In this age of media-projected perfectionism through weight control that causes some to feel pressure fit a certain mold, both women and men succumb to a list of eating disorders in order to attain perfection.

New research shows doctors may miss or misdiagnose a relatively unknown form of bulimia nervosa, called purging disorder, where an individual won’t binge eat – but will vomit large or small quantities of food.

Pamela Keel, associate professor of psychology at the University of Iowa, along with other medical researchers, have just published research about the disorder, in hopes that the American Psychiatric Association could change its guidelines for diagnosing eating disorders.

Keel wrote in an e-mail interview that the medical world at large has struggled with recognizing purging disorder because it does not involve binge eating, although suffers have the same “negative body image.” Sufferers may have also lied about “a history of low weight,” which is a central feature of anorexia nervosa, and “denies a history of large binge-eating episodes,” which is the common identifier of bulimia nervosa.

“A central criteria [of] bulimia nervosa is large, out-of-control binge episodes – this has been a consistent part of the definition of the disorder since it was first introduced to the medical literature in 1979. Purging has been viewed largely as a consequence of binge-eating episodes,” she wrote. “So, most of the research on bulimia nervosa has focused on the understanding the precipitants of binge eating with the expectation that people will stop purging once the binge eating stops.”

According to the APA’s Web site, purging, like bulimia, can lead suffers to develop “anemia, palpitations, hair and bone loss, tooth decay, esophagitis, and the cessation of the menstrual period.”

Keel’s research shows women with purging disorder are not eating any more or less than a normal person, but their responses to a meal test showed they have the same amount of an intestinal-tract chemical called cholecystokinin, which signals people to stop eating. Women with bulimia had a lower amount of the chemical.

The causes for eating disorders in general start with a psychological need where some women feel a “discrepancy between what they actually weigh and what they would like to weigh,” which contributes to a woman’s negative body image, Keel wrote.

Keila Tyner, graduate student in textiles and clothing, agrees some women are made to feel that they have to achieve a certain criteria to fit into society.

“I think that the main reason is that women are portrayed in the media as sexual objects, which causes them to be affected more,” Tyner said.

Tyner feels the “thin ideal,” which is what “sells” in this society, is so internalized by some that it makes them feel bad about themselves, causing a negative body image, which drags self-esteem down.

“It is a common notion that a woman’s self-worth can be equated with her appearance,” she said.