Bulimia nervosa and binge eating disorder are both types of eating disorders. Both may start during adolescence and involve eating large amounts of food in a short period, but they have important differences.
Bulimia nervosa and binge eating disorder are distinct eating disorders. However, both types involve periods of bingeing, which is eating a large amount of food in a short period.
Bulimia nervosa also involves compensatory behaviors, such as taking laxatives or inducing vomiting.
Both types of eating disorders can affect a person’s physical and mental health. Treatment, such as psychotherapy, can help a person reach and maintain recovery.
The use of binary terms such as “male” and “female” or “men” and “women” in this article reflects the language of the sources we’ve used. Unless otherwise noted, it’s unclear whether the research we reference included participants with expansive gender identities.
The table below outlines some key similarities and differences between
| Bulimia nervosa | Binge eating disorder | |
|---|---|---|
| Characteristic features | bingeing episodes followed by compensatory behaviors to avoid weight gain, at least once a week for 3 months | bingeing episodes without compensatory behaviors, at least once a week for 3 months |
| Treatment options | • selective serotonin reuptake inhibitors • cognitive behavioral therapy (CBT) • interpersonal psychotherapy | • individual or group psychotherapy • selective serotonin reuptake inhibitors • lisdexamfetamine (Vyvanse, Elvanse) • behavioral weight loss |
| Potential complications | • swollen cheeks and saliva glands • gastroesophageal reflux disease (GERD) • constipation • dental enamel erosion • type 2 diabetes • arrhythmia | • musculoskeletal pain • metabolic syndrome • high blood pressure • cardiovascular disease • type 2 diabetes • sleep disorders |
| Outlook | most people with bulimia nervosa recover |
Both bulimia nervosa and binge eating disorder involve episodes of bingeing. Bingeing is the
A person may have binge eating disorder if they have a bingeing episode at least once a week for 3 months. They may also experience negative feelings, such as depression or guilt, after bingeing episodes.
Someone with binge eating disorder will not carry out compensatory behaviors to prevent weight gain after bingeing episodes.
A person may have bulimia nervosa if they have a bingeing episode followed by compensatory behaviors at least once a week for 3 months.
Examples of compensatory behaviors include:
Bulimia nervosa vs. binge eating disorder symptoms
The main difference between bulimia nervosa and binge eating disorder is the presence of compensatory behaviors.
People with bulimia nervosa may experience additional symptoms that relate to these behaviors, such as:
- dental enamel erosion
- low blood pressure
- swollen glands
- dry skin
- Russell’s sign, calluses on the back of the hand
- hair loss
- nosebleeds
After bingeing episodes, people with binge eating disorder may also experience feelings of guilt, disgust, or depression.
Some research suggests that binge eating disorder is the
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According to the review, bulimia nervosa rates range from 0.1% to 2.6% and binge eating disorder rates range from 0.3% to 6.1%.
The review suggests both eating disorders tend to have a higher prevalence among women than men. However, various factors may affect this trend, including a fear of stigmatization preventing men from seeking diagnoses or support with disordered eating.
It is important to note that most of the research into the prevalence of eating disorders focuses on people who meet the diagnostic criteria. Rates of disordered eating that just fall short of these criteria may be significantly higher.
Actual eating disorder rates may also be higher than research suggests, since not everyone with an eating disorder may feel able or ready to speak with a healthcare professional.
Treatment for both of these eating disorders may aim to reduce bingeing behavior. Healthcare professionals will also focus on reducing compensatory behaviors in people with bulimia nervosa.
Treatment approaches are typically multifaceted. Healthcare professionals will tailor a person’s treatment plan to their needs. Treatment options
Psychotherapy
Psychotherapy is a first-line treatment option for binge eating disorder and bulimia nervosa. A doctor
- enhanced cognitive behavioral therapy
- interpersonal psychotherapy
- family-based treatment
Medications
A healthcare professional may combine psychotherapy with medications when treating eating disorders.
The Food and Drug Administration (FDA)
A doctor
Other potential medications include different types of selective serotonin reuptake inhibitors (SSRIs),
- citalopram (Celexa)
- sertraline (Zoloft)
- fluvoxamine (Luvox)
A doctor may also prescribe medications to address mental health issues or complications of the person’s eating disorder.
Nutritional counseling
Nutritional counseling
A doctor may refer a person to a nutritionist to counsel them on the nutritional quality of food. They may also help a person with planning meals and managing their weight, if necessary.
Monitoring and ongoing support
People with eating disorders may find it challenging to continue with an ongoing treatment plan.
As part of their treatment and recovery, their healthcare team may schedule regular checkups and ensure the person has ongoing support.
A person with binge eating disorder
Delaying treatment
Ongoing help and support are vital when seeking treatment or in recovery from an eating disorder. The following organizations and support groups can offer real-time, virtual help and solidarity from others in similar experiences:
- National Association of Anorexia Nervosa and Associated Disorders, which provides general and focused eating disorder support groups
- National Alliance for Eating Disorders, which provides focused support groups for:
- friends and family of people with eating disorders
- people with larger bodies
- the LGBTQ+ community
- BIPOC adults
- National Eating Disorders Association, which offers a list of state-specific in-person support groups
- Renewed Support, which offers focused virtual support groups, including groups for men, people in the LGBTQ+ community, and more
It is not possible for a person to have both bulimia nervosa and binge eating disorder. The diagnostic criteria for both conditions involve bingeing episodes at least once a week for 3 months.
Bulimia nervosa also involves compensatory behaviors to prevent weight gain, such as self-induced vomiting or excessive exercise, while binge eating disorder does not.
Bulimia nervosa and binge eating disorder are not dependent on a person’s weight or sex. Anyone can have one of these eating disorders, regardless of sex, gender, or weight.
Bingeing and overeating are not the same thing. Bingeing is uncontrollably eating more than is typical in a similar circumstance over a short period, usually less than two hours.
Bingeing may also include:
- eating very quickly
- eating when not hungry
- eating until uncomfortably full
- feeling depressed, guilty, or ashamed afterward
- eating alone
Binge eating disorder and bulimia nervosa both involve bingeing episodes. This is an uncontrollable episode in which a person eats large amounts in a short period.
People with bulimia nervosa will also carry out compensatory behaviors, such as self-induced vomiting, in an attempt to maintain the same weight after bingeing.
Treatment can help with both types of eating disorders. People can speak with a healthcare professional to learn the treatment options available to them.