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Diagnostic criteria for Eating Disorders DSM IV

Anorexia Nervosa (307.1)

  • 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).
  • Intense fear of gaining weight or becoming fat, even though underweight. .
  • 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.
  • In postmenarcheal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles. (Diagnosis „Anorexia Nervos“ is also given if the menstrual cyles occur only by using hormons eg. oestrogene

Type: Restricting Type vs. Binge-Eating/Purging Type.
Specify type:

Restricting Type

During the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).

Binge-Eating/Purging Type

During the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).

 

Bulimia Nervosa (307.51)

  • 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).
  • 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.
  • The binge eating and inappropriate compensatory behaviors occur, on average, at least twice a week for three 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).

Purging type

During the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.

Non-purging Type

During the current episode of Bulimia Nervosa, the person has used other
inappropriate compensatory behaviors, such as fasting or exessive exercice, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.

 

Diagnostic Criteria: Binge Eating Disorder

  • Recurrent episodes of binge eating. An episode is characterized by:
    1. Eating a larger amount of food than normal during a short period of time (within any two hour period)
    2. Lack of control over eating during the binge episode (i.e. the feeling that one cannot stop eating).
  • Binge eating episodes are associated with three or more of the following:
    1. Eating until feeling uncomfortably full 
    2. Eating large amounts of food when not physically hungry
    3. Eating much more rapidly than normal
    4. Eating alone because you are embarrassed by how much you're eating
    5. Feeling disgusted, depressed, or guilty after overeating
  • Marked distress regarding binge eating is present
  • Binge eating occurs, on average, at least 2 days a week for six months
  • Binge eating is not associated with the regular use of inappropriate compensatory behavior (i.e. purging, excessive exercise, etc.) and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.

 

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:

  • For females, all of the criteria for Anorexia Nervosa are met except that the individual has regular menses. (F50.1)
  • All of the criteria for Anorexia Nervosa are met except that, despite significant weight loss, the individual's weight is in the normal ramge. (F50.1)
  • 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. (F50.3)
  • 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). (F50.3)
  • Repeatedly chewing and spitting out, but not swallowing, large amounts of food. (F50.8)
  • 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). (F50.9)

Source: From the DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, fourth edition, Washington D.C.: American Psychiatric Association, 1994.

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