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Definition
Characterized by restriction of energy intake leading to significantly low body weight, an intense fear of gaining weight, and a distorted body image.
Core Features:
Refusal to maintain minimally normal weight
Fear of becoming fat despite being underweight
Disturbance in how one’s body weight or shape is experienced
DSM-5-TR Subtypes:
Restricting Type – Weight loss through dieting, fasting, and/or excessive exercise.
Binge-Eating/Purging Type – Recurrent bingeing or purging behavior (vomiting, laxatives) while underweight.
Medical Consequences:
Amenorrhea (loss of menstruation)
Dry skin, brittle hair and nails
Lanugo (fine body hair growth)
Sensitivity to cold
Cardiovascular problems (low blood pressure, heart failure)
Electrolyte imbalance
Death rate: ~5–10%, often due to heart failure or suicide
Associated Psychological Features:
Rigid thinking and control needs
Distorted self-evaluation (“I’m still fat”)
Comorbid depression, OCD-like rituals, and anxiety
Course and Onset:
Onset: Early to mid-teens (average 15–18 years)
Chronic if untreated; high relapse rate
One of the deadliest psychiatric disorders
Prevalence:
Lifetime prevalence: ~0.6% females, 0.1% males