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EATING DISORDER DIAGNOSTIC CRITERIA*
Anorexia Nervosa (AN) Hallmark Criteria:
Restriction of food intake, leading to low body weight, which is considered less than the normal range for age/height.
Intense fear of gaining weight or becoming fat, or persistent behavior that prohibits weight gain, even when the body weight is significantly low.
Body image disturbance, whereby the individuals continually perceive themselves to be fat, despite a low body weight.
Low BMI < 18.0 (Normal is 18.5-24.9).
Subtypes include binge-eat/purging AN.
Commonly begins in adolescences or young adulthood.
Most often associated with a stressful life event.
Bulimia Nervosa (BN) Hallmark Criteria:
Recurrent episodes of binge-eating characterized as:
- Eating a large amount of food over a relatively short period of time (2 hours or less)
- Lack of control over eating during these episodes
Recurrent inappropriate compensatory measures to prevent weight gain through:
- Laxative abuse
- Self-induced vomiting
- Diuretics
- Fasting
- Excessive exercise
The binge-eating and compensatory behaviors both occur at least once a week on average over a period of 3 months.
Body image disturbance, influenced by shape and weight.
The behaviors do not occur exclusively during episodes of anorexia nervosa.
Commonly begins in adolescence or young adulthood.
Peaks in older adolescence.
May be triggered by dieting.
Binge Eating Disorder (BED):
Recurrent episodes of binge-eating characterized as:
- Eating a large amount of food over a relatively short period of time (2 hours or less).
- Lack of control over eating during these episodes.
Binge-eating episodes are associated with 3 or more of the following:
- Eating much more rapidly than normal
- Eating until feeling uncomfortably full
- Eating large amounts of food when not feeling physically hungry
- Eating alone because of feeling embarrassed by how much a person is consuming
- Feeling disgusted with oneself, alone, depressed, or extremely guilty after the binge
Marked distress regarding the binge eating behavior.
The binge eating occurs at least once a week on average over a 3 month period.
The binge eating is not associated with recurrent use of inappropriate compensatory behavior as noted with bulimia nervosa or anorexia nervosa.
Occurs in normal-weight, overweight, and obese individuals, but most often associated with overweight and obesity in treatment seeking individuals.
Distinct from obesity.
Less disparity in gender differences with prevalence.
Dieting often follows the development of BED.
Typically begins in later adolescence and young adulthood, but can begin in later adulthood.
Other Specified Feeding or Eating Disorder (OSFED):
Atypical Anorexia Nervosa:
Criteria met for AN is met, except that despite significant weight loss, the individual’s weight is within or above the normal range.
Bulimia Nervosa (of low frequency and/or limited duration)
All the criteria for BN is met, except that binge-eating and compensatory measures occur less than once a week and/or for less than 3 months.
Binge-eating Disorder (of low frequency and/or limited duration)
All of the criteria for BED is met except that the binge eating occurrences are on average, less than once a week and/or less than 3 months duration.
Purging Disorder:
Recurrent purging behavior (i.e. laxatives, vomiting, etc.) to influence shape or weight in the absence of binge-eating.
Night Eating Syndrome:
Recurrent eating episodes of night eating that occur after awakening from sleep or by excessive food consumption after the evening meal. The night eating is not related to changes in sleep/wake cycles or social norms.
Causes significant distress and impairment in functioning.
Not attributed to other medical disorders, mental disorders or medication.
* (Criteria taken from the DSM-5 Manual, 2013)