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Table 10-11

Signs and Symptoms AnorexiaBulimia
Behavioral
  • Self-starvation
  • Rituals regarding food, eating, and weight loss
  • Behaviors to ↓ weight: purging, exercise, use of laxatives, enemas, and diuretics
  • Repetitive secret bingeing and purging
  • Behaviors to ↓ weight: purging, exercise, use of laxatives, enemas, and diuretics
  • Fasts to compensate for bingeing
Physical
  • Weight loss 15% below ideal
  • Cachexia (sunken eyes, protruding bones, dry skin)
  • Amenorrhea
  • ↓ Pulse, ↓ body temperature
  • Lanugo on face
  • Constipation
  • Sensitivity to cold
  • Weight is usually normal; may be ↑ or ↓ 
  • Fluid/electrolyte imbalances (↓ K, metabolic alkalosis, dehydration)
  • Menstrual irregularities
  • Dental caries, loss of dental enamel,
  • ↓ BP, cardiac dysrhythmias, constipation or diarrhea, GERD, parotid enlargement
Psychological
  • Appears fat to self
  • Intense, irrational fear of being fat
  • Preoccupation with cooking, food, nutrition
  • Delayed psychosexual development
  • Perfectionist, high achiever
  • Excessive concern about weight, shape, proportions
  • Lack of control over eating during bingeing
  • Depression, shame, self-contempt follow bingeing
  • Mood swings, irritability
  • Impulsive, extrovert

BP = blood pressure, GERD = gastroesophageal reflux disease.