Bulimia vs Binge Eating: What’s the Difference?

Key Similarities Between Bulimia & Binge Eating Disorder

Bulimia and BED have many similarities yet are distinct at the same time.

Binge eating episodes

The most obvious similarity is that both conditions involve periods of excessive food consumption, the basic definition of a “binge” episode. In both binge eating disorder vs bulimia, people have repeated episodes of consuming an unusually large amount of food in a single sitting. These recurrent episodes are often done secretly, sometimes late at night or when nobody else is around. Most people who binge state they feel “out of control” when binging.

Loss of control

The feeling of losing control is a common thread between bulimia nervosa vs. binge eating disorder. During a binge episode, someone isn’t eating because they’re hungry — they’re eating because they feel like they can’t control or stop the intake.

Emotional activators

Emotional activators can set off a binge, too. Feeling stressed, depressed, anxious, sad, or bored can be the catalyst for the next binge episode for someone living with bulimia or BED. It’s not the same emotion for everyone, either.

Feelings of guilt and shame

Immediately following — or even during — a binge, it’s common for someone to experience deep feelings of guilt and shame. They regret their decisions and behavior but often feel powerless and unable to exert any control to stop the pattern of their eating habits.

Psychological impact

Beyond the physical implications, there are psychological impacts of binge eating and bulimia to be concerned about, too. Living with an eating disorder can have damaging psychological effects, including low self-esteem, anxiety, depression, and other mental health conditions. In extreme cases, the negative thought and behavior patterns can even lead to thoughts of suicide. Studies show that suicidal behavior is more prevalent in people with BED or bulimia when compared to the general population.

Used as a coping mechanism

Many eating disorders start as coping mechanisms for life’s stresses or traumas. The problem, though, is they aren’t a permanent solution. Even if it feels like there’s some temporary relief, the feeling doesn’t last long and the compulsive eating continues.

Key Differences Between Bulimia & Binge Eating Disorder

Despite there being similarities between bulimia vs. binge eating disorder, there are also noticeable differences. It’s essential to fully understand the distinctions between the two conditions because this helps get the proper treatment.

Purging behavior vs. lack of purging

The main difference between bulimia and binge eating is purging after a binge. With bulimia, someone will engage in compulsive eating (binging) followed by self-induced vomiting. People showing signs of binge eating disorder don’t use secondary methods, like purging, to counteract the consequences of a binge, which often include weight gain and feelings of guilt and shame.

Motivation

It’s not always the case for everyone, but a fear of weight gain drives some people with bulimia. It’s also not uncommon for people with bulimia nervosa to have distorted body image issues. While people with binge eating disorder may be unhappy with their weight, the feeling doesn’t tend to be strong enough to motivate them to purge, as is the case with somebody living with bulimia.

Weight fluctuations

One more notable distinction between bulimia and binge eating lies in possible weight fluctuations. Some people living with bulimia can maintain an “average” body weight due to their alternating periods of binging, followed by purging. Others, however, might purge to the point that they’re noticeably underweight or unhealthy.

Since people with binge eating disorder do not compensate for the additional calories they take in during a binge, they commonly see significant weight gain over time.

Diagnosis criteria

Like many mental health conditions, the diagnosis criteria for binge eating disorder vs. bulimia can differ.

• The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) states that for a bulimia diagnosis to be made, several criteria must be met. One condition is there must be regular episodes of binge eating accompanied by purging behavior at least once a week for 3 months.
• BED can be diagnosed if someone has recurrent binging without any purge active activity for the same period.

There are other conditions that must be met for a diagnosis to be made as well, but the major differentiator is the absence of purging.

Treatment approaches

No single treatment is guaranteed suitable or effective for everyone with bulimia or binge eating disorder. Both conditions have been found to respond to talk therapy, and in some cases, efficacy can be enhanced when treatment is combined with medication.

Getting a Proper Diagnosis & Treatment

Understanding the differences between bulimia and binge eating disorder is crucial, and getting an accurate diagnosis from a qualified medical or mental health professional is key.

Accurately identifying the issues associated with either condition can be a pathway to successful therapy that allows you to regain control of your life. For many people, treatment can lead to disorder recovery, according to research.

• One study suggests that as many as 68.2% of people recovered from bulimia 22 years post-treatment.
• Other research notes that interpersonal psychotherapy (IPT) and cognitive behavioral therapy (CBT) can offer long-term success and complete disorder recovery from binge eating in 64% of people. However, the study notes that more research is needed.

Getting a diagnosis is the first step in overcoming any disordered eating condition. Online therapy platforms like Talkspace make getting help affordable and convenient. Talkspace makes it simple to connect with a professional and get a diagnosis to start online treatment for binge eating disorder or bulimia. Find out how Talkspace can help you or a loved one overcome the pain and fear of an eating disorder. You’ll learn to take proactive steps toward a healthy, rewarding life free of the grip binge eating holds over you.