Binge eating and purging can be present in both anorexia nervosa (AN) and bulimia nervosa (BN). In both disorders, the individual may engage in objective binge episodes (eating a large amount of food in a short period of time accompanied by a sense of feeling out of control) and engage in compensatory behaviours.
For individuals who binge and purge in the context of other symptoms of anorexia, we do not give an additional diagnosis of bulimia nervosa. Binge and purge episodes can look the same in both disorders. The main difference between the two is that those with anorexia nervosa have significantly low body weights for age and height. This is considered an important difference, diagnostically.
Remember that diagnoses are designed to:
1. describe groups of symptoms that fall together so clinicians and researchers around the world are looking at/talking about the same thing.
2. capture important differences between illnesses such as genetics, biology, and course and outcome.
The fact that those with AN get to such dangerously low body weights has been the focus of much research. There is strong genetic data to demonstrate abnormalities in the brain and the metabolic system in those with AN that might account for the weight and food regulation pieces and this may be different in those with other eating disorders. The course and outcome for those with AN is also markedly different than those with BN. Therefore, while there are many overlapping symptoms between the disorders, there are enough important differences to separate them out diagnostically.
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