Eating disorders diagnoses

The way that I understand the current classification of eating disorders is that the disorders are divided by their most common eating disorder behaviour into anorexia, bulimia and Eating Disorder Not Otherwise Specified (EDNOS). Furthermore, this is the assumed most common eating disorder behaviour and individuals vary in what behaviours they use. The main recognised eating disorder behaviours are:

  • restriction: reducing food intake which can range in severity from small decreases to fasting
  • binging: eating in a discrete period of time (e.g. two hours) an amount of food that is definitely larger than most individuals would eat under similar circumstances (this is straight out of the DSM-IV)
  • purging: self-induced vomiting, laxatives, diuretics, excessive/compulsive exercise, restriction or starvation (and possibly other behaviours) that is aimed at ‘compensating’  or cancelling out calorie intake

It’s very important to realise that there are several other common eating disorder behaviours such as compulsive exercise (not only used as method of purging), orthorexia, chewing and spitting and pica but these aren’t specified in the current diagnostic criteria. Also, binge eating disorder isn’t yet officially included in DSM-IV or ICD-10 and is still technically a research tool. However, it does look likely that it will be included as a separate disorder in its own right rather than being bundled in with EDNOS which is the current situation.

The DSM-IV (published by the American Psychiatric Association) and the ICD-10 (published by the World Health Organisation) are not the only way that eating disorders could have been classified. By definition, diagnoses must include only the core and specific aspects of the disorder but there are many behaviours that are excluded. This is a problem for the people experiencing this behaviours as it may not be recognised that they have a genuine disorder and that treatment is available. The same issue is also a problem for the healthcare workers trying to diagnose them.

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