Eating Disorders (DSM-IV)


Eating Disorders (DSM-IV)

ANOREXIA NERVOSA

Diagnostic criteria:

A) The refusal to maintain the body weight above or at the normal minimum weight according to the age and stature (for example weight loss that leads to keeping the body weight less than 85% of that estimated, or the incapability of reaching the estimated weight during the period of growth in height, with the consequence of the weight remaining under 85% of that estimated).

B) Intense fear of weight gain or of becoming fat, even when one is underweight.

C) Changes in the way in which the person perceives weight or the body shape, or an excessive influence of the weight and body shape on the person�s self-esteem, the refusing to admit the seriousness of the actual condition of being underweight.

D) In females after the menarche, amenorrhoea, that is to say the absence of at least 3 consecutive menstrual cycles.

Subtypes:

With restrictions: in the actual episode of Anorexia Nervosa, the subject has shown no regular signs of eating binges or expulsive behaviour (for ex. self-induced vomiting, inappropriate use of laxatives, diuretics or enemas).

With Binging/Expulsive behaviour: in the actual episode of Anorexia Nervosa the subject has shown regular signs of binging or expulsive behaviour (for ex. self-induced vomiting, inappropriate use of laxatives, diuretics or enemas).


BULIMIA NERVOSA

Diagnostic criteria:

A) Recurrent eating binges. A binge is characterized by both of the following elements:

1- Eating in a certain period of time a quantity of food that is significantly greater than what the majority of people would eat in the same period of time and in similar circumstances.

2- The sensation of losing control regarding food consumption during the episode (for ex. The sensation of not being able to stop eating and of not being able to control the food and the quantity that one is eating).

B) Recurrent and inappropriate compensatory behaviour in order to prevent weight gain, such as self-induced vomiting, abuse of laxatives, diuretics, enemas or other medicines, fasting or excessive physical exercise.

C) The eating binges and the compensatory behaviour are both manifested on average at least twice a week for three months.

D) The levels of self-esteem are unduly influenced by the body shape and weight.

E) The change does not exclusively manifest itself during the course of episodes of Anorexia Nervosa.

Subtypes:

With Expulsive Behaviours: in the actual episode of Bulimia Nervosa, the subject has regularly manifested self-induced vomiting or the inappropriate use of laxatives, diuretics or enemas.

Without Expulsive Behaviours: in the actual episode, the subject has regularly utilized other inappropriate compensatory behaviours, such as fasting or excessive physical exercise but does not regularly practise self-induced vomiting or the inappropriate use of laxatives, diuretics or enemas.


UNCONTROLLED EATING DISORDER (BINGE EATING DISORDER)

Diagnostic criteria:

A) Recurrent episodes characterized by the loss of eating control. An episode is characterized by both of the following elements:

1- Eating in a limited period (for example two hours) a quantity of food significantly greater than that which the majority of people would eat in the same period and in similar circumstances.

2- The sensation of losing control regarding food consumption during the episode (for example the sensation of not being able to stop eating nor being able to control the food and the quantity that one is eating).

B) The episodes are associated with three (or more) of the following factors:

- Eating more quickly than normal;

- Eating until one feels uncomfortably full;

- Eating a quantity of food that is notably greater with regard to the physical feeling of hunger;

- Eating alone because the subject feels embarrassed about how he or she is eating;

- Feeling disgusted with oneself, depressed or guilty after having eaten.

C) There is a marked uneasiness with regard to the eating behaviour.

D) The eating binges take place on average at least two days a week in the course of 6 months.

E) The uncontrolled food disorder is not associated with the regular manifesting of inappropriate compensatory behaviours (self-induced vomiting, inappropriate use of laxatives, diuretics, enemas and fasting or excessive physical exercise) and it does not only manifest itself in the course of AN or BN.


EATING DISORDERS OTHERWISE NOT SPECIFIED

The categories include those behaviours that do not enter into the criteria of certain specific eating disorders.

Examples include:

1- For the female sex, all the criteria required for diagnosing Anorexia Nervosa in the presence of a regular menstrual cycle.

2- All the symptoms of Anorexia Nervosa are present but despite the significant weight loss, the actual weight is normal.

3- All the symptoms of Bulimia Nervosa are present except for the fact that the eating binges and the compensatory behaviour are less frequent than two episodes a week for three months.

4- Subjects with a normal weight who regularly manifest an inappropriate compensatory behaviour after having eaten small quantities of food (for example self-induced vomiting after having eaten two biscuits).

5- Subjects who repeatedly chew and spit out, without swallowing, large quantities of food.

6- Uncontrolled Eating Disorders: recurrent episodes of eating binges without regular compensatory behaviours that are typical of Bulimia Nervosa.