Bulimia nervosa (BN) and binge eating disorder (BED) are two different eating disorders that share some of the same characteristics. Both involve consuming what are considered large amounts of food in one sitting or across several hours. But people who have binge eating disorder do not engage in compensatory purging behaviors to make up for food eaten, while those who have bulimia do.
If you think you may have an eating disorder, it’s important to determine which type you have, so you can get an accurate diagnosis, receive the proper treatment, and work toward full recovery.
Bulimia is an eating disorder characterized by a cycle of binging and then compensating in some way–either by purging, exercising, or restricting food intake–for the amount of food eaten. The underlying reason driving the compensatory behavior is fear of consuming too many calories and gaining weight.
There are three different types of bulimia: purging, non-purging, and atypical bulimia. Purging methods of compensatory behavior can include vomiting or using laxatives, diuretics or enemas. Non-purging methods to compensate for food consumed include exercising excessively or fasting. Atypical bulimia involves fewer binge/purge episodes and doesn’t meet full diagnostic criteria for bulimia nervosa. Purging is the most common type of bulimia, and atypical bulimia is the least common type.
Common personality traits of those with bulimia include perfectionism, compulsiveness, impulsiveness, and sensation seeking. (1)
Binge eating disorder is characterized by eating what is considered a large amount of food in a short period of time and doing so frequently over a longer period of time, feeling out of control while doing so, and experiencing shame afterward. People who have binge eating disorder typically exhibit these behaviors: (2)
There are some similarities between bulimia and binge eating disorder. Individuals who have bulimia and those who have binge eating disorder both experience binging episodes in which they eat large quantities of food over a short period of time and do so frequently.
A desire to lose weight is common in those who have bulimia and binge eating disorder.
Mood disorders, such as depression and anxiety, commonly co-occur with both bulimia and binge eating disorder. (1)
How are bulimia and binge eating disorder different?
The age of onset of bulimia is younger than in those with binge eating disorder. Those with binge eating disorder tend to be older and have a family history of obesity. (3,6)
Binge eating disorder and the different types of bulimia vary in severity. Most severe is the purging type of bulimia. Next is the non-purging type. Binge eating disorder is the least severe. Atypical bulimia lies somewhere in between the non-purging type and binge eating disorder. (5,6)
Those who have binge eating do not have the purging compensatory mechanisms found in those with regular bulimia. (7) Those who have binge eating disorder have less of a restraint and drive for thinness than those with purging or non-purging bulimia. (7)
While body dissatisfaction is common among most eating disorders, it is highest in the non-purging type of bulimia. (9)
While BMI is not an indicator of health and is used here purely to distinguish among the different types of bulimia, research has found differences in BMI among those with different types of bulimia. Those who purge have the lowest BMI of all types of bulimia. The highest BMI is found in those with binge eating disorder. Those with non-purging bulimia and atypical bulimia fall in the middle range, between those who have purging bulimia and those with binge eating disorder. (7,8)
Those who engage in purging are significantly more likely to use vomiting than those with atypical bulimia. Those who have atypical bulimia are less likely to use vomiting than those with the non-purging type, according to one study. (8)
Those who purge have greater feelings of stomach fullness and GI distress compared to those who do not purge. (9)
If you suspect you or someone you know may have binge eating disorder or one of these types of bulimia, it’s critical to seek professional help. Eating disorders do not go away by themselves, but full recovery is possible with an accurate diagnosis and proper treatment.