Anorexia Nervosa

1. 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).
2. Intense fear of gaining weight or becoming fat even though underweight.
3. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-starvation, or denial of the seriousness of the current low body weight.
4. In postmenarcheal 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 administration (e.g., birth controll pills, estrogen).

Specify type:
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/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)

Medical Complications Associated with Anorexia Nervosa
1.   Dry skin and dehydration
2.   Hair loss
3.   Constipation
4.   Low blood sugar
5.   Impaired renal function/kidney infections
6.   Cramps and muscle spasms from insufficient potassium and protein intake
7.   Low heart rate and blood pressure
8.   Loss of menstrual cycle, infertility
9.   Osteoporosis
10.  Heart attack
11.  Death

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Bulimia Nervosa

1. 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)
2. 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.
3. The binge eating and inappropriate compensatory behaviors both occurred, on average, at least twice a week for 3 months.
4. Self-evaluation is unduly influenced by body shape and weight.
5. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

Specify type:
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

Medical Complications Associated with Bulimia Nervosa
1.   Destruction of teeth
2.   Rupture of esophagus, swollen glands in the neck
3.   Damage to the lining of the stomach
4.   Loss of menstrual cycle, infertility
5.   Weakened immune system
6.   Fainting spells, seizures
7.   Dehydration
8.   Dry, blotchy skin
9.   Electrolyte imbalances
10.  Heart attack
11.  Death

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Binge Eating Disorder (BED) 

Binge Eating Disorder (BED) is a newly recognized condition.  People with BED frequently eat larger than normal amounts of food while feeling a loss of control over their eating and do not purge after the binge.

1. Eating to the point of discomfort or pain.
2. Feeling that the eating behavior is out of control.
3. Frequently dieting without weight loss.
4. Recurrent episodes of binge eating without purging.
5. Feeling depressed, disgusted or upset over the amount eaten.

Medical Complications Associated with BED   

1. Obesity
2. High blood pressure
3. Type 2 diabetes
4. High blood cholesterol
5. Gall bladder disease
6. Heart disease
7. Osteoarthritis
8. Joint pain
9. Gastrointestinal problems
10. Depression, anxiety or stress
11. Sleeping problems
12. Substance abuse

Eating Disorder Not Otherwise Specified (EDNOS)

The Eating Disorder 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 the criteria for 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 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 3 months.
4. The regular use of inappropriate compensatory behavior 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 regular use of inappropriate compensatory behaviors characteristic of Bulimia Nervosa.

Gastric Bypass

Psychological Evaluation for Bariatric Surgery: EDC-Denver provides candidates for Bariatric Surgery (Gastric By-Pass or Lap Band Procedures) with comprehensive evaluations, a necessary component of the requirements for weight loss surgery. Our aim is to identify strengths, areas of concern and strategies in order to provide the candidate and the bariatric team recommendations to optimize the individual's weight loss efforts and the most challenging aspect, weight maintenance. 

Additional Resources

Eating Disorder Screening Test 
I Think My Loved One Has An Eating Disorder
Do’s & Don’ts
Recommended Reading List

Mirror-Mirror.org is a web site dedicated to raising awareness and providing information on eating disorders.  Definitions, signs and symptoms, getting help, relapse warning signs, approaching a loved one and more. For more information, click here.

Healthygenius.com is a mental health disorders portal that address a variety of disorders including eating disorders, depressive disorders, impulse control disorders, anxiety disorders, sleep disorders, biopolar disorders and many more.

BeyondtheMirror.org is a counseling center for women & youth.  It is dedicated to empowering individuals to see beyond their reflections through counseling, outreach & education, and connection to services.

Eating Disorder Recovery is an information source for eating disorder recovery articles, discussion forum, DSM-V-TR descriptions, support group information, access to in-patient/residential treatment centers, self-help workbook and more.

Eating Disorder Answers  was developed by a woman in recovery from an eating disorder.  When she was first diagnosed, she couldn't find a web site that had all of the answers as information was scattered over several web sites.  This was very confusing and frustrating for her, so she decided to develop her own. Viewers of the site are encouraged to share their stories.

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