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EATING DISORDER DEFINITIONS

Learn the criteria related to diagnosing an eating disorder and descriptions of them.


There are several different kinds of eating disorders.  The most well-known ones are anorexia and bulimia, but others exist, too.  Binge eating disorder was just officially added to the DSM (Diagnostic & Statistical Manual of Mental Disorders) this year as its own specific eating disorder, and is widely considered to be a lot more prevalent than was previously believed.  It's not uncommon for a sufferer to experience more than one eating disorder, sometimes moving back and forth among different ones.  For example, a person might start out meeting the definition of having bulimia, then later fit more into the category of EDNOS (eating disorder not otherwise specified).  All eating disorders are quite serious, and none is any "safer" than the others.  Diagnostic criteria for eating disorders is used by doctors, therapists, researchers and insurance companies in order to diagnose someone.  An eating disorder can be present without every single item on the criteria check list occurring.


All eating disorders have emotional issues and situations as their backbone, and need to be addressed as more than just behavioral problems.  A person with an eating disorder cannot be guilted or bribed into giving up behaviors.  The disease must be treated as the mental illness it is, with an understanding that it takes time to recover (usually years), and the person will experience both triumphs and setbacks along the way.  Remember, an eating disorder is not a diet that's out of control or something that will go away on its own.  It is a very deadly condition, and the sooner a person enters recovery, the better.  See the Getting Help section for more information.


ANOREXIA

  • Does not maintain a minimally normal weight for age, height, and gender; usually less than 85% of expected size

  • Persistent restriction of food intake, going long stretches without eating
  • Intense fear of gaining weight or being fat
  • Obsession with food, calories, weight, and body size
  • Possible interruption in or loss of menstrual cycle (this is not experienced by all)
  • Use of diet pills, laxatives, diuretics or compulsive exercising
  • Self-evaluation is unduly influenced by body shape and weight


BULIMIA

  • Frequent episodes of eating an excessive amount of food in a short period of time, i.e. two hours or less

  • A feeling of a lack of control over how much one is eating or being able to stop eating

  • Behavior is usually followed by compensatory purging behaviors, most commonly self-induced vomiting, but can also include things like diet pills, laxatives, restricting, diuretics, and compulsive exercise

  • Self-evaluation is unduly influenced by body shape and weight

  • The behaviors occur at least once a week for three months

BINGE EATING DISORDER

  • Frequent episodes of eating an excessive amount of food in a short period of time, i.e. two hours or less

  • A feeling of a lack of control over how much one is eating or being able to stop eating

  • Eating usually consists of at least three of the following:  consuming food very rapidly, eating until uncomfortably full, eating when not hungry, eating alone out of embarrassment of food consumption, feeling disgusted, guilty or depressed after eating

  • Eating is not usually or is never followed by compensatory purging behaviors, such as self-induced vomiting, diet pills, laxatives, diuretics, restricting or compulsive exercise

  • Self-evaluation is unduly influenced by body shape and weight

  • The behaviors occur at least once a week for three months


EDNOS (Eating Disorder Not Otherwise Specified)

This is a commonly diagnosed eating disorder, and is just as serious and potentially deadly as any other eating disorder.   It is often the diagnosis for an individual that does not fit fully into the category of another eating disorder, usually anorexia or bulimia.  A person with EDNOS may:

  • Meet most of the qualifications for anorexia, except their weight is above the standard  85% of expected size

  • Meet most of the qualifications for bulimia, but the number of times behaviors occur is less than the requirement listed

  • Use compensatory purging behaviors, most commonly self-induced vomiting, but can also include things like diet pills, laxatives, diuretics, restricting, and compulsive exercise, after eating small amounts of food

  • Chew and spit their food out without swallowing it

  • Self-evaluation is unduly influenced by body shape and weight



MISCELLANEOUS EATING DISORDERS & BODY IMAGE CONDITIONS:


COMPULSIVE OVEREXERCISING

While regular exercise done in moderate amounts can be great for a person, compulsive exercising is something extreme that is often used in conjunction with an eating disorder, such as anorexia or bulimia.  A person who compulsively exercises may do some or all of the following:

  • Push themselves past the normal amount of time a person would exercise, sometimes working out every day, for hours a day, or more than once a day

  • Exercise outside even in extreme heat, cold, rain or snow

  • Put off or cancel work, school, social or family activities in order to devote themselves to exercise

  • Become stressed and obsessive if they cannot exercise

  • Ignore signs they need to stop, such as tightness in the chest, trouble breathing, excessive sweating, and injuries

  • May use compensatory purging behaviors, such as diet pills or diuretics, to assist in weight loss


PICA

  • Persistent eating of non-nutritive substances (i.e. dirt, chalk, plaster, or many other things) for a period of at least one month
  • The eating of non-nutritive substances is inappropriate to the development level of the individual
  • The eating behavior is not part of a culturally supported or socially normative practice
  • Can be associated with mineral deficiencies, developmental delays, mental deficiencies, and even pregnancy


NOCTURAL SLEEP-RELATED DISORDER

Also known as Sleep Eating Disorder, it consists of eating while sleep-walking.  The person usually does not remember that they have gotten out of bed, often cooked, and then consumed food, all while still technically asleep.  Evidence comes later when they wake up and find empty food containers and wrappers, dirty dishes and other clues that indicate what happened while they were asleep.  Sometimes the person will consume raw or frozen food, or will cook in an abnormal fashion, such as heating bacon on a coffee pot base, leading to a risk of consuming food that may be contaminated.  They may also consume non-food substances, such as glue or wood.  The amount of food eaten is usually a larger amount than a person would normally eat while fully awake.


ORTHOREXIA

This is an extreme or excessive preoccupation with avoiding foods the person believes to be unhealthy.  It often begins with an earnest attempt to eat healthier, with a focus on foods that are low in fat or calorie content, and sometimes avoiding entire food groups, such as sugar, wheat or dairy.  It then spirals down to an obsession with an ever decreasing list of foods that feel 'safe' to the individual, and can result in extreme weight loss, malnutrition, other physical health risks, and social isolation due to the limited number of things the person will eat.  A person often experiences a feeling of 'purity' and control when following their new dietary plan; conversely they feel guilty and bad when they deviate from it.    


PRADER-WILLI SYNDROME

This is a rare, genetic disorder that causes the person to have an insatiable appetite.  A defect in the part of the brain that regulates hunger causes the person to constantly feel hungry, and take extraordinary steps in order to attempt to satiate it.  These steps can include stealing food, eating spoiled food, and eating inappropriate things, such as pet food.  Often victims of this disorder end up dealing with obesity due to the constant high calorie intake of food.


BODY DYSMORPHIC DISORDER

This  is a condition that sometimes accompanies an eating disorder. It is not just having a bad body image, which usually goes along with an eating disorder, but rather a diagnosed condition in addition to the disorder.  A person with this condition obsesses over their appearance, often focused on one particular part of their body.  They believe there to be a flaw, often something small, and it may be real or imagined.  The obsession over this often results in depression and an inability to enjoy life.  The person may engage in multiple attempts at cosmetic procedures or other extreme actions in order to feel better, although nothing they do results in a quieting of the constant nagging thoughts, shame and dissatisfaction they feel.


MUSCLE DYSMORPHIA (aka Bigorexia)

This falls under the heading of a body image condition, rather than strictly an eating disorder, but can exist along with an eating disorder.  It is a condition in which the person becomes obsessed with the thought of developing and maintaining muscles, particularly of the typical bodybuilder type, while maintaining a lean stature.  Even after pronounced development of muscles, the sufferer usually is not able to fully see this or be satisfied with the results, and continues to attempt to increase their muscular structure and size.  It is most commonly found in males, but females can have it, too, with a high population among body builders, wrestlers and other athletes.