B. Eating Disorders

Severity of anorexia is determined by BMI (Body Mass Index). For adults, it's the current BMI; for children, it's BMI percentile. Severity can be increased if clinical symptoms or functional disability is present.

Anorexia Nervosa can be categorized by subtypes. The main subtype relates to binge eating (and subsequent purging). A subtype includes purging without significant binge eating.

Persistent reduction in food intake.

Intense fear of gaining weight or becoming fat or behavior that interferes with weight gain.

Disturbance in self-perceived weight or shape.

A measure of body fat based on weight and height.

BMI of 17kg/m2 or more.

BMI of 18.5 kg/m2 or more is considered normal body weight for adults. Lower than this is considered underweight.

Clinician inference from history, observations, physical/lab findings, or longitudinal course (fear of weight gain/preventing it) supports the diagnosis.

Distorted body image, individuals may feel overweight despite being thin or may focus on specific body areas as "too fat."

Frequent weighing, measuring body parts, and excessive mirror use are common in individuals with anorexia nervosa.

Strongly related to perceived body shape and weight, weight loss is viewed positively while weight gain is negative.

Not recognizing the severity of their malnourished state, despite possible thinness.

Obtaining information from family or others is crucial to accurately assess weight loss history and illness features.

Semistarvation can cause serious medical conditions, affecting organ systems and producing various disturbances, often seen alongside purging behaviors.

Individuals are often prompted to seek help due to distress over physical and mental health consequences of starvation, rather than the weight loss itself.

Anorexia Nervosa is more common in developed countries with higher incomes like the US, Europe, Australia, and Japan. It's also increasing in some developing countries.

Anorexia Nervosa affects mostly women and usually starts in adolescence or early adulthood. It's less prevalent in people of color compared to non-Latinx White individuals.

The progress of anorexia nervosa can vary a lot. Some individuals recover fully after a single episode, while others may experience a fluctuating pattern of weight gain and relapse or a chronic course.

The onset of anorexia nervosa is often associated with stressful life events, such as leaving home for college or major life changes.

Individuals experiencing anorexia nervosa often present with a strong fear of gaining weight, a distorted body image, and a persistent reduction in food intake.

Some individuals with anorexia nervosa may not exhibit the typical fear of fat or have a more nuanced relationship with their weight.

People with anorexia nervosa may experience a chronic course over many years, leading to complications and potential requirement for hospitalization.

Individuals with anorexia nervosa have a higher mortality rate, approximately 5% per decade.

Methods used to counteract binge eating, like purging (vomiting, laxatives), excessive exercise, or fasting, to prevent weight gain.

Some individuals with bulimia may try to avoid weight gain by taking thyroid hormone, hoping it will increase metabolism.

Individuals with bulimia and diabetes might alter their insulin doses to reduce food metabolism after binging.

Exercise that interferes with daily life, occurs at inappropriate times or places, or continues despite injury.

Body shape and weight are extremely important to self-worth for individuals with bulimia.

Bulimia shares similarities with anorexia (fear of weight gain, dissatisfaction with body), but unlike anorexia, bulimia involves binge eating and compensatory behaviors.

Individuals with bulimia typically have a normal or overweight BMI, not typically underweight like those with anorexia.

Purging behaviors can lead to serious health problems like esophageal tears, gastric rupture, heart rhythm issues, and dependence on laxatives.

Unlike bulimia nervosa, conditions like Kleine-Levin syndrome involve disturbed eating, but NOT the excessive concern with body shape and weight that characterizes BN.

Atypical depression involves overeating, but unlike bulimia nervosa, those with this disorder lack the urge to compensate for the overeating and do not have an excessive concern with body shape and weight.

Both disorders involve binge-eating behavior, but the underlying motivation and context differ. In borderline personality disorder, it's seen as part of impulsive behavior.

No, individuals with bulimia nervosa frequently experience other mental health conditions, like depression, anxiety, and substance abuse.

Individuals with bulimia nervosa often experience depression, bipolar disorder, or anxiety. These mood issues may begin alongside or after bulimia, or even precede it.

At least 30% of those with bulimia nervosa also struggle with substance abuse, particularly alcohol or stimulants. The reason? Stimulants are sometimes used to suppress appetite.

Bulimia often coexists with personality disorders, especially borderline personality disorder. This reflects shared impulsive behaviors and emotional dysregulation.

While both involve binge eating, bulimia nervosa includes recurrent purging behaviors (vomiting, laxatives, exercise) to compensate. Binge-eating disorder lacks these compensatory behaviors.

Recurrent episodes of binge eating, characterized by eating a significantly larger amount of food than most people would in a short period, with a sense of lack of control during the episode.

A defining characteristic of binge eating is a feeling of lack of control over the amount or type of food consumed during the episode.

Besides the core features of binge eating, there are other common symptoms like eating rapidly, feeling uncomfortably full, eating when not hungry, and feeling guilty afterward.

For a diagnosis, binge eating episodes need to occur at least once a week, on average, for a period of three months.

Binge eating disorder is distinct from bulimia, as it doesn't involve the recurrent use of inappropriate compensatory behaviors like purging.