Eating disorders are complex, serious mental health conditions that affect people of all genders, ages, and backgrounds. Despite this, myths and misunderstandings are still widespread. Two diagnoses most people recognize—anorexia nervosa and bulimia nervosa—are often confused with one another, sometimes even used interchangeably. While they share some overlapping features, they are not the same illness.
Understanding the differences and similarities between anorexia and bulimia can help break down stigma and improve awareness. It can also highlight the importance of seeking care, since both disorders can be life-threatening but also highly treatable.
Let’s walk through the diagnostic distinctions between anorexia and bulimia, explore some of the psychological and behavioral patterns that can show up, and take a look at other eating disorders beyond these two.
Anorexia vs. Bulimia: The Diagnostic Differences
At their core, anorexia nervosa and bulimia nervosa differ in how they present in the body and behaviors.
Anorexia nervosa is characterized by restriction of food intake, which leads to significantly low body weight. A person with anorexia often experiences an intense fear of gaining weight, alongside a distorted body image—they may perceive themselves as overweight even when severely underweight.
There are two main subtypes of anorexia:
- Restricting type, in which weight loss is achieved primarily through dieting, fasting, and excessive exercise.
- Binge-purge type, where restriction is the baseline, but episodes of binge eating and purging also occur.
It’s important to note that, while the DSM differentiates between anorexia nervosa and “atypical anorexia nervosa,” from the perspective of those who treat, and those who live with these disorders, they are rather fundamentally the same, despite relative body weight.
Bulimia nervosa, by contrast, does not require low body weight. The hallmark is a cycle of binge eating and compensatory behaviors. During a binge, someone consumes an unusually large amount of food in a short period of time, accompanied by a sense of loss of control. Afterward, they may engage in purging (vomiting, misuse of laxatives or diuretics) or non-purging behaviors (fasting or excessive exercise) to “undo” the binge.
Anyone of any size can have bulimia nervosa, which often makes it harder to detect from the outside. Because of this, bulimia can be overlooked or misdiagnosed, even though it carries very serious medical risks.
In simple terms:
- Anorexia = restriction + (sometimes) low weight (with or without binge/purge behaviors)
- Bulimia = binge/purge cycle
Traits and Temperaments: Where They Overlap
Eating disorders are not just about food—they’re often rooted in temperament, coping strategies, and psychological factors. While everyone’s experience is unique, research has found that some traits appear more commonly among those with anorexia and bulimia.
- Perfectionism: A drive to meet high, sometimes impossible standards, which can fuel restrictive behaviors in anorexia and self-critical spirals in bulimia.
- Impulsivity vs. rigidity: People with anorexia often lean toward control, structure, and rigidity, while bulimia may involve more impulsive or fluctuating patterns of behavior. That said, this isn’t a hard line—there’s plenty of overlap.
- Emotional regulation difficulties: Both disorders can develop as ways of coping with distress. Restriction can serve as a way to numb emotions; bingeing and purging can become attempts to manage overwhelming feelings.
- Low self-esteem and body dissatisfaction: Preoccupation with body image, weight, or shape is common in both.
It’s worth stressing that these traits are not diagnostic. Not everyone with anorexia or bulimia shares these tendencies, and having these traits does not mean someone will develop an eating disorder.
Similarities between Anorexia and Bulimia
Even though anorexia and bulimia differ in diagnosis, they share significant similarities:
- Both are serious mental health conditions, not choices or phases.
- Both are linked to distorted body image and an intense preoccupation with weight and shape.
- Both can cause serious medical complications, including heart problems, digestive issues, electrolyte imbalances, weakened bones, and reproductive health concerns.
- Both thrive in secrecy, making early recognition and intervention harder.
- Both respond best to comprehensive treatment—medical, nutritional, and therapeutic support tailored to the individual.
Beyond Anorexia and Bulimia: Other Eating Disorders
While anorexia and bulimia are the most commonly recognized eating disorders, they are far from the only ones. Expanding awareness of other diagnoses helps people get the support they need.
- Binge Eating Disorder (BED): The most common eating disorder, characterized by recurrent binge episodes without purging or compensatory behaviors. BED often co-occurs with shame, guilt, and weight stigma.
- Avoidant/Restrictive Food Intake Disorder (ARFID): Involves extreme restriction of food intake, but not because of weight or body image concerns. Reasons may include sensory sensitivities, fears of choking or vomiting, or a general lack of interest in food.
- Other Specified Feeding or Eating Disorder (OSFED): A diagnosis used when disordered eating patterns don’t fit neatly into one category but are still significant and harmful.
It’s helpful to compare some of these side by side. For instance, bulimia vs. binge eating disorder: both involve binge episodes, but bulimia includes purging or compensatory behaviors, while BED does not. Similarly, anorexia (restricting type) vs. ARFID: both involve severe restriction, but anorexia is driven by body image and weight concerns, while ARFID is generally not.
These comparisons highlight how eating disorders can look different on the surface but share underlying distress and impairment.
Why These Distinctions Matter
You may wonder: why does it matter to distinguish between anorexia and bulimia—or between bulimia and binge eating disorder? The answer lies in treatment and safety.
Different eating disorders carry different medical risks. For example, anorexia can lead to life-threatening malnutrition and organ failure, while bulimia can cause dangerous electrolyte imbalances from repeated purging. BED is strongly linked to metabolic complications, and ARFID can cause nutrient deficiencies that affect growth and development.
Accurate diagnosis also guides treatment. While there’s overlap in therapies, such as cognitive behavioral therapy (CBT) and family-based treatment, the focus may differ. For instance, restoring weight is often an urgent goal in anorexia, while breaking the binge-purge cycle is central to bulimia treatment.
On a broader level, understanding the differences reduces stigma. When people see eating disorders as monolithic—only affecting thin, white, young women—many who don’t fit that stereotype get overlooked. Recognizing the full spectrum helps ensure that men, people of color, older adults, and those in larger bodies also receive the care they deserve.
A Final Word
Anorexia and bulimia are two distinct eating disorders, but they share common ground: both are serious, both are misunderstood, and both are treatable with the right support. Knowing how they differ—and how they overlap—helps us move beyond stereotypes and toward compassion and awareness.
At the same time, it’s important to remember that anorexia and bulimia are not the only eating disorders. Conditions like binge eating disorder, ARFID, and OSFED also deserve recognition and care. Eating disorders are diverse, complex, and never one-size-fits-all.
If you or someone you love is struggling with disordered eating, know that help is available. Recovery is not only possible—it is worth it.
