eating disorders

Pica

Diagnostic Criteria

  • A: Persistent consumption of nonnutritive, nonfood substances for at least one month.

  • B: Behavior is inappropriate for the individual's developmental level.

  • C: Behavior is not culturally supported or socially normative.

  • D: Severity warrants clinical attention if occurring in the context of another mental disorder or medical condition.

  • Common nonfood items consumed include paper, cloth, chalk, and soil.

  • Associated Features: Nutritional deficiencies might occur, but not always noted. Complications include gastrointestinal issues and poisoning.

  • Prevalence: Unclear, but more common in those with intellectual disabilities.

Rumination Disorder

Diagnostic Criteria

  • A: Repeated regurgitation of food for at least one month with no nausea or disgust.

  • B: Not attributed to a medical condition.

  • C: Does not occur solely during other eating disorders.

  • D: If related to another disorder, must be severe enough to need clinical attention

  • Common in infants, may lead to malnutrition and complications.

  • Development & Course: Can develop at any age, often remits in infants but could lead to severe health issues.

Avoidant/Restrictive Food Intake Disorder (ARFID)

Diagnostic Criteria

  • A: Significant failure to meet nutritional needs leading to:

    • Weight loss or failure to gain weight

    • Nutritional deficiencies

    • Dependence on feeding supplements

    • Social interference

  • B: Not due to lack of available food.

  • C: Not exclusively during other eating disorders.

  • D: No significant medical conditions account for behavior.

  • Associated with sensory aversions that affect food intake, often presenting in childhood.

  • Development: Can manifest in childhood and persist, leading to developmental issues.

Anorexia Nervosa

Diagnostic Criteria

  • A: Restriction of energy intake leading to significantly low weight.

  • B: Intense fear of weight gain.

  • C: Disturbance in body image.

Subtypes

  • Restricting: No binge-eating or purging behaviors in the past three months.

  • Binge-eating/Purging: Includes compulsive behaviors to lose weight.

Features & Consequences

  • Can lead to severe health issues and is marked by physical and psychological impairments.

  • Course: Often begins in adolescence; may have variable outcomes; hospitalization may be required.

Prevalence

  • More common in females, with a lifetime prevalence estimated between 0.9% and 2% for women and 0.3% for men.

Differential Diagnosis

  • Consider other eating disorders (Bulimia Nervosa, Binge-Eating Disorder), as well as body dysmorphic disorder, and depressive disorders.

Bulimia Nervosa

Diagnostic Criteria

  • A: Recurrent binge-eating episodes.

  • B: Inappropriate compensatory behaviors.

  • C: Occurs at least once a week for three months.

  • D: Self-evaluation overly influenced by body shape and weight.

Features

  • Binge eating often occurs in secret, leading to feelings of shame.

  • Comorbid mental disorders are common, and mortality rates are high.

Prevalence

  • More prevalent in females, with an estimated lifetime prevalence ranging from 1% to 3% among women and about 0.1% in men.

Differential Diagnosis

  • Must differentiate from Anorexia Nervosa, Binge-Eating Disorder, and other mood and anxiety disorders.

Binge-Eating Disorder

Diagnostic Criteria

  • A: Recurrent binge-eating episodes without compensatory behaviors at least once a week for three months.

  • B: Associated with marked distress regarding binge eating.

Features

  • Distinct from obesity, often associated with significant psychological distress and lower overall quality of life.

Prevalence

  • Prevalence rates suggest that about 2% to 3% of the general population may experience binge-eating disorder, being equally common in males and females.

Differential Diagnosis

  • Differentiation is needed from Bulimia Nervosa and Anorexia Nervosa, as well as other mental health concerns like depression, anxiety disorders, and emotional eating.

Other Specified Feeding or Eating Disorder

  • Specific presentations that cause distress or impairment but do not meet full criteria for other disorders.

    • Examples include atypical anorexia nervosa or night eating syndrome.

Unspecified Feeding or Eating Disorder

  • Used when there is insufficient information for a more specific diagnosis, especially in emergency settings.