Eating Disorders-DSM
Anorexia Nervosa
Criteria:
- Restriction of energy intake leading to significantly low body weight
- Intense fear of gaining weight or persistent behavior that interferes with weight gain
- Disturbance in how one's body weight or shape is experienced
- Symptoms must be present for at least 3 months
Specifiers:
- Restricting type - Weight loss mainly from dieting, fasting or excessive exercise
- Binge-eating/purging type - Recurrent binge eating or purging behaviors
Etiology: Biological, psychological and social factors contribute
- Genetic predisposition and neurobiological factors
- Personality traits like perfectionism, obsessive traits
- Social pressures about body image and ideals
Prevalence: Lifetime (2-4%), 10:1 (women:men)
Clinical Picture:
- Relentless pursuit of thinness and unwillingness to maintain healthy weight
- Intense fear of gaining weight
- Body image distortion
- Very low BMI, often <17.5 kg/m2
- Physical complications like osteoporosis, amenorrhea, cardiovascular and neurological
issues
Bulimia Nervosa
Criteria:
- Recurrent episodes of binge eating
- Recurrent inappropriate compensatory behaviors to prevent weight gain
- Both binge eating and compensatory behaviors occur at least once per week for 3 months
Specifiers:
- Purging type - Vomiting or misuse of laxatives/diuretics
- Non-purging type - Fasting or excessive exercise
Etiology: Similar to anorexia, with biological, psychological and social factors
Clinical Picture:
- Binge and purge cycle, usually normal weight
- Feeling out of control during binge episodes
- Excessive concerns about body shape and weight
Binge Eating Disorder
Criteria:
- Recurrent episodes of binge eating
- Markers of feeling out of control and distress
- Binge eating occurs at least once per week for 3 months
Specifiers: None
Etiology: Similar factors as other eating disorders
Clinical Picture:
- Frequently consuming very large amounts of food
- Feeling disgusted, depressed or guilty after overeating
- Often trying different diets without success
- Higher rates of obesity and weight cycling
Treatments: ALL EATING DISORDERS
- Nutritional rehabilitation and weight restoration
- Psychotherapy like CBT, interpersonal therapy
- Medications like antidepressants in some cases
- Family-based treatment for adolescents