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  • Diagnosing an Eating Disorder

    DSCN1899For clinicians, the “official” diagnosis of an eating disorder is made by using the criteria listed in the Diagnostic and Statistical Manuel V Edition (DSM-V). While the official diagnostic criteria is found in the DSM-V, there may be tremendous variations in the presentation of an individuals eating disorder.

    Anorexia Nervosa

    Anorexia nervosa (AN) is a disorder in which individuals exhibit significant weight loss and extreme restrictions in their food intake. It is estimated that 1-2.2% of the population meet criteria for anorexia nervosa. Specific criteria for the diagnosis of anorexia nervosa includes:

    • Weight loss and refusal to maintain what is considered a normal body weight for that person’s age and height (minimally 85% of expected normal weight).
    • Intense fear of gaining weight despite being below expected weight and/or denial of the seriousness of their low weight.
    • Disturbance in the way one perceives their body weight or shape and/or an excessive emphasis that is placed on body weight/shape with self-evaluation.

    Additionally, Anorexia Nervosa is specified into two types:

    • Restricting Type:

    Categorized as severe restriction of food intake with the absence of binge-eating or purging behaviors.

    • Binge/Purge Type:

    Categorized as engaging in binge eating or purging behavior while also exhibiting behaviors meeting criteria for anorexia nervosa. Purging is characterized as a way to eliminate food from your body either through self-induced vomiting, excessive exercise, or through laxatives, diuretics, or enemas.

    Bulimia Nervosa

    Bulimia nervosa (BN) is a disorder in which individuals eat excessive amounts of food in a short period of time and afterwards eliminate this food from their body through some type of purging behavior. It is estimated that 1.1 to 4.2% of the female population suffers from BN.

    Criteria for diagnosis of bulimia nervosa include:

    • Recurring episodes of binge eating, characterized as an uncontrollable consumption of food in a short period of time (under 2 hours), eating substantially more than most people would eat under similar circumstances.
    • Recurrent episodes of compensatory behaviors following binging episode in which the individual tries to prevent weight gain through self-induced vomiting, laxatives, diuretics, enemas, fasting, or excessive exercise.

    The binge eating and compensatory behaviors occur, on average, at least once a week for a period of at least 3 months.

    Self-evaluation is significantly influenced by weight and body shape.

    Binge-Eating Disorder (BED)

    Recurrent episodes of binge-eating without the use of inappropriate compensatory mechanisms found with bulimia nervosa.

    Avoidant/Restrictive Food Intake Disorder

    Formally feeding disorder of infancy or early childhood with expanded criteria and not limited to children (can be diagnosed in adults). Criteria includes a lack of interest/avoidance of food based on sensory characteristics or aversion to consequences with failure to meet nutritional and energy needs.

    Criteria includes one or more of following:

    • Significant weight loss or fail to achieve expected weight/growth
    • Significant nutritional deficiency
    • A dependence on enteral feeding or oral supplements
    • A marked interference with psychosocial functioning.

    Rumination Disorder

    Repeated regurgitation of food over a period of at least 1 month. Does not occur exclusively with an eating disorder.

    Night Eating Syndrome

    Recurrent episodes of night awakenings from sleep with compulsive eating, often with no recollection of the event the next day.


    Pica is the persistent eating of nonnutritive substances at an age where the behavior may be considered inappropriate. Individuals with pica have been reported to mouth and/or ingest a wide variety of nonfood substances, including, but not limited to, clay, dirt, sand, stones, pebbles, hair, feces, lead, laundry starch, vinyl gloves, plastic, pencil erasers, ice,foam rubber, fingernails, paper, paint chips, coal, chalk, wood, plaster, light bulbs, needles, string, cigarette butts, wire, and burnt matches.

    In response to COVID-19 Please Note: Dr. DeSarbo and the ED-180 staff will be working remotely through the use of telemedicine until it is safe for patients and staff. While you may leave a message on the office phone, we prefer it if you can communicate through our office email DeSarbo312@gmail.com for appointments, refills, and other messages. Thank you and please be safe.