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WHAT WE NEED TO KNOW:Diagnostic Criteria:Anorexia (restricting/binge-purging) A. Lowered Weight through methods of food restriction, purging, hyper-exercisingB. Fear and prevention of weight gain (significant weight loss does not decrease the fear)C. Body Image distortion, importance of weight or shape, lack of recognition of low weight. RESTRICTING TYPE (in a time span of 3 months)•Weight loss mostly due to food restriction (dieting, fasting, hyper-exercise)•No regular binge eating or purging behavior•No self-induced vomiting, misuse of laxatives, diuretics, or enemasBINGE-EATING/PURGING TYPE•Regular binge-eating or purging behavior•Purging (if someone is not eating much and then they are purging, this is anorexia with purging behaviors and it is one of the most serious forms of anorexia)•Hyper exercise, laxativesPrevalence: •More in adolescents than general female populationo1-2% of adolescent/ young adult femaleso0.3-0.5% female pop (whereas it is 1~4% bulimia)oStarts early (12-13 or 16-17)oMortality rate 4-5%•Anorexia: The least out of all the Eating Disorders•Anorexia: Female to male (10:1)Changes from DSM-4 to DSM-5•Category change: feeding and eating disorders•Anorexiao“Refusal” removedo85% if body weight removedoAmenorrhea removed Bulimia (purging/non-purging) A1. Binge Eating Episode •Eating more food than most would in a similar situation within a 2-hour period•Food amount matters more than food type•Usually foods that are avoided: high calorie, sweet, carbs•Start at one place and continue in another (start at restaurant, continue at home)•Binging occurs in secret because ashamedA2. Loss of control over eating •Feel like they cannot stop, feels driven to continue eating•May or may not be planned•Fast-paced eatingB. Inappropriate Compensatory Behavior
•Self-induced vomiting•Laxatives•Diuretics •PURGING TAKES AWAY THE GUILT OF THE BINGE THAT JUST OCCURRED AND THE FEAR OF WEIGHT GAIN C. Binging and Inappropriate Compensatory Behaviors•2x per week for 3 monthsD. Self Evaluation is unduly influenced by body shape and weight (like in anorexia)•Wants to lose weight/fear of weight gain•Think they are fat E. Binging and Purging is not happening in the Context of Anorexia (if the person meets criteria for Anorexia and Bulimia, Anorexia should be the diagnosis because this is the more serious diagnosis because there is a higher level of mortality)Prevalence•Women: 1-4%•Men: .1-.3% •Usually develops in late adolescence/early adulthoodoSlightly older onset than people with AN •30% of people with bulimia have had a history of ANBinge Eating Disorder A: Binge Eating Episodes•Large amount of food in short periods of time•Loss of control: feeling unable to stop eating B: Episodes include at least 3 of these•Eating faster, feeling uncomfortably full, eating when not hungry, eating alone due to embarrassment•Feeling disgusted, depressed, or guilty about binging