General Description
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition, Text Revision. Washington , DC.
An eating disorder is a severe problem in eating behavior. There are two specific eating disorders Anorexia Nervosa and Bulimia Nervosa. Also there is an eating disorder not otherwise specified that does not meet the criteria for a specific eating disorder.
Anorexia Nervosa (307.1) has two subtypes. The first is the restricting type, in which weight loss in accomplished primarily through dieting, fasting, or excessive exercise. The second subtype is Binge-Eating/Purging Type this is when the individual usually engages in binge-eating or purging (or both) and often uses laxatives, diuretics, or enemas during their episodes with Anorexia Nervosa.
Bulimia Nervosa (307.51) has two subtypes. The first is purging type, in this subtype the individual regularly engages in self-induced vomiting or misuses laxatives, diuretics, or enemas during an episode. The second is the nonpurging type, in this subtype the individual uses behaviors such as fasting or excessive exercise, but does not engage in self-induced vomiting.
Eating Disorder Not Otherwise Specified (307.50) This diagnose can be used if an individual does not meet the criteria for any specific eating disorder but still does not have normal eating habits.
Diagnostic Criteria
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition, Text Revision. Washington , DC.
Anorexia Nervosa (307.1)
Anorexia Nervosa could be diagnosed if:
- The individual refuses to maintain a normal body weight at or above a minimally weight for their age and height.
- Has an intense fear of gaining weight or becoming fat, even though underweight.
- Disturbed by the way their body looks or weights, evaluates sense of self based on body weight or shape, or is in denial about seriousness about low body weight.
- In females that are postmenarcheal, they experience an absence of at least three menstrual cycles.
Bulimia Nervosa (307.51)
Bulimia Nervosa could be diagnosed if:
- There are reoccurring episodes of binge eating. Where as binge eating includes:
- Eating a large amount of food that is larger than what is consider normal within a 2-hour period.
- A sense of a lack of self control during the episode.
- Reoccurring compensatory behavior to prevent weight gain such as self-induced vomiting, misuse of laxatives or other medications, fasting, or excessive exercise.
- If both symptoms 1 and 2 occur on average twice a week for three months.
- If self-evaluations depend heavily on one's body shape and weight.
- These symptoms do not occur during Anorexia Nervosa episodes.
Eating Disorder Not Otherwise Specified (307.50)
Eating Disorder Not Otherwise Specified could be diagnosed if:
- Individual does not meet the all symptoms for the other eating disorders. Such as:
- Individual might meet every symptom for Anorexia Nervosa except they are not underweight.
- Individual might meet every symptom for Bulimia Nervosa except the binge eating does not happen as frequently in order to be diagnosed for Bulimia Nervosa
Etiology
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition, Text Revision. Washington , DC.
Anorexia rarely occurs before puberty, but it is possible that severity may be greater if associated mental disturbances occur before puberty. The eating disorders are more popular in industrialized nations where a large emphasis on looking attractive is placed on being thin.
Bulimia has been found to be more prevalent in individuals that are first-degree biological relatives of individuals with the same disorder.
Comorbidity
Some common disorders associated with individuals that have eating disorders are Major Depression or dysthymia (50 to 75% of people with anorexia and bulimia), Obsessive-compulsive disorder (up to 25% of people with anorexia), Personality disorders (42% to 75% of people with any eating disorder), Substance abuse disorders (30-37% of people with bulimia; 12-18% of people with anorexia).
Prevalence
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition, Text Revision. Washington , DC.
Anorexia and bulimia are disorders of eating and body perception that largely, but not exclusively, affect women. The disorders are relatively rare: anorexia affects about 0.5% of women and bulimia about 1-2%. Since the 1950's the prevalence of eating disorders has increased. Experts believe this may be the result of modern standards of attractiveness that have established thinness as a desired characteristic of ideal body shape.
EBP Treatment Approaches
Listed below are either evidence-based practices or promising practices that have been successful at treating Eating Disorders.
Anorexia Nervosa
Psychosocial Treatments
- Nutritional rehabilitation - Considerable evidence suggests that nutritional monitoring is effective in Family psychotherapy Inpatient behavioral programs
Pharmacological Treatments
Bulimia Nervosa
Psychosocial Treatments
- Cognitive Behavioral Therapy
- Combined Treatments
- Group Therapy
Pharmacological Treatments
(Click on Medications)
References
Steiner, H.; Lock, J. (1998, Apr.) Anorexia Nervosa and Bulimia Nervosa in children and adolescents: a review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry. 37(4):352-359.
Note - Full text is available through the University at Buffalo Libraries.
Collection of Evidence-Based Treatment Modalities for Children and Adolescents with Mental Health Treatment Needs: Section II
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Links
APA Practice Guideline
Practice Guideline Clearing House
Practice Guideline Gateway
Diagnosis, Treatment, Research Gateway
National Eating Disorders Association
National Alliance for the Mentally Ill
ANRED: Anorexia Nervosa and Related Eating Disorders
Mirror-Mirror: Eating Disorders
National Eating Disorder Information Centre
Something Fishy's Eating Disorder Site
Center for Eating Disorders - St. Joseph Medical Center
Eating Disorder Referral and Information Center
Eating Disorder Association (U.K.)
Alliance for Eating Disorders Awareness
Yahoo's Eating Disorders Links
www.eating.ucdavis.edu
Pale Reflections Eating Disorder Community
Fact Sheets
Fact Sheets from the American Academy of Child and Adolescent Psychiatry
Note - Click on topic. (Please note disclaimer).
The AACAP developed Facts for Families to provide concise and up-to-date information on issues that affect children, teenagers, and their families.
The AACAP website includes facts, statistics, and overviews of different problems children and adolescents face and different mental health disorders that affect children and adolescents.
Fact Sheets from the National Institute of Mental Health
Note - Click on "select a topic".
NIMH offers a variety of publications and other educational resources to help people with mental health disorders, the general public, mental health and health care practitioners, and researchers gain a better understanding of mental illnesses and the research programs of the NIMH.
This website includes facts, statistics, pamphlets, checklists, and overviews of mental health disorders.
Fact Sheets from the National Mental Health Association
Note - Click on topic.
The NMHA offers answers to frequently asked questions, facts, statistics and overviews about different mental health disorders, as well as information about treatments and other problems that affect children and adolescents.
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