(See “Critical Reading” in Chapter 1)

1

Anorexia nervosa is life-threatening weight loss. Four key features define anorexia nervosa: First, the person refuses to maintain a normal body weight. With a body weight that is 15 percent or more below normal, body mass index can drop to 12 or lower. Second, despite being dangerously underweight, the person with anorexia is intensely afraid of gaining weight or becoming fat. Third, the anorexic has a distorted perception about the size of his or her body. Although emaciated, he or she looks in the mirror and sees someone fat or obese. And fourth, an anorexic denies the seriousness of his or her weight loss (American Psychiatric Association [APA], 2000).

2

Perfectionism and rigid thinking, poor peer relations, social isolation, and low self-esteem are common (Halmi et al., 2000). Although estimates vary, approximately 10 percent of people with anorexia nervosa die from starvation, suicide, or physical complications accompanying extreme weight loss (APA, 2000; Kaye, Klump, Frank, and Strober, 2000).

3

Bulimia nervosa is bingeing and purging of food. Like people with anorexia, people with bulimia nervosa fear gaining weight. Intense preoccupation and dissatisfaction with their bodies are also apparent. However, people with bulimia stay within a normal weight range or may even be slightly overweight. Another difference is that people with bulimia usually recognize that they have an eating disorder.

4

People with bulimia nervosa experience extreme episodes of binge eating, consuming as many as 50,000 calories in a single binge. Binges typically occur twice a week and are often triggered by negative feelings or hunger (Agras & Apple, 1997). During the binge, the person usually consumes sweet, high-calorie foods that can be swallowed quickly, such as ice cream, cake, and candy. Binges typically occur in secrecy, leaving the person feeling ashamed, guilty, and disgusted by his or her own behavior. After bingeing, the bulimic compensates by purging him- or herself of the excessive food by self-induced vomiting or by misuse of laxatives or enemas. After purging, he or she often feels psychologically relieved. Some people with bulimia do not purge themselves of the excess food. Rather, they use fasting and excessive exercise to keep their body weight within the normal range (APA, 2000).

References

Agras, W. S., & Apple, R. F. (1997). Overcoming eating disorders: A cognitive-behavioral treatment for bulimia nervosa and binge-eating. San Antonio, TX: Harcourt Brace.

American Psychiatric Association. (2000). Practice guidelines for the treatment of patients with eating disorders (revision). American Journal of Psychiatry, 157 (Suppl.), 1–39.

Halmi, K. A., Sunday, S. R., Strober, M., Kaplan, A., Woodside, D. B., Fichter, M., Treasure, J., . . . Kaye, W. H. (2000). Perfectionism in anorexia nervosa: Variation by clinical subtype, obsessionality, and pathological eating behavior. American Journal of Psychiatry, 157, 1799–1805.

Kaye, W. H., Klump, K. L., Frank, G. K., & Strober, M. (2000). Anorexia and bulimia nervosa. Annual Review of Medicine, 51, 299–313.

(See “Writing Critically About Readings” in Chapter 1)