Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., 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). (A weight "85% less than the expected" is a BMI of less than 17.5, you can find out your BMI here: http://nhlbisupport.com/bmi/bmicalc.htm. BMI is not applicable to those who have not gone through puberty, for example a 14-year-old can have a BMI as low as 13 and not be considered underweight. 2 years after starting your period is usually a good guide for knowing that you have completed most of puberty.)
Intense fear of gaining weight or becoming fat, even though underweight.
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.
In postmenarcheal females (women who have not yet gone through menopause), amenorrhea (the absence of at least three consecutive menstrual cycles).
Restricting Type: during the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)
Binge-Eating Type or Purging Type: during the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating OR purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)
(There are several things worth noting from the diagnostic criteria for anorexia: 1) bingeing and purgeing is mentioned, so if you engage in these AND fit all the other criteria for anorexia you are bulimarexic; 2/3s of anorexics are bulimarexic. 2) There is no mention of how much the anorexic eats in the diagnostic criteria or any other behaviour - this means someone can be diagnosed with anorexia despite not restricting very hard at all, or not fitting any of the other anorexia stereotypes).
Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
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 (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise.
The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months.
Self-evaluation is unduly influenced by body shape and weight.
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-induced 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 behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas
Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
Eating, in a discrete period of time (eg, within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances;
A sense of lack of control over eating during the episode (eg, a feeling that one cannot stop eating or control what or how much one is eating).
The binge eating episodes are associated with at least three 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 being embarrassed by how much one is eating
Feeling disgusted with oneself, depressed, or feeling very guilty after overeating
Marked distress regarding binge eating.
The binge eating occurs, on average, at least 2 days a week for 6 months.
The binge eating is not associated with the regular use of inappropriate compensatory behaviors (eg, purging, fasting, excessive exercise) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa.
This eating disorder does not have specific diagnostic criteria.
People suffering with Compulsive Overeating have what is characterized as an "addiction" to food, using food and eating as a way to hide from their emotions, to fill a void they feel inside, and to cope with daily stresses and problems in their lives.
People suffering with this Eating Disorder tend to be overweight, are usually aware that their eating habits are abnormal, but find little comfort because of society's tendency to stereotype the "overweight" individual. Words like, "just go on a diet" are as emotionally devastating to a person suffering Compulsive Overeating as "just eat" can be to a person suffering Anorexia. A person suffering as a Compulsive Overeater is at health risk for a heart attack, high blood-pressure and cholesterol, kidney disease and/or failure, arthritis and bone deterioration, and stroke.
Men and Women who are Compulsive Overeaters will sometimes hide behind their physical appearance, using it as a blockade against society (common in survivors of sexual abuse). They feel guilty for not being "good enough," shame for being overweight, and generally have a very low self-esteem... they use food and eating to cope with these feelings, which only leads into the cycle of feeling them ten-fold and trying to find a way to cope again. With a low self esteem and often constant need for love and validation he/she will turn to obsessive episodes of binging and eating as a way to forget the pain and the desire for affection.
This eating disorder does not have specific diagnostic criteria.
Orthorexia Nervosa is an obsession with a "pure" diet, where it interferes with a person's life. It becomes a way of life filled with chronic concern for the quality of food being consumed. When the person suffering with Orthorexia Nervosa slips up from wavering from their "perfect" diet, they may resort to extreme acts of further self-disipline including even strictor regimens and fasting.
"This transference of all of life's value into the act of eating makes orthorexia a true disorder. In this essential characteristic, orthorexia bears many similarities to the two well-known eating disorders anorexia and bulimia. Where the bulimic and anorexic focus on the quantity of food, the orthorexic fixates on its quality. All three give food an excessive place in the scheme of life." (Steven Bratman, M.D., October 1997)
As noted by BeyondVeg.com, Orthorexia Nervosa should only be characterised when it is in the long-term (paying attention to healthy food for a few weeks where it becomes a normal and healthy routine not obsessed over, would not be considered a disorder), when it has a significant negative impact on an individual's life (thinking about food to avoid the stresses of life, thinking about how food is prepared to avoid negative emotions, thinking about food the majority of each individual's day), and where food rituals are not better explained by something like religious rites (such as in the Orthodox Jewish religion).
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