What is the major clinical difference between anorexia nervosa and bulimia nervosa?

• A. The degree of dietary restriction
• B. The presence of binge eating episodes
• C. The sense of control over eating
• D. The weight status of the patient

Answer: (C)

The ability to control eating behavior is the main difference. In anorexia nervosa, individuals exert strict, sustained control over intake with severe caloric restriction and an intense fear of weight gain, often leading to significantly low body weight. In bulimia nervosa, there are recurrent binge eating episodes characterized by a sense of loss of control during the binge, followed by compensatory behaviors to prevent weight gain, and weight is usually within the normal range or near it. Because the core distinction lies in how much control a person feels they have over eating, this difference best separates the two disorders. Other features—such as how much restriction is present, whether binge eating occurs, or exact weight status—can overlap or vary with subtypes, making them less definitive differentiators.