Anorexia involves what is most simply described as an obsession with being thinner. Not thinner as in 'I should be more or less 135 lbs, and I need to lose 10-15 lbs to get near that weight,' but thinner as in 'I'm fat, I'm bloated, I have to be thinner!' There is NO correlation between the strength of the determination or its urgency and the person's actual weight. Persons dealing unsuccessfully with anorexia literally starve themselves to death.

Definition, Signs, Symptoms : Anorexia is a disorder in which the individual deliberately acts to reach and maintain a below-normal body weight, is intensely afraid of gaining weight, and shows a disturbed and inaccurate perception of the size and shape of his or her body. Anorexic thought patterns and eating/exercise behaviour obviously precede reaching anorexic weight, and it is important to seek treatment when these patterns and behaviours appear, and not wait for the extreme weight loss to seek a confirming diagnosis. The anorexic believes herself to be fat or "just right" when everyone else sees her as shockingly thin. Anorexia usually begins in mid-adolescence, with a peak age of onset around 16 years. Ninety percent are females. The illness does occur in males (10%) and in all major respects is identical to that in females, with the obvious exception of the amenorrhea. There is probably some tendency for children who eventually develop anorexia nervosa to be somewhat obsessional and shy beforehand. However, most patients show little or no serious psychopathology until the development of anorexia nervosa. The onset frequently seems precipitated (perhaps a last straw) by a minor trauma, such as leaving home for school or camp, the beginning of dating, or a casual unflattering remark. Patients begin to diet in an apparent attempt to restore their self-esteem, and their dieting initially does not obviously differ from that of others who never develop psychological problems. However, in those who develop anorexia nervosa, the more weight that is lost, the more patients wish to lose. They typically become socially isolated and withdrawn, assume a moralistic demeanor, and become stubborn and intent on losing weight. Patients retain some sensation of hunger until very late in the illness, with the frequent occurrence of uncontrollable binge eating. At some point during the evolution of the illness, most patents with anorexia engage in increased physical activity, which serves both their intense drive for accomplishment and their desire to expend calories. About 90% of anorexics are women, presumable because women in our culture are under greater pressure than men to be thin. Anorexic weight is 15% or more below normal. A body mass chart indicates a healthy 5'9'' man may weigh as little as 140#, below that he is underweight, and 120# is crossing the borderline from underweight to anorexic. For a 5'5'' woman, about 122 is the borderline between healthy and underweight. Below about 108 she is judged anorexic. See the chart that evaluates your weight-height combination, at the end of this file: Body Mass Index..

Bulimia involves forcing oneself to throw up after eating and/or the abusive use of diuretics, laxatives, rules, restrictions, or exercise. It frequently involves binge eating. Unlike persons with anorexia, those with bulimia look anywhere from skeletal to very overweight, but most are of average ('normal') weight. In addition, bulimia can be (and often is) found combined

Definition, Signs, Symptoms : Bulemia is a disorder in which the person has recurrent episodes of binge-eating *and* acts to prevent weight gain by self-induced vomiting or other compensatory behaviours. Bulemia is a combination of binge-eating... ie eating, with a sense of lack of control, in a single time period, an amount of food that is *definitely* larger than most people would eat during a similar time period... and recurrent inappropriate compensatory behaviour, in order to prevent weight gain. After a binge, someone who's ill with bulemia may make him/herself ill, absuse laxatives or diuretics, fast, or exercise excessively. The binge eating and inappropriate compensatory behaviours both occur at least twice a week for 3 months. Note that 'fasting' includes going without food for longer than the usual time between meals or snacks, ignoring hunger signals; that is, 'fasting' does *not* refer *only* to the more extreme practice of going days without food. Fasting between daily episodes of binge eating is probably the most common compensatory behaviour used by bulimics. And please note also that although many people loosely self-define a "binge" as eating any food or quantity of food that does not conform to their personal diet rules--eating a muffin at coffee break, for example, when they had promised themselves never to eat at coffee break, this is *not* the clinical definition of a binge. Bulimia nervosa has been identified primarily in men and women in their teens and 20s, with about 90% women and 10% men (the same as for anorexia). Studies using rigorous dianostic criteria suggest that about 1% to 2% of precollege and college women are bulimic, although occasional bulimic behaviour appears to be much more common. Although the majority of patients who are currently diagnosed as bulimic are of normal weight, bulimia nervosa may be underrecognized in obese persons. Self-evaluation of one's worth as a person is unduly influenced by body shape and weight. The disordered self-evaluation does not occur exclusively during episodes of Anorexia Nervosa. Some bulemics are also anorexic.

Body Mass Index Are you anorexic? Obese? Underweight? Is your weight in the healthy range for your height? The BMI (Body Mass Index) is one way to tell. The formula is, Body Mass Index equals body weight in kilograms divided by the square of height in meters. Strip for this: weight without clothes, height without shoes. Since most of the world uses the metric system, the formula uses metric measurements, and you will first have to calculate your weight and height in kilograms and meters. Pretty Euro-cool. A calculator is a must.

1.Divide your weight in pounds by 2.2, to get your weight in kilograms. (Example: 130 lbs./2.2 = 59 kilograms.) 2.Divide your height in inches by 39.4 to get your height in meters. (Example: 65 inches/39.4 = 1.65 meters.) Now square this number. (Example: 1.65 x 1.65 = 2.72.) 3.Divide weight number by the height number (height squared). That's your BMI. (Example: 59 kilograms / 2.72 = 21.7 BMI.)

Okay, get dressed. You've got your number: what does it mean? A booklet distributed by some eating disorder programs gives these ranges for both men and women:

You'll see that there's a lot of latitude within the categories, to allow for variations in frame size and body type. Cut yourself a little slack for your own unique body and metabolism, too. But after taking all that into account, be realistically concerned if your BMI is out of the Healthy range, in either direction.