What is the difference between bulimia and binge-eating disorder?

The direct answer

Both bulimia nervosa and binge-eating disorder can involve recurrent episodes of eating an unusually large amount with a sense of lost control. Bulimia also involves recurring behaviors intended to compensate for eating. Binge-eating disorder does not involve that regular pattern of compensation. Diagnosis requires a fuller assessment. [1], [2]

Does compensation only mean vomiting?

No. Compensatory behaviors can also include fasting, excessive exercise, or misuse of laxatives. These behaviors can cause serious health problems. Tell a healthcare professional about them even if you feel unsure whether they count or do not happen after every episode. [2]

An introductory conversation could begin: ‘Sometimes I feel unable to stop eating, and afterward I try to make up for it.’ You do not have to arrive with a precise clinical description.

What if I feel out of control but do not know whether it is a binge?

Describe what you experienced rather than deciding alone whether it meets a formal definition. A provider can ask about the circumstances, frequency, distress, and other behaviors. NIDDK notes that a mental health professional can assess binge-eating disorder and discuss treatment options. [3]

Useful notes might include when the pattern began, what you mean by ‘out of control,’ and what happens afterward. Ask the clinician what information would help; there is no need to prepare a detailed calorie record for this article.

What should I ask about care?

Ask how your provider will address both eating behavior and its physical effects, and whether additional medical or nutritional care is needed. You can also ask what the early goals would be and how the plan would change if symptoms continue.

The purpose of the distinction is to guide care. It is not a ranking of whose distress matters more. When reaching out, name the experience you want help with, even if your diagnosis is unknown.

Explore care at Rumi Counseling

• Eating disorder therapy
• Bulimia therapy
• Binge-eating therapy
• Eating disorder therapy at Rumi Counseling