Anorexia Nervosa is a disorder of restricted energy intake relative to requirements which leads to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. There is often an intense fear of gaining weight or of becoming fat with persistent behavior that attempts to interfere with weight gain despite already being at a significantly low weight. There is often a disturbance in the way in which one’s body weight or shape is experienced with undue influence of body weight or shape on self-evaluation, and a persistent lack of recognition of the seriousness of the individual's low body weight.
Types of Anorexia Nervosa
Restricting type: The individual has not engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas). This subtype describes presentations in which weight loss is accomplished primarily through dieting, fasting, and/or excessive exercise.
Binge-eating/purging type: The individual has engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).
Severity of Anorexia Nervosa
The minimum level of severity is based, for adults, on current body mass index (BMI) (see below) or, for children and adolescents, on BMI percentile. The ranges below are derived from World Health Organization categories for thinness in adults; for children and adolescents, corresponding BMI percentiles should be used. The level of severity may be increased to reflect clinical symptoms, the degree of functional disability, and the need for supervision.
Moderate: BM116-16.99 kg/m2
Severe: BM115-15.99 kg/m2
Extreme: BMI < 15 kg/m2
Bulimia Nervosa is an eating disorder characterized by recurrent episodes of binge eating, which is defined by both eating an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances AND a sense of lack of control over eating during that period of time (i.e., a feeling that one cannot stop eating or control what or how much one is eating). In addition, there are recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise. Self-evaluation is unduly influenced by body shape and weight in most cases.
Severity of Bulimia Nervosa:
The minimum level of severity is based on the frequency of inappropriate compensatory behaviors (see below). The level of severity may be increased to reflect other symptoms and the degree of functional disability.
Mild: An average of 1-3 episodes of inappropriate compensatory behaviors per week.
Moderate: An average of 4-7 episodes of inappropriate compensatory behaviors per week.
Severe: An average of 8-13 episodes of inappropriate compensatory behaviors per week.
Extreme: An average of 14 or more episodes of inappropriate compensatory behaviors per week.
For Mental Health Professionals:
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.
- Levenson, J. L. (2019). The American Psychiatric Association Publishing textbook of psychosomatic medicine and consultation-liaison psychiatry. Washington, D.C.: American Psychiatric Association Publishing.
- Schatzberg, A. F., & DeBattista, C. (2015). Manual of clinical psychopharmacology. Washington, DC: American Psychiatric Publishing.
- Schatzberg, A. F., & Nemeroff, C. B. (2017). The American Psychiatric Association Publishing textbook of psychopharmacology. Arlington, VA: American Psychiatric Association Publishing.
- Stern, T. A., Freudenreich, O., Fricchione, G., Rosenbaum, J. F., & Smith, F. A. (2018). Massachusetts General Hospital handbook of general hospital psychiatry. Edinburgh: Elsevier.
- Hales et al. The American Psychiatric Association Publishing Textbook of Psychiatry. 6th Edition.
- Benjamin J. Sadock, Virginia A. Sadock. Kaplan & Sadock’s Comprehensive Textbook of Psychiatry. Philadelphia.