Transcript Document

Eating Disorders
Diagnostic Features of
Anorexia Nervosa
Bulimia Nervosa
Overview
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Anorexia is characterized by a refusal to maintain a
minimally normal body weight.
Bulimia is characterized by repeated episodes of binge
eating followed by inappropriate compensatory behaviors
such as self-induced vomiting; misuse of laxatives,
diuretics, fasting, or excessive exercise.
A disturbance in perception of body shape and weight is an
essential feature of both Anorexia and Bulimia.
Anorexia Nervosa
Diagnostic Criteria
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Refusal to maintain body
weight at or above a minimally
normal weiht 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.
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Disturbance in the way in
which one’s body weight or
shape is experienced, undue
influence of body weight or
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.
Anorexia Nervosa
Associated Features
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Depressed mood, social withdrawal, irritability, insomnia, and diminished
interest in sex.
May meet the symptomatic requirements for Major Depressive Disorder,
which is secondary, or a manifestation of starvation.
Obsessive-compulsive features, both related and unrelated to food
(perfectionism)
Constipation
Abdominal pain
Intolerance to cold
Lethargy
Excess energy
Emaciation
Bulimia Nervosa
Diagnostic Criteria
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Recurrent episodes of binge
eating. An episode of binge
eating is characterized by both
of the following:
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
Sense of lack of control over
eating during the episode
(feeling that one cannot stop
eating or control how much)
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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.
Binge eating/compensatory
behaviors both occur, on
average, at least twice a week
for 3 months.
Self-evaluation is unduly
influenced by body shape and
weight.
Bulimia Nervosa
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Associated Features
Typically within the normal weight range (some may be slightly under
or overweight)
Between binges, individuals typically restrict their total caloric
consumption and avoid foods they perceive to be fattening or likely to
trigger a binge.
While binge-eating, food types tend to be high in carbohydrates, cakes,
ice-cream, cookies but are not exclusive to these.
Increased frequency of depressive symptoms (low self-esteem;
deflated mood)
Increased frequency of anxiety symptoms (fear of social situations;
agitation)
1/3 to 1/2 meet the criteria for Borderline Personality Disorder
Two sub-types: Purging Type and Non-purging Type
Those who do not purge (vomit) tend to fast or exercise excessively
following an episode of binge eating.