Patients with anorexia nervosa have an intense fear of gaining weight. They are severely underweight, but continue to restrict food intake despite being thin. Medical signs of anorexia are BMI less than 17.5, irregular or slow heartbeat, low BP, slow pulse rate and abnormal blood counts. Patients with anorexia tend to have a flat disposition and lack emotional expression.
Dry skin and thinning hair are other symptoms, but patients with anorexia may also grow soft downy hair to keep the body warm. Irregular menstruation or amenorrhea frequently occurs in women with anorexia.
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Patients with anorexia feel cold even when the temperature is normal. Their hands may be cold to touch due to poor circulation, and they may have blue, brittle nails.
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Other physical symptom of bulimia include dry skin, bloating, swollen salivary glands in the cheeks, and cuts and bruises on the knuckles and hands due to teeth breaking the skin during self-induced vomiting.
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Patients with bulimia eat lots of food in a short amount of time (binging) and then try to prevent weight gain by getting rid of the food (purging). They are typically normal to slightly overweight, but often exhibit rapid fluctuations in weight. Purging techniques include vomiting and abusing laxatives, diuretics and enemas. Like anorexics, patients with bulimia may also practice fasting, dieting and excessive exercise to compensate for food intake.
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Physical signs of bulimia include the destruction of the teeth and gums, rupture of the esophagus, cardiac irregularities, gastrointestinal damage and aspiration pneumonia due to purging.
Anorexia nervosa and bulimia nervosa are eating disorders that cause serious medical problems. Anorexia and bulimia frequently develop during adolescence or early adulthood, but can occur during childhood or later in adulthood. An estimated 8 million Americans – 7 million women and 1 million men – have an eating disorder.
Malnutrition due to anorexia and bulimia can lead to damage to the organs, vitamin and mineral deficiencies, cardiac irregularities, muscle depletion, bone loss and increased risk for fractures. Although eating disorders also have the highest mortality associated with any mental illness, only one in 10 receive treatment. Approximately 20% of people with anorexia will prematurely die from complications related to their eating disorder, including suicide and heart problems.
Learn more about the signs and symptoms of these two eating disorders, so you can recognize them in your patients.