A similar language problem exists with bulimia. The word comes from the Greek meaning “ox hunger”- certainly a vivid image. Before the 1980s, doctors used the term bulimia exclusively to mean a disorder of overeating. But, like anorexia, the word refers only to a particular symptom: in this case, binge eating. It doesn’t include the flip side of the binge, the purge. The term is thus too narrow to describe the many different eating patterns that characterize the disorder.
For example, all bulimics eat large amounts of food, but there is a wide variation in weight. Some patients are exclusively bulimic, but roughly half of all anorexics also binge and purge. Their starving bodies scream for food; once they yield, they may consume an enormous amount at one sitting. To keep their weight down, these people desperately try to get rid of the meal. Still other bulimics were once self-starvers; they have returned to their normal weight but continue to binge and purge. It’s important to recognize these variations, because they each call for a somewhat different treatment.
In the mid-1970s someone coined the term bulimarexia (“hunger/starvation”) to describe the condition in which a purge follows a binge. Not a particularly graceful word, bulimarexia never caught on. British experts chose to use bulimia nervosa. As with anorexia nervosa, the term distinguishes the symptom from the syndrome and shows that the disorder has both psychological and physical elements.
Only in the late 1980s did doctors in this country accept bulimia nervosa as the best name.
If this seems a bit confusing, take heart-even medical professionals are sometimes bewildered by the subtleties of these terms. I’ve mentioned the debate to show how our perceptions of eating disorders change as we learn more about them.
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