One suggestion has been to change the criteria for eating disorders so more people will be included in the recognized disorders. The suggestions for anorexia are to change the weight criteria to body mass index and open the psychopathology of anorexics to those without body image distortions. The suggestion for bulimia nervosa is to lower the minimum binge/purge cycle from twice a week to once a week. These changes would not affect the overall diagnoses because these patients still have the same psychological and physical health issues as the patients diagnosed with the original criteria (Grave, 2007). Another suggestion that has been made is to remove amenorrhea from the diagnostic criterion for anorexia nervosa. This would mean prepubescent girls, and young women who have not lost their menstrual cycle would still meet the criteria from anorexia nervosa. Based on the studies there have been no significant differences in patients who have and have not lost their menstrual cycle (Attie, 2009). The small changes suggested here would help eliminate many, if not all, of the patients being diagnosed .
Eating disorders such as; anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified have the highest mortality rate of any mental illness. Although many people, especially men, do not seek help, researchers estimate 8 million Americans suffer from an eating disorder, an outstanding 7 million women and 1 million men. One in 200 American women suffers from anorexia and, 2 or 3 in every 100 American women suffer from bulimia. Of the 8 million people who suffer from eating disorders 50% of them have been diagnosed with EDNOS and according to recent studies EDNOS has the highest mortality rate of the three diagnoses. EDNOS has been found to be unpredictable when it comes to recovery. Because the issues patients are dealing with that causes EDNOS, patients do not receive the same considerations as people suffering from Anorexia or Bulimia (Hogan, 2004).
What reoccurring criteria in EDNOS patients could help to break the group up into smaller, more specific diagnoses? <br />
Anorexia Nervosa<br />The patient refuses to maintain a body weight normal for age and height<br />Intense fear of becoming fat, even though underweight<br />A distorted self-image that results in diminished self-confidence<br />Denial of the seriousness of emaciation and starvation<br />The loss of menstrual function for at least 3 months<br />
Bulimia Nervosa<br />•“Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: <br />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 <br />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) <br />• 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. <br />• The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months. <br />• Self-evaluation is unduly influenced by body shape and weight. <br />• The disturbance does not occur exclusively during episodes of Anorexia Nervosa (Ben-Tomvin, 2001)“<br />
What is Eating Disorder Not Otherwise Specified?<br />many people do not fit all the criteria for a specific eating disorder, or they tend to have symptoms from both disorders. <br />When this happens the person is diagnosed with EDNOS, or eating disorder not otherwise specified. <br /> It has been found that 50%-70% of patients being treated for an eating disorder, are suffering from an eating disorder not otherwise specified (Knoll, 2011).<br />
References:<br />Attia, E., & Roberto, C. A. (2009). Should amenorrhea be a diagnostic criterion for anorexia nervosa?. International Journal of Eating Disorders, 42(7), 581-589. doi:10.1002/eat.20720<br />Ben-Tomvin, D. (2001). Outcome in patients with eating disorders: a 5-year study. Medical Sciences, 357(9264), Retrieved from http://search.proquest.com/docview/199024931?accountid=34899<br />Fairburn, C. (2003). Eating disorders. Medical Sciences, 361(9355), Retrieved from http://search.proquest.com/docview/199093684?accountid=34899<br />Grave, R., & Calugi, S. (2007). Eating disorder not otherwise specified in an inpatient unit: the impact of altering the DSM-IV criteria for anorexia and bulimia nervosa. European Eating Disorders Review, 15(5), 340-349. doi:10.1002/erv.805<br />
Hogan, E. (2004). An overview of anorexia nervosa, bulimia nervosa, and binge eating disorders: implications for rehabilitation professionals. Journal of Applied Rehabilitation Counseling, 34(4), Retrieved from http://search.proquest.com/docview/216481605?accountid=34899<br />Knoll, S. (2011). Do the currently proposed dsm-5 criteria for anorexia nervosa adequately consider developmental aspects in children and adolescents?. European Child & Adolescent Psychiatry, 20(2), Retrieved from http://search.proquest.com/docview/858290589?accountid=34899<br />Loa, C. (2011). Validating the eating disorder inventory-3 (edi-3): a comparison between 561 female eating disorders patients and 878 females from the general population. Journal of Psychopathology and Behavioral Assessment, 33(1), Retrieved from<br />Thomas, J. (2010). How do eating disorder specialist clinicians apply dsm-iv diagnostic criteria in routine clinical practice? implications for enhancing clinical utility in dsm-5. Psychiatry Research, 178(3), Retrieved from http://search.proquest.com/docview/754059583?accountid=34899<br />