DSM-IV Criteria for the Eating Disorders.
This material was taken from the DSM-IV (see reference below). It is intended for educational purposes ONLY!
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: Author.
307.1 Anorexia Nervosa
A. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 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).
B. Intense fear of gaining weight or becoming fat, even though underweight.
C. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body shape on self-evaluation, or denial of the seriousness of the current low body weight.
D. In postmenarcheal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles.
Type: Restricting Type vs. Binge-Eating/Purging Type.
307.51 Bulimia Nervosa
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
(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 (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
B. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, enemas, or other medications; fasting, or excessive exercise.
C. The binge eating and inappropriate compensatory behaviors occur, on average, at least twice a week for three months.
D. Self-evaluation is unduly influenced by body shape and weight.
E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.
Type: Purging Type vs. Non-purging Type (exercise & fasting to compensate).
307.50 Eating Disorder NOS (Not Otherwise Specified)
The Eating Disorder Not Otherwise Specified category is for disorders of eating that do not meet the criteria for any specific Eating Disorder. Examples include:
1. For females, all of the criteria for Anorexia Nervosa are met except that the individual has regular menses.
2. All of the criteria for Anorexia Nervosa are met except that, despite significant weight loss, the individual's weight is in the normal ramge.
3. All of the criteria for Bulimia Nervosa are met except that the binge eating and inappropriate compensatory mechanisms occur at a frequency of less than twice a week or for a duration of less than 3 months.
4. The regular use of inappropriate compensatory behavior by an individual of normal body weight after eating small amounts of food (e.g., self-induced vomiting after the consumption of two cookies).
5. Repeatedly chewing and spitting out, but not swallowing, large amounts of food.
6. Binge-eating disorder: recurrent episodes of binge eating in the absence of the regular use of compensatory behaviors characteristic of Bulimia Nervosa (Binge eat, but do not purge).
SOME MEDICAL COMPLICATIONS OF EATING DISORDERS (The material that follows is the product of a literature review conducted by the webmaster.)
Eating disorders lead to multiple health consequences both mental and physical. Some of the consequences include the following:
I. Changes in attitudes and behavior towards food.
a.) food preoccupation
b.) unusual eating habits
c.) binge eating
II. Emotional and social changes.
c.) irritability, anger
d.) "psychotic" episodes
e.) personality changes
f.) social withdrawal
III. Cognitive changes.
a.) decreased concentration
b.) poor judgment
IV. Physical changes.
a.) Sleep disturbances
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
l.) Hyperacuity (hypersensitivity) to noise and light
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
"Redux" (fenfluramine + phenteramine) or "Fen-Phen", a prescription "diet pill" has been linked to cardiomyopathy (or heart muscle damage). It has since been removed from the market by the FDA. However, anyone who has ever taken the drug (was exposed to the drug) SHOULD contact their physician for a thorough physical work-up to rule out heart muscle damage!!
"Syrup of Ipecac" or "Ipecac" is a substance that some bulimic individuals use to help induce vomiting. The therapeutic use of Ipecac is as an antidote for accidental poisonings as directed by the poison control center or a physician. It is intended to be used as a one-time antidote, not for repeated administration. What many people do not know is that Ipecac's active ingredient is emetine (a poison) that builds up in the system with repeat administration and causes irreversible heart muscle damage. Many people do not know that the famous singer/songwriter Karen Carpenter really died of emetine poisoning from repeated use of Ipecac, not the anorexia per se. If you, or a friend, is currently using this dangerous substance please think twice. It is a dangerous game of Russian Roulette. This is your life that we're talking about.
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