Bulimia nervosa is a serious life threatening disorder commonly affecting young women. They go through binging (consumption of large amounts of food very quickly) and purging (elimination of the food by vomiting, laxatives, etc.) Bulimics fast, exercise vigorously, vomit, and/or use laxatives. This disorder is partly caused by extreme concern about weight and self image.

Anorexia Nervosa is an eating disorder commonly among young women. This disorder is caused by excessive worry about the appearance of their body which results in the fear of gaining weight, self-starvation, and a distorted view of body image. There are two types of anorexia: on characterized by strict diet and exercise, and the other involves binging and purging.

Bulimia Binging/purging Excessive concern with weight Depression/mood swings Irregular menstrual periods Unusual dental problems Swollen cheeks/glands Heartburn/bloating Anorexia (vary widely Thin body Dry yellowish skin Low blood pressure Amenorrhea Constipation Lack of energy Chills/damaged teeth

Bulimia: The word bulimia comes from the Greek words bous (ox) and limos (hunger), meaning a state of excessive hunger. This disorder is characterized by frequent binging associated with emotional misery and accompanied by excessive exercise, self- induced vomiting, diuretic abuse, laxative abuse, use of appetite suppressants, and/or medications used to speed up the metabolism. Eating disorders as a group are characterized by a fear of weight gain and a distorted body image. Bulimia and anorexia nervosa are more common in young females, while binge-eating disorder is the most common eating disorder overall, and is more common in adults, with a 2:1 ratio of females to males.

Anorexia: Anorexia Nervosa was first described in England in the 17th Century. It was known as an illness by modern medicine over one hundred years ago by Professor Ernest Lasegue of the University of Paris. Since more than 90 percent of people who are affected are adolescents and young women, the disorder can be characterized as a women's illness. Most activists of the biological cause believe that anorexia is caused genealogically (passed down through their parents). According to recent studies, mothers and sisters of people with anorexia or bulimia are at higher risk of having one of these disorders. Compared to the rest of the population, these mothers and sisters have a risk for anorexia that is 11 times higher and a risk for bulimia that is 4 times higher.

Bulimia: One hypothesis of a cause involves abnormalities of serotonergic function. Serotonin is involved in the development of satiety. It is believed to increase postprandial satiety rather than directly decreasing appetite. Disturbances in serotonergic function or low levels of serotonin may be responsible for stopping the sensation of satiety and prolonging periods of food ingestion. Another possible pathophysiology involves the presence of increased levels of peptides, specifically, pancreatic polypeptide, known to increase appetite. Increased levels of the pancreatic polypeptide have been found in some individuals with bulimia. Abnormalities of central nervous system neurotransmitters may also be involved in bulimia nervosa.

Anorexia: Evidence for the biological etiology of anorexia is found in the twin and family background. Siblings of anorexics have are at a higher risk of anorexia than the general population. This may be influenced by other family factors. Identical twin studies have shown a higher concordance rate in identical twins. Past research has made several connections with anorexia and hormonal fluctuations, particularly in the hypothalamus and the anterior pituitary gland. Anorexia is also shown to be associated with right temporal disturbance. These are considered secondary factors in the etiology of either anorexia or bulimia. Hormonal changes have been shown to occur as a result of starvation.

Cognitive Behavior Therapy- This most common type of therapy for this dysfunction focuses on the thoughts that envelop food and eating and presents a challenge to the dysfunctional beliefs on the part of the anorexic. The disorder is treated as if it is nothing more than a fight for freedom, intelligence, self-respect, and self-discipline. Another goal of CBT is to correct the unhealthy cognitive processes that are causing the distorted beliefs. One of the main goals of CBT is for the affected person to have a more self-focused and self- observant approach, so the person is asked to keep a diary of food intake and a journal of thought processes during the treatment period.

There are six cognitive approaches that are widely used in CBT: 1) education about the disorder 2) providing informational answers to questions in regard to weight, calorie intake, and changing health status 3) showing the patient to recognize and focus upon negative thoughts and other emotions linked to the distorted beliefs and fixations associated with weight, body shape, nutrition, exercise, and other aspects of the disorder. 4) teaching the patient to come up with and replace alternative, more productive and positive thoughts for the negative ones 5) problem-solving discussions 6) teaching alternative coping strategies (Yager )

Family therapy is proved to be highly effective and necessary in most cases, especially in cases where the patient is still living at home. This is because anorexia creates high emotional stress that echoes among all family members. Families in which there is a lot of ‘free expressed emotion' (families that express large amounts of negative and critical attitudes) affect the progress of an anorexic patient. Families undergoing a large amount of stressors may benefit from behavioral therapy techniques in which the patient and the family together learn communication and problem-solving skills

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