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The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorder, or DSM, is a classification of mental disorders with associated criteria designed to facilitate more reliable diagnoses of these disorders (American Psychiatric Association, 2013). DSM started in America but is now widely used by students and psychologists to accurately diagnose mental disorders.

                  There are many psychological conditions that affect more
women than men such as depression and anxiety. One that is less known is eating
disorders like bulimia and anorexia. Eating disorders are defined as an
abnormal change in eating habits that can greatly affect a person’s mental
health. Hsu (1989) found that bulimia nervosa is more
common among woman as they are
more self-conscious about their bodies so will turn to dieting to help control
their weight. The media could be a heavy influence on them as celebrities are
known to keep in shape for award ceremonies and photo shoots. WebMD has stated
that, according to the National Institute of Diabetes and Digestive and Kidney
Diseases, patients diagnosed with bulimia have a history of depression. This
shows there is a link between depression and eating disorders. This essay with
look at the impact of bulimia nervosa and how it affects more women than men.

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nervosa is very common amongst adolescent girls and young women. Their
behaviours can range from episodes of binge eating to over-consumption. By
preventing weight gain, women can pick up on other inappropriate behaviour such
as self-induced vomiting, misuse of certain medications, fasting or
over-exercising. Women are so adamant about their weight and body shape that it
can lead to suicide. Crow, Peterson, Swanson, Raymond, Specker, Eckert and
Mitchell (2009) conducted a longitudinal study to see if eating disorders are
associated with increased mortality and suicide levels. They assessed 1885
patients, using the National Death Index, who had attended a specialised eating
disorder clinic within the last 8 to 25 years. They found that mortality and suicide
rates were elevated in people suffering from bulimia nervosa. The limitations
of this study include no real age range and only including participants from a
specific clinic. It lacks population validity and can’t be generalised. Nevertheless,
a longitudinal study has many benefits as people are observed over a long
period of time, resulting in more accurate and natural results, as stated by
Caruana, Roman, Hernandez-Sanchez and Solli (2015).


anorexia nervosa, people with bulimia nervosa tend to maintain a normal and
healthy BMI. This is due to them either overeating or undereating. They are
known to experience episodes of binge eating, where they can consume between
1,000 and 2,000 calories, followed by self-induced vomiting to cancel out what
they have eaten (Barlow, 2014). To be diagnosed with bulimia
nervosa, the patient must show symptoms of repeated episodes of binge eating
ranging from once or twice a week to several times a day for a minimum of 3
months. Women can also suffer from other internal problems such as menstrual
irregularity or gastrointestinal symptoms. A serious problem is cardiac
arrhythmias, although this is rare (American
Psychiatric Association, 2013). Due to some patients abusing alcohol and drugs,
this can lead to them possibly being diagnosed with borderline personality


are some risk factors associated with bulimia such as temper, physiology and
genetic problems. Upbringing can cause vulnerability of certain disorders,
especially in those who experienced sexual or physical abuse (American
Psychiatric Association, 2013). Culture is another issue. Studies found that bulimia
nervosa is common in developing countries such as India (Sharan, & Sundar,
2015). A study by Chugh and Puri (2001) found that majority of the obese
students from a Delhi background were unhappy with their current weight and
their rate of dieting was very high. Gupta, Chaturvedi, Chandarana, &
Johnson (2001) compared students from India and Canada and found that women
scored equally on the tests. These studies demonstrate that eating disorders do
occur in Western countries and the levels may increase, calling for further


close the gap on how eating disorders affect women more, a study was carried
out by Striegel-Moore, Rosselli, Perrin, DeBar, Wilson, May and Kraemer (2009).
They collected a sample of men and women aged 18 to 35, who were given a
questionnaire to fill out by mail or online. Results showed that men were more
likely to report overeating while women were more likely to show loss of
control. It was found that women were also more likely to report acts of body
checking, binge eating and vomiting than men, although there was a small difference
between the genders. This study showed that only a minority of men report
eating disorders and even then, very few studies include men. Like the last
study, this can’t be generalised as only participants from the organization
were used. Other limitations include the low response rate, especially among
men. This resulted in sampling bias. It also lacks population validity as most
of the participants were white, non-Hispanic. Striegel-Moore et al. believed
that their study needed to be replicated for future research, showing

meta-analysis performed by the UK
National Institute for Health and Clinical Excellence found that cognitive
behavioural therapy is the most effective treatment for those suffering with
bulimia. They also found that this type of therapy is not always the best
solution as their sample only showed a small amount making a full recovery from
the disorder. Shortly afterwards a new enhanced version was introduced and
proved more effective (Fairburn, Cooper, & Shafran, 2003). This version is
specifically aimed at young people and inpatients (Cooper & Stewart, 2008;
Fairburn, 2008).


are many ways to manage eating disorders. Patients are advised to maintain a
stable body weight, stop abnormal behaviour and view themselves positively. Further
treatment, other than cognitive behavioural therapy, involves tests to better
understand the severity of the illness. From this, doctors can then decide
whether the patient needs to be admitted to hospital to help with their
disorder or given a course of antidepressants and sent home. Antidepressants
such as serotonin are said to be useful in treating bulimia (Sheran, & Sundar, 2015).


the years people have been made more aware of eating disorders and there is
even an

Eating Disorders Awareness Week. Before this launched the
Mental Health Foundation found that 1

in 3 people had experienced stigma or discrimination in the
workplace. This is due to employers having

no education on eating disorders, making them unknowledgeable
of the matter. Employees may feel

unsupported at work and 38% of respondents said they had to
resort to using their holiday to go to

appointments. Discrimination can be a threat and affect
people’s wellbeing especially when they are

experiencing a mental health problem. This may put them off
seeking additional help and will affect

their physical health. People’s opinions and attitudes
towards eating disorders may even convince

people to have a breakdown and commit suicide. People even
shrug off the disorder and call victims

attention seekers or that it’s a lifestyle choice. The launch
of Eating Disorder Awareness Week is a

great way to give people, especially employers, better
understanding of the illness and break the

stigma that it isn’t a real disorder.


                  In a world of technology
patients often share their own experiences in their blogs about what they went
through from suffering from bulimia. Many admit that their upbringing and
experiences as a child greatly participated their illness. This could include
rejection from relatives or, as mentioned before, physical or sexual abuse. Victims
may also try to hide their illness which can lead to depressing and suicidal


                  Overall, many studies don’t
include enough men to formally accept that women suffer from eating disorders
more than men. What we do know is that women are more likely to admit to the
illness than men. More community awareness needs to be built to alleviate the negativity
surrounding eating disorders so patients don’t feel like they should hide their
illness. This could also help hospitals and clinics to build a safe environment
for patients, giving them much needed help and support. Long term treatment is
important especially to drop suicide and mortality rates and lessen chances of
relapses. If men admitted to
suffering from this illness there would be a better chance of them being more
involved in research and studies and this would help break the stigma that it
is only a female disease. 

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