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Anorexia Nervosa (AN)
- Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health- Intense fear of gaining weight or becoming fat, even though underweight 1
- Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight. 1
- Certain psychological conditions and features that often coincide with AN include anxiety, depression, social isolation, and perfectionism 2
Bulimia Nervosa (BN)
- Recurrent episodes of binge eating characterized by BOTH of the following:
- Eating in a discrete amount of time (within a 2 hour period)large amounts of food.
- Eating in a discrete amount of time (within a 2 hour period)large amounts of food.
- Recurrent inappropriate compensatory behavior in order to prevent weight gain (purging). 1
- The binge eating and compensatory behaviors both occur, on average, at least once a week for three months. 1
- Self-evaluation is unduly influenced by body shape and weight. 1
- The disturbance does not occur exclusively during episodes of anorexia nervosa. 1
- Psychological conditions and features that often co-occur include anxiety, depression, substance use, and difficulties with impulse control 2
Binge Eating Disorder (BED)
- Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following
- eating, in a discrete period of time (for example, within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period 1 of time under similar circumstances
- a sense of lack of control over eating during the episode (for example, a feeling that one cannot stop eating or control what or how much one is eating) 1
- eating, in a discrete period of time (for example, within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period 1 of time under similar circumstances
- The binge-eating episodes are associated with three (or more) of the following: 1
- eating much more rapidly than normal
- eating until feeling uncomfortably full
- eating large amounts of food when not feeling physically hungry
- eating alone because of feeling embarrassed by how much one is eating
- feeling disgusted with oneself, depressed, or very guilty afterwards
- Marked distress regarding binge eating is present. 1
- The binge eating occurs, on average, at least once a week for three months. 1
- The binge eating is not associated with the recurrent use of inappropriate compensatory behavior (for example, purging) and does not occur exclusively during the course of AN, BN, or ARFID 1
- Related psychological conditions include anxiety, depression, and substance use 2
Avoidant Restrictive Food Intake Disorder (ARFID) 7
- An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following
- Significant weight loss (or failure to achieve expected weight gain or faltering growth in children).
- Significant nutritional deficiency
- Dependence on enteral feeding or oral nutritional supplements
- Marked interference with psychosocial functioning.
- The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice.
- The eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced.
- The eating disturbance is not attributable to a concurrent medical condition or not better explained by another mental disorder. When the eating disturbance occurs in the context of another condition or disorder, the severity of the eating disturbance exceeds that routinely associated with the condition or disorder and warrants additional clinical attention.
Otherwise Specified Feeding or Eating Disorder (OSFED) 3
In the DSM- these eating disorders would be classified as: Unspecified Feeding or Eating Disorder (UFED). It is important to note the symptoms and consequences of a diagnosis of OSFED or UFED can be just as serious and life-threatening as Anorexia, Bulimia or BED! If someone is displaying symptoms of an eating disorder of any type- seeking professional help is critical!
- Atypical anorexia nervosa: All of the criteria for anorexia nervosa are met, except that despite significant weight loss, the individual's weight is within or above the normal range.
- Bulimia nervosa (of low frequency and/or limited duration): All of the criteria for bulimia nervosa are met, except that the binge eating and inappropriate compensatory behaviors occur, on average, less than once a week and/or for less than 3 months.
- Binge-eating disorder (of low frequency and/or limited duration): All of the criteria for binge-eating disorder are met, except the binge eating occurs, on average, less than once a week and/or for less than 3 months.
- Purging Disorder: Recurrent purging behavior to influence weight or shape (e.g., self-induced vomiting, misuse of laxatives, diuretics, or other medications) in the absence of binge eating.
- Night eating syndrome: Recurrent episodes of night eating, as manifested by eating after awakening from sleep or by excessive food consumption after the evening meal. There is awareness and recall of the eating. The night eating is not better explained by external influences such as changes in the individual's sleep-wake cycle or by local social norms. The night eating causes significant distress and/or impairment in functioning. The disordered pattern of eating is not better explained by binge-eating disorder or another mental disorder, including substance use, and is not attributable to another medical disorder or to an effect of medication.
In the DSM- these eating disorders would be classified as: Unspecified Feeding or Eating Disorder (UFED). It is important to note the symptoms and consequences of a diagnosis of OSFED or UFED can be just as serious and life-threatening as Anorexia, Bulimia or BED! If someone is displaying symptoms of an eating disorder of any type- seeking professional help is critical!
- Orthorexia Nervosa: An unhealthy obsession with "clean eating" and health. This kind of food restriction can often be a precursor to Anorexia Nervosa. 4
- "Bigorexia": Also known as Muscle Dysphoria, Bigorexia is a disorder that causes a person to constantly obsess and/or worry about being too small, underdeveloped, and/or underweight. This disorder is a form of Body Dysmorphic Disorder and is related to Obsessive Compulsive Disorder. Those with Muscle Dysmorphia constantly obsess over their imperfections, further distorting their self perception. This can significantly impair the person's mood, often causing depression or other emotional distress. Feelings of inadequacy may affect many areas of their life. 5
- "Drunkorexia": A combination of substance abuse and an eating disorder includes behaviors such as replacing food consumption with excessive alcohol consumption or consuming food along with sufficient amounts of alcohol to induce vomiting as a method of purging and numbing feelings. A slang term for someone who struggles with an eating disorder and alcohol abuse, or undereats during the day and binge drinks at night.6
- Diabulimia: When an individual with type 1 diabetes omits or misuses insulin in order to purge calories.6
References
1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
2. Berkman ND, Lohr KN, Bulik CM. Outcomes of eating disorders: a systematic review of the literature. Int J Eat Disord. 2007;40(4):293-309.
3. http://www.allianceforeatingdisorders.com/portal/fed-nec#.UvgLNvbVvdE
4. https://www.nationaleatingdisorders.org/orthorexia-nervosa
5.https://www.allianceforeatingdisorders.com/portal/muscledysmorphia
6.https://www.nationaleatingdisorders.org/learn/glossary
7. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid/overview
1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
2. Berkman ND, Lohr KN, Bulik CM. Outcomes of eating disorders: a systematic review of the literature. Int J Eat Disord. 2007;40(4):293-309.
3. http://www.allianceforeatingdisorders.com/portal/fed-nec#.UvgLNvbVvdE
4. https://www.nationaleatingdisorders.org/orthorexia-nervosa
5.https://www.allianceforeatingdisorders.com/portal/muscledysmorphia
6.https://www.nationaleatingdisorders.org/learn/glossary
7. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid/overview