Binge/purge anorexia (also known as binge-eating/purging type anorexia) is a subtype of the eating disorder anorexia nervosa that varies somewhat from the common perception of that disorder. People affected by binge/purge anorexia participate in some of the same behaviors that characterize two other diagnosable eating disorders, called bulimia nervosa and binge-eating disorder. However, each of these disorders differs from the other in important ways, and doctors use the dissimilarities between the conditions to make accurate diagnoses in their patients.
Classic Anorexia Basics
All people with anorexia nervosa have a disordered pattern of eating that produces a body weight dangerously below normal for their age, height and gender. While there is no official set point for viewing weight loss as dangerous, the vast majority of doctors and mental health professionals consider an anorexia diagnosis in people who develop eating behaviors that leave them at least 15 percent lighter than their age, height and gender counterparts unaffected by eating problems. In the most well-known form of anorexia, a dysfunctional relationship between body weight, body shape and food intake is maintained through a severe restriction of everyday dietary choices. Some people with this classic form of anorexia support the effects of restrictive food consumption with participation in a ritualistic, overly intense exercise program.
Binge/Purge Anorexia Basics
People with binge/purge anorexia have the same basic dysfunctional relationship with food, body weight and body size that appears in people with classic anorexia. In line with this fact, they generally restrict their daily food intake in order to reduce their calorie consumption and keep their body weight down. However, binge/purge anorexics also periodically engage in excessive food binges that produce a temporary, drastic increase in their calorie intake. Since they still have the weight and size obsessions associated with all forms of anorexia, they must find some way to eliminate the calories they consume during their food binges. Methods used for this purpose include forced vomiting, an inappropriate reliance on laxative products, an inappropriate reliance on diuretic products, and an inappropriate reliance on colon-emptying enemas.
Bulimia Nervosa Basics
People with bulimia nervosa have a version of the same weight/size/food fixation that appears in people with anorexia. However, rather than restricting their food intake in the vast majority of circumstances, bulimics express their underlying fixations by periodically engaging in episodes of extraordinarily heavy food intake. In a misguided attempt to cancel out their extreme binge-related calorie intake, individuals affected by bulimia also engage in the same range of calorie-eliminating behaviors found in people affected by binge/purge anorexia. Still, taken as a whole, these behaviors are far more characteristic in cases of bulimia than they are in cases of anorexia.
Binge-Eating Disorder Basics
Binge-eating disorder was only officially recognized as a unique eating disorder by the American Psychiatric Association in May 2013. People with this condition follow a dysfunctional pattern of excessive calorie consumption that’s more or less identical to the pattern found in people with bulimia; during binging episodes, the disorder also bears a passing resemblance to binge/purge anorexia. However, unlike bulimics or binge/purge anorexics, individuals affected by binge-eating disorder don’t take extra measures to prevent normal calorie processing or the weight gain that stems from that processing. As a result, they frequently add substantial amounts of weight to their bodies over time.
Distinguishing Between the Conditions
Despite their superficial similarities and (in some cases) deeper resemblances, binge/purge anorexia nervosa, bulimia nervosa, and binge-eating disorder differ from each other in key ways, and doctors use the physical and behavioral distinctions between the conditions to make their diagnoses. Regardless of its presentation of food binging episodes, the main underlying characteristic of binge/purge anorexia is still the maintenance of an unhealthy body weight that falls 15 percent or more below generally accepted norms. This characteristic ties the binge/purge subtype to classic anorexia and distinguishes the condition from both bulimia and binge-eating disorder.
While bulimics attempt to offset their food binges through unhealthy means just like people with binge/purge anorexia, when viewed as a whole, people with the disorder lack the catastrophic weight loss that characterizes anorexia. In fact, an individual with bulimia can have a body weight that ranges all the way from significantly underweight to significantly overweight. When compared to both binge/purge anorexia and bulimia, the distinguishing characteristic of binge-eating disorder is the absence of rigorous weight-control measures. In addition, because of the weight gain associated with uncompensated food binging, people with the disorder often gain enough weight to qualify as overweight, obese, or morbidly obese.