How do I know if I or a loved one has an ED?
The American Psychiatric Association published a book called the DSM IV( Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) to classify what different eating disorders look like. The following is an abbreviated version of the criteria for anorexia, bulimia and eating disorder NOS (not otherwise specified).
Anorexia Nervosa
- Refusal to maintain body weight at or above a minimally normal weight for age and height: Weight loss leading to maintenance of body weight <85% of what is 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 under weight.
- Disturbance in the way one's body weight or shape are experienced, undue influence of body weight or shape on self evaluation, or denial of the seriousness of the current low body weight.
· Amenorrhea (at least three consecutive cycles) in postmenarchal girls and women. Amenorrhea is defined as periods occurring only following hormone (e.g., estrogen) administration.
Bulimia Nervosa
Recurrent episodes of binge eating characterized by both:
- 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
- A sense of lack of control over eating during the episode, defined by a feeling that one cannot stop eating or control what or how much one is eating
· Recurrent inappropriate compensatory behavior to prevent weight gain:
Self-induced vomiting
Misuse of laxatives, diuretics, enemas, or other medications
Fasting
Excessive exercise
· The binge eating and inappropriate compensatory behavior both occur, on average, at least twice a week for 3 months.
Eating Disorder NOS (Not Otherwise Specified)
- For female patients, all of the criteria for anorexia nervosa are met except that the patient has regular menses.
- All of the criteria for anorexia nervosa are met except that, the patient's current weight is in the normal range.
- All of the criteria for bulimia nervosa are met except that the binge eating and inappropriate compensatory mechanisms occur less than twice a week or for less than 3 months.
- The patient has normal body weight and regularly uses inappropriate compensatory behavior after eating small amounts of food (e.g., self-induced vomiting after consuming two cookies).
· Repeated chewing and spitting of food.
Eating Disorder Stats
Eating disorders do not discriminate. Yes, most people who have EDs are female (7 million) but there is also a growing number of men who suffer from one of the EDs as well (1 million). You likely know someone who has an ED as 3-4 out of 100 females suffer from anorexia or bulimia. Eating disorders affect nearly the same number of non-Caucasian as Caucasian. An unfortunate statistic is only 1 out of 10 sufferers receive the treatment they need.
Mortality Rates
Premature death from complications relating to anorexia nervosa (AN) happen to 20% of the sufferers. A young girl suffering from AN will have a 12x higher rate of death than others in the 15-24 year age range. National Assoc. of AN and Associated Disorders reported that 5-10% of AN die within 10 years after contracting the disease; 18-20% of AN will die after 20 years and only 30-40% fully recover.
Dieting Predicts *More* Weight Gain in Teenagers (1)
Dieting Predicts Binge Eating in Teenagers (1)
Dieting is the Most Important Predictor of New Eating Disorders in
Teenagers (2)
1. Neumark-Sztainer D. et al. Obesity, disordered eating,and eating disorders
in a longitudinal study of adolescents: how do dieters fare five years
later?J Am Diet Assoc.
2. British Medical Journal.1999;318:765- 768.
