Eating Disorders: Anorexia &
Bulimia Nervosa
Eating Disorders are illnesses that are characterized by irregular eating habits and extreme
distress or concern about body weight or shape. Eating disturbances may involve inadequate or
excessive food intake which can basically cause harm to a person’s well-being. The most
common forms of eating disorders are anorexia nervosa, bulimia nervosa, binge-eating disorder,
pica, rumination disorder, avoidant or restrictive food intake disorder (ARFID), and other specified
feeding or eating disorder (OSFED). Read this study guide and learn more about eating
disorders (anorexia nervosa and bulimia nervosa), its nursing care management, interventions,
and assessment.
What are Eating Disorders?
Eating disorders are characterized by a repeated disturbance of eating or eating-related
behavior that results in the altered consumption or absorption of food and that significantly
diminishes physical health or psychosocial functioning. Eating disorders can be viewed on a
continuum, with clients with anorexia nervosa eating too little or starving themselves, clients with
bulimia eating chaotically, and clients with obesity eating too much.
● Although many believe that eating disorders are relatively new, documentation from
the Middle Ages indicates willful dieting leading to self-starvation in female saints
who fasted to achieve purity.
● In the late 1800s, doctors in England and France described young women who
apparently used self-starvation to avoid obesity.
● It was not until the 1960s, however, that anorexia nervosa was established as a
mental disorder.
● Bulimia nervosa was first described as a distinct syndrome in 1979.
Types of Eating Disorders
The most common eating disorders found in the mental health setting are anorexia nervosa,
bulimia nervosa, binge-eating disorder, pica, rumination disorder, avoidant or restrictive food
intake disorder (ARFID), and other specified feeding or eating disorder (OSFED).
● Anorexia Nervosa. Anorexia nervosa is a life-threatening eating disorder
characterized by the client’s refusal or inability to maintain a minimally normal body
weight, intense fear of gaining weight or becoming fat, significantly disturbed
perception of the shape or size of the body, and steadfast inability or refusal to
acknowledge the seriousness of the problem or even that one exists.
, ● Bulimia Nervosa. Bulimia nervosa, often simply called bulimia, is an eating disorder
characterized by recurrent episodes (at least twice a week for 3 months) of binge
eating followed by inappropriate compensatory behaviors to avoid weight gain such
as purging, fasting, or excessively exercising.
● Binge-Eating Disorder (BED). Binge-eating disorder is another eating disorder
characterized by recurrent episodes of binge eating but it is not associated with the
recurrent use of inappropriate compensatory behaviors as in bulimia nervosa, and
does not occur exclusively during the course of bulimia nervosa, or anorexia nervosa
methods to compensate for overeating, such as self-induced vomiting.
● Pica. Pica is an eating disorder that involves persistent eating of non-nutritive
substances such as hair, dirt, and paint chips for a period of at least one month.
● Rumination disorder. Rumination disorder is characterized by repeatedly and
persistently regurgitating food after eating, but it’s not due to a medical condition or
another eating disorder such as anorexia nervosa, bulimia nervosa, binge-eating
disorder, or avoidant/restrictive food intake disorder.
● Avoidant/Restrictive Food Intake Disorder (ARFID). Avoidant or restrictive food
intake disorder is an eating or feeding disturbance characterized by persistent failure
to meet appropriate nutritional or energy needs due to having no interest in eating
regarding food with certain sensory characteristics, such as color, texture, smell or
taste; or fear of choking.
● Other Specified Feeding or Eating Disorder (OSFED). Other specified feeding or
eating disorders or (OSFED) are eating behaviors that cause clinically compelling
distress and impairment in areas of functioning, but do not meet the full criteria for
any of the other feeding and eating disorders.
Causes
A specific cause for eating disorders is unknown; initially, dieting may be the stimulus that leads
to their development.
● Biologic factors. Studies of anorexia nervosa have shown that these disorders tend
to run in families; genetic vulnerability also might result from a particular personality
type or a general susceptibility to psychiatric disorders.
● Developmental factors. Onset of anorexia nervosa usually occurs during
adolescence or young adulthood; some researchers believe its causes are related to
developmental issues.
● Family influences. Girls growing up amid family problems and abuse are at higher
risk for both anorexia and bulimia; disorders eating is a common response to family
discord.
● Sociocultural factors. Adolescents often idealize actresses and models as having
the perfect “look” or body even though many of these celebrities are underweight or
Bulimia Nervosa
Eating Disorders are illnesses that are characterized by irregular eating habits and extreme
distress or concern about body weight or shape. Eating disturbances may involve inadequate or
excessive food intake which can basically cause harm to a person’s well-being. The most
common forms of eating disorders are anorexia nervosa, bulimia nervosa, binge-eating disorder,
pica, rumination disorder, avoidant or restrictive food intake disorder (ARFID), and other specified
feeding or eating disorder (OSFED). Read this study guide and learn more about eating
disorders (anorexia nervosa and bulimia nervosa), its nursing care management, interventions,
and assessment.
What are Eating Disorders?
Eating disorders are characterized by a repeated disturbance of eating or eating-related
behavior that results in the altered consumption or absorption of food and that significantly
diminishes physical health or psychosocial functioning. Eating disorders can be viewed on a
continuum, with clients with anorexia nervosa eating too little or starving themselves, clients with
bulimia eating chaotically, and clients with obesity eating too much.
● Although many believe that eating disorders are relatively new, documentation from
the Middle Ages indicates willful dieting leading to self-starvation in female saints
who fasted to achieve purity.
● In the late 1800s, doctors in England and France described young women who
apparently used self-starvation to avoid obesity.
● It was not until the 1960s, however, that anorexia nervosa was established as a
mental disorder.
● Bulimia nervosa was first described as a distinct syndrome in 1979.
Types of Eating Disorders
The most common eating disorders found in the mental health setting are anorexia nervosa,
bulimia nervosa, binge-eating disorder, pica, rumination disorder, avoidant or restrictive food
intake disorder (ARFID), and other specified feeding or eating disorder (OSFED).
● Anorexia Nervosa. Anorexia nervosa is a life-threatening eating disorder
characterized by the client’s refusal or inability to maintain a minimally normal body
weight, intense fear of gaining weight or becoming fat, significantly disturbed
perception of the shape or size of the body, and steadfast inability or refusal to
acknowledge the seriousness of the problem or even that one exists.
, ● Bulimia Nervosa. Bulimia nervosa, often simply called bulimia, is an eating disorder
characterized by recurrent episodes (at least twice a week for 3 months) of binge
eating followed by inappropriate compensatory behaviors to avoid weight gain such
as purging, fasting, or excessively exercising.
● Binge-Eating Disorder (BED). Binge-eating disorder is another eating disorder
characterized by recurrent episodes of binge eating but it is not associated with the
recurrent use of inappropriate compensatory behaviors as in bulimia nervosa, and
does not occur exclusively during the course of bulimia nervosa, or anorexia nervosa
methods to compensate for overeating, such as self-induced vomiting.
● Pica. Pica is an eating disorder that involves persistent eating of non-nutritive
substances such as hair, dirt, and paint chips for a period of at least one month.
● Rumination disorder. Rumination disorder is characterized by repeatedly and
persistently regurgitating food after eating, but it’s not due to a medical condition or
another eating disorder such as anorexia nervosa, bulimia nervosa, binge-eating
disorder, or avoidant/restrictive food intake disorder.
● Avoidant/Restrictive Food Intake Disorder (ARFID). Avoidant or restrictive food
intake disorder is an eating or feeding disturbance characterized by persistent failure
to meet appropriate nutritional or energy needs due to having no interest in eating
regarding food with certain sensory characteristics, such as color, texture, smell or
taste; or fear of choking.
● Other Specified Feeding or Eating Disorder (OSFED). Other specified feeding or
eating disorders or (OSFED) are eating behaviors that cause clinically compelling
distress and impairment in areas of functioning, but do not meet the full criteria for
any of the other feeding and eating disorders.
Causes
A specific cause for eating disorders is unknown; initially, dieting may be the stimulus that leads
to their development.
● Biologic factors. Studies of anorexia nervosa have shown that these disorders tend
to run in families; genetic vulnerability also might result from a particular personality
type or a general susceptibility to psychiatric disorders.
● Developmental factors. Onset of anorexia nervosa usually occurs during
adolescence or young adulthood; some researchers believe its causes are related to
developmental issues.
● Family influences. Girls growing up amid family problems and abuse are at higher
risk for both anorexia and bulimia; disorders eating is a common response to family
discord.
● Sociocultural factors. Adolescents often idealize actresses and models as having
the perfect “look” or body even though many of these celebrities are underweight or
