In anorexia nervosa, people starve themselves, and anorexics often become skeleton-thin, yet they don’t see themselves that way. Excessive exercising is sometimes a part of the picture, coupled with loss of sleep.

With extreme weight loss also come the unpleasant symptoms of malnutrition and dehydration. As body fat is lost and muscle protein broken down to provide energy; women’s periods will stop, teeth will decay or be lost, the blood will lose important minerals, there will be increased risk of osteoporosis in later life.


In bulimia nervosa (which is more common than anorexia and often follows it), binge eating is followed by self-induced vomiting, periods of starvation and/or purging with laxatives. People with bulimia – mostly women, and generally of an older age group than anorexics – also go through emotional extremes, often feeling out of control.

Because self-induced vomiting is a source of shame, people with bulimia are often devious and deceptive about their problem, going to the bathroom after meals to “get rid” secretly of what they’ve eaten. Habitual vomiting can also erode tooth enamel and cause sore throats, while menstrual disorders may follow and again the risk of osteoporosis is increased.

Possible Causes

Some authorities believe that anorexia and bulimia may be ways of avoiding other, more painful emotional problems, or of coping with long-buried stresses.

Alternatively, it may be a way of exerting control, especially tempting to someone who may feel that their bodies are about the only thing in life they can control. People with eating disorders commonly see “control” over eating as the answer to other problems – until anorexia or bulimia begins to make them so ill that the condition becomes the number one concern.

Another theory is that some eating disorders have a straightforward physiological origin, beginning with food allergy which results in food “addiction”.

Only in the last 20 years have anorexia and bulimia been recognized by the medical profession as “diseases”. People with anorexia and bulimia can and do get better – especially when the disorder is recognized early and treated.

How can we help?

Helping a client with both anorexia and bulimia, may require help from other professionals.( dependant on BMI and age of the client, as well as the number of years the client has suffered)

Often, by giving nutritional fact, rather than information found on the internet on its own, can help de mystify nutrition. Often both anorexics and bullimics become experts on food and calories.

It is also important to acknowledge some of the side effects caused by vomiting for example. Acidity of the stomach contents can cause extreme sore throats, so simply expecting a client to eat more calories without helping this secondary symptom will have limited effect.