Commonly confused in nursing
Anorexia Nervosa vs Bulimia Nervosa
Both are eating disorders, but the NCLEX expects you to match specific lab values, physical findings, and mortality data to the correct diagnosis. Picking the wrong electrolyte pattern or missing refeeding syndrome risk on an anorexia question can cost you the item — and in practice, the patient's life.
Which One Is It?
1 / 4 · score 0The finding: Lanugo, hypothermia, dry/yellow skin
Side-by-side comparison
Side-by-side2 compared
Focus
Dimension
Anorexia Nervosa
Bulimia Nervosa
Pathophysiology & risk
- Severe caloric restriction
- Significantly low weight (BMI < 18.5)
- Binge, then purge (vomit, laxatives)
- Usually normal or slightly above weight
Signs & symptoms
- ★Lanugo, hypothermia, dry/yellow skin
- Emaciation, muscle wasting
- Sees self as fat
- denies problem (ego-syntonic)
- ★Russell's sign (knuckle calluses)
- Parotid swelling
- dental enamel erosion
- Aware, ashamed (ego-dystonic)
Diagnostics & labs
- Hypoglycemia, hyponatremia
- Bradycardia, orthostatic hypotension
- ★Hypokalemia + metabolic alkalosis
- Hypomagnesemia if laxative abuse
Nursing priorities
- Medical stabilization first
- Slow refeeding
- Supervised meals + weights
- Interrupt binge-purge cycle
- Supervise 1 hr post-meal
- Monitor K⁺ (purging losses)
Treatment & meds
- Weight restoration, then CBT
- No FDA-approved drug
- CBT first-line
- Fluoxetine 60 mg — FDA-approved
Patient teaching
- Refeeding risk
- realistic weight goals
- Address body-image distortion
- Stop self-induced vomiting
- dental care
- Identify binge triggers
- no ipecac
Red flags — escalate
- ★Refeeding syndrome: ↓ phosphate
- Bradycardia then cardiac arrest
- Hypokalemic dysrhythmias
- Esophageal tear (Mallory-Weiss)
Complications
- Highest mortality of any psych disorder
- Osteoporosis
- cardiac arrest
- Chronic electrolyte imbalance
- esophagitis
Pathophysiology & risk
Anorexia Nervosa
- Severe caloric restriction
- Significantly low weight (BMI < 18.5)
Bulimia Nervosa
- Binge, then purge (vomit, laxatives)
- Usually normal or slightly above weight
Signs & symptoms
Anorexia Nervosa
- ★Lanugo, hypothermia, dry/yellow skin
- Emaciation, muscle wasting
- Sees self as fat
- denies problem (ego-syntonic)
Bulimia Nervosa
- ★Russell's sign (knuckle calluses)
- Parotid swelling
- dental enamel erosion
- Aware, ashamed (ego-dystonic)
Diagnostics & labs
Anorexia Nervosa
- Hypoglycemia, hyponatremia
- Bradycardia, orthostatic hypotension
Bulimia Nervosa
- ★Hypokalemia + metabolic alkalosis
- Hypomagnesemia if laxative abuse
Nursing priorities
Anorexia Nervosa
- Medical stabilization first
- Slow refeeding
- Supervised meals + weights
Bulimia Nervosa
- Interrupt binge-purge cycle
- Supervise 1 hr post-meal
- Monitor K⁺ (purging losses)
Treatment & meds
Anorexia Nervosa
- Weight restoration, then CBT
- No FDA-approved drug
Bulimia Nervosa
- CBT first-line
- Fluoxetine 60 mg — FDA-approved
Patient teaching
Anorexia Nervosa
- Refeeding risk
- realistic weight goals
- Address body-image distortion
Bulimia Nervosa
- Stop self-induced vomiting
- dental care
- Identify binge triggers
- no ipecac
Red flags — escalate
Anorexia Nervosa
- ★Refeeding syndrome: ↓ phosphate
- Bradycardia then cardiac arrest
Bulimia Nervosa
- Hypokalemic dysrhythmias
- Esophageal tear (Mallory-Weiss)
Complications
Anorexia Nervosa
- Highest mortality of any psych disorder
- Osteoporosis
- cardiac arrest
Bulimia Nervosa
- Chronic electrolyte imbalance
- esophagitis
★ marks the fact that sets a column apart.
Clinical Pearl
Underweight + lanugo + refeeding risk = anorexia. Normal weight + Russell's sign + metabolic alkalosis = bulimia.
Play this as a game — free
Drill Anorexia Nervosa vs Bulimia Nervosa in Swipe Right & Speed Sort. Free to start, no card required.
More commonly confused pairs
Keep going
- ComparisonAnorexia Nervosa vs Bulimia Nervosa: Restriction vs Binge-Purge CycleBoth are eating disorders, but the NCLEX expects you to match specific lab values, physical findings, and mortality data to the correct diagnosis. Picking the wrong electrolyte…
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