Eating Disorders
Eating disorders are generally defined by severe disturbances in eating behavior. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) the specific diagnoses include Anorexia Nervosa, Bulimia Nervosa, and Eating Disorders Not Otherwise Specified. Binge Eating Disorder is currently included in the subcategory Eating Disorders Not Otherwise Specified as experts are in the process of researching and determining if Binge Eating Disorder should become its own diagnostic category.
Below are the definitions of each of the major eating disorders (summarized from the Academy for Eating Disorders Website). While they are each slightly different in their presentation, they are all associated with physical and emotional distress. Eating disorders are very serious psychiatric illnesses as they are associated with many medical conditions and even death.
Anorexia Nervosa
Individuals with anorexia nervosa are unable or unwilling to maintain a healthy body weight that is expected for their age and height. There is no definition of "normal" or "too low", so the medical community has generally agreed to use 85% of normal (healthy for age and height) weight as a guide. Individuals with anorexia nervosa have a strong fear of weight gain and a dread of becoming fat even though they are markedly underweight. Weight and shape concerns affect how the person evaluates him or herself. The seriousness of the weight loss and its health implications is usually minimized, if not denied, by the individual.
There are two subtypes of the anorexia nervosa: First, individuals with the restricting type maintain their low body weight purely by restricting food intake and, possibly, by exercise. Second, those with the binge-eating/purging type usually restrict their food intake as well, but also regularly engage in binge eating and/or purging behaviors such as self-induced vomiting or the misuse of laxatives, diuretics or enemas.
Bulimia Nervosa
Individuals with bulimia nervosa regularly engage in bouts of overeating and then compensate for the overeating to avoid gaining weight. Compensation could include various ways of getting rid of the calories such as self-induced vomiting, misuse of laxatives, enemas, diuretics, severe caloric restriction, or excessive exercising A binge is generally defined as ingesting an amount of food that most others would consider "large" in a similar situation. The individual also notes feeling out of control such that when they start it is difficult for them to stop or that they are unable to prevent the binge from occurring. The binge purge episodes occur at least twice per week for three months or more. Similar to anorexia nervosa, individuals with bulimia nervosa also have marked concerns about their weight and shape and such concerns influence the way they feel about themselves.
There are two subtypes of bulimia nervosa. First, the purging type describes those who regularly compensate for the binge eating with self-induced vomiting or through the use of laxatives, diuretics, or enemas. Second, the non-purging type is used to describe individuals who compensate through excessive exercising or dietary fasting.
Anorexia Nervosa versus Bulimia Nervosa
**Many people believe that those with anorexia nervosa do not eat while those with bulimia nervosa binge and purge. As you can see above, those in either category can engage in binge eating and purging. The most notable difference is that those with anorexia nervosa are at an unhealthily low body weight. One can not be diagnosed with anorexia nervosa and bulimia nervosa at the same time.**
Binge Eating Disorder
Binge Eating Disorder is a new entity and the term was coined in 1992 to describe individuals who binge eat but do not regularly use inappropriate compensatory weight control behaviors such as fasting or purging to lose weight. A binge is defined as eating a large amount of food (given the situation) in a short period of time (typically within two hours) and feeling out of control (i.e., can not stop eating). In addition, the binge eating may involve eating quickly, eating until feeling uncomfortably full, eating a large amount when not hungry, and feeling shame or embarrassment after the eating occurred.
Binge eating disorder is often associated with obesity; approximately 20% of the people who seek professional treatment for obesity meet the criteria for binge eating disorder. In the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM- IV-TR), binge eating disorder is not an officially recognized eating disorder, but is included in the category titled Eating Disorder Not Otherwise Specified (EDNOS). Often people classify binge eating as compulsive eating or emotional eating.
Eating Disorder Not Otherwise Specified
There are several types of disordered eating in addition to binge eating disorder that do not meet the diagnostic criteria for anorexia nervosa or bulimia nervosa, but nevertheless are eating disorders requiring treatment. For example, those with disordered eating behaviors that resemble anorexia nervosa or bulimia nervosa but do not meet one or more essential diagnostic criteria may be diagnosed with EDNOS. Examples of EDNOS include individuals who regularly purge but do not binge eat, individuals who meet criteria for anorexia nervosa but continue to menstruate, and individuals who meet criteria for bulimia nervosa, but binge eat less than twice weekly. Again, one does not need to have a diagnosis of an eating disorder per se to determine that they have disordered eating and / or need treatment.
Obesity
Obesity is not included as a mental disorder. Rather, it is included in the International Classification of Diseases as a general medical condition. This is because obesity has not been consistently associated with any psychological syndrome. Nevertheless, many patients who are obese experience mental disorders alongside including depression, anxiety, binge eating, pain, and other diseases and disorders.
Statistics
About 0.5 - 1.0 % of late adolescent or adult women meet criteria for the diagnosis of Anorexia Nervosa while. approximately 1.0 - 2.0 % of late adolescent and adult women meet criteria for the diagnosis of Bulimia Nervosa.
When looking at the symptoms more generally (and not looking at satisfying a full diagnosis), about 10% or more of late adolescent and adult women report symptoms of eating disorders, which are also concerns for physical and emotional health. In addition, the vast majority of American women are dissatisfied with their appearance and /or body. Some will develop full blown eating disorders, some will experience symptoms but not will not meet diagnostic criteria, and others may not experience difficulties. Although treatment could be helpful at any point in time, it is important not to wait until one has a full blown eating disorder; early treatment may prevent the manifestation of a more serious disorder.
Below are the definitions of each of the major eating disorders (summarized from the Academy for Eating Disorders Website). While they are each slightly different in their presentation, they are all associated with physical and emotional distress. Eating disorders are very serious psychiatric illnesses as they are associated with many medical conditions and even death.
Anorexia Nervosa
Individuals with anorexia nervosa are unable or unwilling to maintain a healthy body weight that is expected for their age and height. There is no definition of "normal" or "too low", so the medical community has generally agreed to use 85% of normal (healthy for age and height) weight as a guide. Individuals with anorexia nervosa have a strong fear of weight gain and a dread of becoming fat even though they are markedly underweight. Weight and shape concerns affect how the person evaluates him or herself. The seriousness of the weight loss and its health implications is usually minimized, if not denied, by the individual.
There are two subtypes of the anorexia nervosa: First, individuals with the restricting type maintain their low body weight purely by restricting food intake and, possibly, by exercise. Second, those with the binge-eating/purging type usually restrict their food intake as well, but also regularly engage in binge eating and/or purging behaviors such as self-induced vomiting or the misuse of laxatives, diuretics or enemas.
Bulimia Nervosa
Individuals with bulimia nervosa regularly engage in bouts of overeating and then compensate for the overeating to avoid gaining weight. Compensation could include various ways of getting rid of the calories such as self-induced vomiting, misuse of laxatives, enemas, diuretics, severe caloric restriction, or excessive exercising A binge is generally defined as ingesting an amount of food that most others would consider "large" in a similar situation. The individual also notes feeling out of control such that when they start it is difficult for them to stop or that they are unable to prevent the binge from occurring. The binge purge episodes occur at least twice per week for three months or more. Similar to anorexia nervosa, individuals with bulimia nervosa also have marked concerns about their weight and shape and such concerns influence the way they feel about themselves.
There are two subtypes of bulimia nervosa. First, the purging type describes those who regularly compensate for the binge eating with self-induced vomiting or through the use of laxatives, diuretics, or enemas. Second, the non-purging type is used to describe individuals who compensate through excessive exercising or dietary fasting.
Anorexia Nervosa versus Bulimia Nervosa
**Many people believe that those with anorexia nervosa do not eat while those with bulimia nervosa binge and purge. As you can see above, those in either category can engage in binge eating and purging. The most notable difference is that those with anorexia nervosa are at an unhealthily low body weight. One can not be diagnosed with anorexia nervosa and bulimia nervosa at the same time.**
Binge Eating Disorder
Binge Eating Disorder is a new entity and the term was coined in 1992 to describe individuals who binge eat but do not regularly use inappropriate compensatory weight control behaviors such as fasting or purging to lose weight. A binge is defined as eating a large amount of food (given the situation) in a short period of time (typically within two hours) and feeling out of control (i.e., can not stop eating). In addition, the binge eating may involve eating quickly, eating until feeling uncomfortably full, eating a large amount when not hungry, and feeling shame or embarrassment after the eating occurred.
Binge eating disorder is often associated with obesity; approximately 20% of the people who seek professional treatment for obesity meet the criteria for binge eating disorder. In the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM- IV-TR), binge eating disorder is not an officially recognized eating disorder, but is included in the category titled Eating Disorder Not Otherwise Specified (EDNOS). Often people classify binge eating as compulsive eating or emotional eating.
Eating Disorder Not Otherwise Specified
There are several types of disordered eating in addition to binge eating disorder that do not meet the diagnostic criteria for anorexia nervosa or bulimia nervosa, but nevertheless are eating disorders requiring treatment. For example, those with disordered eating behaviors that resemble anorexia nervosa or bulimia nervosa but do not meet one or more essential diagnostic criteria may be diagnosed with EDNOS. Examples of EDNOS include individuals who regularly purge but do not binge eat, individuals who meet criteria for anorexia nervosa but continue to menstruate, and individuals who meet criteria for bulimia nervosa, but binge eat less than twice weekly. Again, one does not need to have a diagnosis of an eating disorder per se to determine that they have disordered eating and / or need treatment.
Obesity
Obesity is not included as a mental disorder. Rather, it is included in the International Classification of Diseases as a general medical condition. This is because obesity has not been consistently associated with any psychological syndrome. Nevertheless, many patients who are obese experience mental disorders alongside including depression, anxiety, binge eating, pain, and other diseases and disorders.
Statistics
About 0.5 - 1.0 % of late adolescent or adult women meet criteria for the diagnosis of Anorexia Nervosa while. approximately 1.0 - 2.0 % of late adolescent and adult women meet criteria for the diagnosis of Bulimia Nervosa.
When looking at the symptoms more generally (and not looking at satisfying a full diagnosis), about 10% or more of late adolescent and adult women report symptoms of eating disorders, which are also concerns for physical and emotional health. In addition, the vast majority of American women are dissatisfied with their appearance and /or body. Some will develop full blown eating disorders, some will experience symptoms but not will not meet diagnostic criteria, and others may not experience difficulties. Although treatment could be helpful at any point in time, it is important not to wait until one has a full blown eating disorder; early treatment may prevent the manifestation of a more serious disorder.