Ritualistic eating, including cutting food into small pieces.
• Hypersensitivity to cold. (In fact, some women wear several layers of clothing to both keep warm and hide their thinness.)
• Yellowish skin, especially on the palms of the hands and soles of the feet. (This occurs in people eating too many vitamin A-rich vegetables, such as carrots.)
• The skin may be dry and covered with fine hair.
• Normal scalp hair may be thin.
• The feet and hands may be cold or sometimes swollen.
• The stomach is often distressed and bloated after eating.

Thinking may be confused or slowed, and an anorexic patient may have poor memory and lack judgment.