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Mind Your Head
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Lady Sitting

an eating disorder, either anorexia nervosa or bulimia nervosa

Eating: Do I have a problem with anorexia or bulimia?

  1. I have lost a lot of weight in a relatively short time
  2. I am intensely afraid of gaining weight
  3. I sometimes refuse to eat but tell people that I’m not hungry
  4. I feel like I am quite fat, although people tell me I’m thin, or at least not fat
  5. I have withdrawn from social activities I used to enjoy
  6. I have trouble sleeping
  7. Recently, I have had soft hair appearing on my face and/or body
  8. I often experience constipation, incontinence, or abdominal pain
  9. My skin is dry
  10. I am often cold, even in a warm climate
  11. I have low blood pressure
  12. I may have an excessively negative, distorted body image
  13. I have a strong focus on body shape and weight
  14. My self-esteem is low
  15. I fear eating in public or with others
  16. I sometimes have irregular heart rhythms or heartbeat
  17. I sometimes have fainting, dizziness, or headaches
  18. I sometimes get dehydrated
  19. I exercise a lot, and feel quite upset if I have to miss an exercise session
  20. My mood is off: sometimes I’m irritable, depressed, or fatigued
  21. I sometimes don’t have my period (for women who are not yet at menopause)
  22. I am preoccupied with thoughts of food, weight, or cooking
  23. I sometimes hide food in odd places to either avoid eating it or to eat later
  24. I have had sessions of eating until I am in pain, often with high-fat or sweet foods
  25. I have the sense that I cannot control my eating behaviour
  26. I sometimes induce vomiting
  27. I use a lot of laxatives or do a lot of enemas
  28. I often go to the bathroom after eating or during meals
  29. My bowels do not function normally
  30. My teeth and gums seem damaged and/or I have sores in my throat and mouth
  31. I sometimes have swollen salivary glands in my cheeks
  32. I have sores, scars, or calluses on my knuckles or hands
  33. I am frequently either dieting or fasting
  34. I sometimes binge and then purge food (Mayo Clinic, 2012; Eating Disorders Victoria, 2012d; Something Fishy, 2007)

For those statements above that apply to you, where were you more often in agreement that the statement represented something you do: in the top half of the list, or in the lower half?

  • Statements 1 – 11 are relevant mostly to the eating disorder of anorexia nervosa
  • Statements 24 – 34 are relevant mostly to the eating disorder of bulimia nervosa
  • Statements 12 – 23 are relevant to both anorexia and bulimia.

Whichever symptoms you believe are true for you, please note that both disorders are serious psychiatric illnesses, with devastating physical consequences.


Those with anorexia usually have low body weight and body image distortion with an obsessive fear of gaining weight, which causes them to deprive themselves of food. Anorexia is the most fatal of all psychiatric illnesses, because the extreme food restriction that characterises it can lead to starvation, malnutrition, and dangerously low body weight: all of which go hand in hand with a wide range of health problems, and often, death (Eating Disorders Victoria (EDV), 2012a).


Bulimia manifests as recurrent binge-eating episodes. These are characterised by consumption of abnormally large amounts of food in a relatively short period of time, followed by compensatory behaviours such as purging through self-induced vomiting or over-exercising. Bulimia is associated with a loss of control and feelings of shame and guilt after the eating episode, which induces the compensatory behaviours. Because many bulimics are close to average weight, the detection of the disorder can be delayed or missed altogether. Many times, the bulimia gets started when someone goes on a weight loss diet. The resultant food deprivation and inadequate nutrition set up a starvation reaction: an intense desire to eat. Once the person begins to give into the urge, it is difficult to impossible to stop, leading to the binge-purge (compensate) cycle (EDV, 2012b).

Risk factors

There are many! Psychological risk factors include feeling depressed, anxious, or inadequate, and having a perfectionistic personality, coupled with ineffective coping strategies, rigid thinking and fear of conflict. Many eating-disordered people come from families with poor parenting or communication skills. Social factors include the extreme value placed by Western cultures on being thin, and needing to have a “perfect body”; media collude with this emphasis on external appearances by portraying men’s and women’s bodies that are not representative of average, “real” men and women. Biological factors include imbalances in the body’s chemicals and hormones, plus emerging evidence of genetic predisposition. External factors associated with eating disorders include difficult life changes; peer pressure; ineffective stress management strategies; history of abuse; family history of obesity, depression, substance abuse, or eating disorders; and troubled personal or family relationships (EDV, 2012c).

Mind Your Head
Australian Counselling Association

ACA - Australian Counselling Association

Mind Your Head is an initiative of the Australian Counselling Association, a national professional association for qualified Counsellors.