Eating Disorders

This is my latest page and is still under construction. i am still searching for more resources and as i find them will update this page. Below you will find the DSM-IV criteria for the different eating disorders. i have included these on my page because of numerous encounters with young girls who insist that they don't have an eating disorder, yet clearly meet these criteria. Unfortunately most women with these disorders think if they don't weigh 100 pounds or "look" as though they are starving, then they are okay and don't have an eating disorder. The sad fact is though that many women who "look" normal are in fact suffering from these vicious addictions and destroying their bodies in the process. It is my hope that my providing clear definitions using the DSM-IV criteria, we may better be able to educate ourselves and be able to recognize the signs of these very dangerous and life-threatening disorders.
If you know someone who may be suffering from and eating disorder, the best thing you can do to help them is to stand by their side and to consistently reassure them that they are indeed worth living. i find time and time again that those of us who have suffered from an eating disorder and those who are suffering still, struggle with the illogical notion that we don't deserve life, we don't deserve pleasure. Most often this is because these young ladies have never "heard" others tell them how special they really are. That they are unique and worthy of life.
Like Inanna describes in her Anorexic Creed, eating disorders are a mindset, belief system, rather than just the behaviours of starving, bingeing and purging, and overexercising. i know from first hand experience that once a person succombs to these behaviours, their mind suddenly takes on a new belief system; sadly one that is completely backwards to their usual healthy belief system. Although they "know" what is healthy and what is unhealthy (not wrong or right - these words hold too much guilt) they struggle with actually "believing" what is healthy. They see being thin as healthy...what they don't realize is that their means to achieving that thinness is in the process very unhealthy and destroying their bodies, rather than slimming them down.

DSM-IV Criteria for Eating Disorders

Anorexia Nervosa

A. Refusal to maintain body weight at or above a minimally normal weight for age and height (eg., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected.

B. Intense fear of gaining weight or becoming fat, even though underweight.

C. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.

D. In postmenarchal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles. ( A woman is considered to have amenorrhea if her periods occur only following hormone, e.g., estrogen, administration.)

Restricting Type: during the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behaviour (i.e., self-induced vomiting, or the misuse of laxatives, diuretics, or enemas)

Binge-Eating/Purging Type: during the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating or purging behaviour (i.e., self-induced vomiting, or the misuse of laxatives, diuretics, or enemas)

Bulimia Nervosa

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

(1) eating, in a discrete period of time (e.g., within any 2-hour period), and amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.

(2) a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)

B. Recurrent inappropriate behaviour in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise.

C. The binge eating and inappropriate compensatory behaviours both occur, on average, at least twice a week for 3 months.

D. Self-evaluation is unduly influenced by body shape and weight.

E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

Purging Type : during the current episode of Bulimia Nervosa, the person has regularly engaged in self-induce vomiting or the misuse of laxatives, diuretics, or enemas.

Nonpurging Type : during the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviours, such as fasting or excessive exercise, but has not regularly engaged in self-induce vomiting or the misuse of laxatives, diuretics, or enemas.

Eating Disorder Not Otherwise Specified

The Eating Not Otherwise Specified category is for disorders of eating that do not meet the criteria for any specific Eating Disorder. Examples include

1. For females, all of the criteria of Anorexia Nervosa are met except that the individual has regular menses.

2. All of the criteria for Anorexia Nervosa are met except that, despite significant weight loss, the individual's current weight is in the normal range.

3. All of the criteria for Bulimia Nervosa are met except that the binge eating and inappropriate compensatory mechanisms occur at a frequency of less than twice a week or for a duration of less than three months.

4. The regular use of inappropriate compensatory behaviour by an individual of normal body weight after eating small amounts of food (e.g., self-induced vomiting after the consumption of two cookies).

5. Repeatedly chewing and spitting out, but not swallowing, large amounts of food.

6. Binge-eating disorder: recurrent episodes of binge eating in the absence of the regular use of inappropriate compensatory behaviours characteristic of Bulimia Nervosa.

Research Criteria for binge-eating disorder

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

(1) eating, in a discrete period of time (e.g., within any 2-hour period), and amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.

(2) a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)

B. The binge-eating episodes are associated with three (or more) of the following:
(1) eating much more rapidly than normal
(2) eating until feeling uncomfortably full
(3) eating large amounts of food when not feeling physically hungry
(4) eating alone because of being embarassed by how much one is eating
(5) feeling disgusted with oneself, depressed, or very guilty after overeating

C. Marked distress regarding binge eating is present.

D. The binge eating occurs, on average, at least 2 days a week for 6 months.

Note: The method of determining frequency differs from that used for Bulimia Nervosa; future research should address whether the preferred method of setting a frequency threshold is counting the number of days on which binges occur or counting the number of episodes of binge eating.

E. The binge eating is not associated with the regular use of inappropriate compensatory behaviours (e.g., purging, fasting, excessive exercise) and does not occur exclusively during the course of Anorexia Nervosa or Bulimia Nervosa.

Eating Disorder Related Links
Eating Disorders Research
Anorexic Creed
Booklist on Eating Disorders created by the author of the above site
Something Fishy
Mirror Mirror
Body Image Betrayal and Related Issues
Unbinding the Body Betrayed webring
Lucy Serpell's Eating Disorder's Resources from the UK based Institute of Psychiatry.
The Body Shop

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