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Eating Disorders

Criteria for Anorexia Nervosa

  • Refusal to maintain body weight at or above a minimally normal weight for age and height: Weight loss leading to maintenance of body weight <85% of that expected or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected.

  • Intense fear of gaining weight or becoming fat, even though under weight.

  • Disturbance in the way one's body weight or shape are experienced, undue influence of body weight or shape on self evaluation, or denial of the seriousness of the current low body weight.

  • Amenorrhea (at least three consecutive cycles) in postmenarchal girls and women.

    Amenorrhea is defined as periods occurring only following hormone (e.g., estrogen)

    Type: Restricting Type vs. Binge-Eating/Purging Type.administration.

    Criteria for Bulimia Nervosa
  • Recurrent episodes of binge eating characterized by both:

    1. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances

    2. A sense of lack of control over eating during the episode, defined by a feeling that one cannot stop eating or control what or how much one is eating

  • Recurrent inappropriate compensatory behavior to prevent weight gain

    1. Self-induced vomiting

    2. Misuse of laxatives, diuretics, enemas, or other medications

    3. Fasting

    4. Excessive exercise

  • The binge eating and inappropriate compensatory behavior both occur, on average, at least twice a week for 3 months.

  • Self evaluation is unduly influenced by body shape and weight.

  • The disturbance does not occur exclusively during episodes of anorexia nervosa.

    Type: Purging Type vs. Non-purging Type (exercise & fasting to compensate).

    Criteria for Eating Disorder Not Otherwise Specified
    Eating disorder not otherwise specified includes disorders of eating that do not meet the criteria for any specific eating disorder. 

    1.For female patients, all of the criteria for anorexia nervosa are met except that the patient has regular menses.

    2.All of the criteria for anorexia nervosa are met except that, despite significant weight loss, the patient's current weight is in the normal range.

    3.All of the criteria for bulimia nervosa are met except that the binge eating and inappropriate compensatory mechanisms occur less than twice a week or for less than 3 months.

    4.The patient has normal body weight and regularly uses inappropriate compensatory behavior after eating small amounts of food (e.g., self-induced vomiting after consuming two cookies).

    5.Repeatedly chewing and spitting out, but not swallowing, large amounts of food.



    American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th Ed.) United States of America: American Psychiatric Association.
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    Symptoms of Eating Disorders:
    Changes in attitudes and behavior towards food. 

    a.) food preoccupation

    b.) unusual eating habits

    c.) binge eating

    II. Emotional and social changes.

    a.) depression

    b.) anxiety

    c.) irritability, anger

    d.) "psychotic" episodes

    e.) personality changes

    f.) social withdrawal

    III. Cognitive changes.

    a.) decreased concentration

    b.) poor judgment

    c.) apathy

    IV. Physical changes.

    a.) Sleep disturbances

    b.) Weakness

    c.) Gastrointestinal disturbances

    d.) Gastrointestinal perforation / Esophageal tears

    e.) Gastric / Esophageal Rupture (usually fatal)

    f.) Fluid & Electrolyte imbalances (Body water & salt imbalances)

    g.) Edema (fluid collecting in extracellular tissue)

    h.) cardiac arrhythmias (heart rhythm disturbances), heart failure & death

    i.) Hypothermia (low body temperature) & cold intolerance

    j.) Decreased Basal Metabolic Rate

    k.) Hypothyroidism

    l.) Hyperacuity (hypersensitivity) to noise and light

    m.) Anemia

    n.) Bone marrow failure

    o.) Hypercholesterolemia (High blood cholesterol levels, often exceeding 300 mg/dl

    p.) Hypercarotenemia (High vitamin A levels in the blood, gives the skin an "orange" appearance

    q.) amenorrhea (absence of at least 3 consecutive menstrual periods)

    r.) osteoporosis (brittle bones)

    s.) erosion of enamel on teeth

    t.) swollen parotid (salivary) glands

    u.) Kidney damage (from diuretic misuse)

    v.) Loss of bowel function


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