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Persons with anorexia refuse to maintain a minimally normal body weight and have an intense fear of weight gain or becoming fat, even though they are underweight (DSM-IV, 1994). DSM Criteria of 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 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.
Type: Restricting Type vs. Binge-Eating/Purging Type.
DSM-IV Diagnostic Criteria for Bulimia Nervosa
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
(1) 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.
(2) 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 occur, on average, at least twice a week for three months.
D. Self-evaluation is unduly influenced by body shape and weight.
E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.
Type: Purging Type vs. Non-purging Type (exercise & fasting to compensate).
No Cost Treatment Available: Columbia Center for Eating Disorders: www.columbiacenterforeatingdisorders.org. The center is a nationally recognized treatment/research program. They conduct research studies on adolescents and adults with Bulimia Nervosa, Anorexia Nervosa, Binge Eating Disorder and Obesity in an effort to better understand these conditions and develop more effective treatments. Adolescent and adult patients who are interested and eligible in the research will receive inpatient or outpatient treatment at no cost. The eligibility criteria for research participation vary from study to study, so interested individuals should contact the center to obtain more information. They are currently conducting a large study of adolescent girls with Bulimia Nervosa (ages 12 to 18 years) and offering treatment, free of charge, and up to $400 for participation. Call the center 212-543-5739 and see the study website for more details: www.teenbulimiastudy.org.