|The Diagnostic and Statistical Manual of Mental Disorders: Fourth Version, otherwise known
as DSM-IV was released in 1994 (the revised Text Version, or DSM-IV-TR was published in 2000), is the standard used by most medical professionals when diagnosing an eating disorder. Each diagnosis is given a
diagnosis code (for example, anorexia nervosa is 301.7), and it is this code that is used when making insurance claims in the United States.
It should be noted that each diagnosis may not be all encompassing and you should always consult a doctor for any medical questions you might have.
Diagnostic criteria for 301.7 Anorexia Nervosa
A. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
B. Intense fear of gaining weight or becoming fat, even though underweight.
C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
D. In postmenarcheal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles. (A woman is considered to have amenorrhea if her periods occur only following hormone, e.g., estrogen, administration.)
- Restricting Type: during the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)
- Binge-Eating/Purging Type: during the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)
Diagnostic criteria for 307.51 Bulimia Nervosa
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
- 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
- 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)
||B. 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.
C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months.
D. Self-evaluation is unduly influenced by body shape and weight.
E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.
- Purging Type: during the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas
- Nonpurging Type: during the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas
Diagnostic criteria for 307.50 Eating Disorder Not Otherwise Specified (E.D.N.O.S.)
The Eating Disorder Not Otherwise Specified category is for disorders of eating that do not meet the criteria for any specific eating disorder (this currently includes binge-eating disorder and compulsive overeating). Examples include:
- For females, all of the criteria for Anorexia Nervosa are met except that the individual has regular menses.
- All of the criteria for Anorexia Nervosa are met except that, despite significant weight loss, the individual’s current weight is in the normal range.
- All of the criteria for Bulimia Nervosa are met except that the binge Eating and inappropriate compensatory mechanisms occur at a frequency of less than twice a week or for a duration of less than 3 months.
- The regular use of inappropriate compensatory behavior by an individual normal body weight after eating small amounts of food (e.g. self-induced vomiting after the consumption of two cookies).
- Repeatedly chewing and spitting out, but not swallowing, large amounts of food.
- Binge-eating disorder: recurrent episodes of binge eating in the absence of the regular use of inappropriate compensatory behaviors characteristic of Bulimia Nervosa (see p. 729 for suggested research criteria).
E.D.N.O.S. and other types