Binge Eating Gains Diagnostic Status, Other Disorders Remain NOS

The new psychiatric diagnostic manual, the DSM-5 (scheduled to be in effect later this spring), includes specific criteria for binge eating disorder (BED). Before this change, binge eating was diagnosed under eating disorder not otherwise specified, or eating disorder NOS.

In the current diagnostic manual, the DSM-4, anorexia and bulimia are listed as specific diagnosable illnesses. A diagnosis is given if a patient meets specific symptom criteria or patterns. Other problems with food and eating, those that do not fit the criteria for anorexia or bulimia, are diagnosed as eating disorder NOS (not otherwise specified) should symptoms disrupt an individual’s normal functioning.

BED Criteria for Diagnosis

In the DSM-5, binge eating disorder has its own list of symptom criteria and can be given as an official, stand alone diagnosis.

According to The American Psychiatric Association, criteria include frequent overeating – at least once per week for three months, the lack of a sense of control, distressed feelings, plus three or more of the following:

• eating fast, more rapidly than normal
• eating until feeling stuffed or uncomfortable
• eating large quantities although not feeling hungry
• eating alone owed to embarrassment about the amount being eaten
• feeling shame, disgust, guilt, or depressed after eating

NOS Eating Disorders

Not all eating disorders with names are considered specific diagnosable illnesses and will continue to be categorized under the umbrella of NOS, or not otherwise specified. This does not mean the problems are less real. They are still worthy of attention and treatment.

Some professionals think one or more of these issues belong in the diagnostic category of obsessive-compulsive disorders, instead of eating disorders.

Orthorexia

Orthorexia is an obsession with eating unprocessed, high quality foods. People with this disorder become so fixated on what they allow themselves to eat, it disrupts their ability to concentrate and otherwise function. The problem often begins as a good intention to eat a nutritious, natural, frequently organic diet. Somehow, the good intentions turn into obsessive eating restrictions that are unhealthy.

Anorexia Athletica

We all know exercise is good for us, but those with anorexia athletica are compulsive about exercising and use it to burn-off or purge themselves of calories. They typically have a rigorous, sometimes regimented exercise routine that they feel compelled to follow, even when it interferes with employment or relationships. Skipping the exercise leaves them plagued with guilt. Many people with anorexia athletica put themselves at risk for cardiac problems, possibly fatal, and often suffer from depression.

Pregorexia

When a woman is pregnant and avoids gaining any weight she is said to have pregorexia. Usually, women with this disorder resort to intense exercise and extreme dieting to remain thin while carrying a child. The risks to mother and the baby include anemia, hypertension, depression, malnourishment, miscarriage, and birth defects.

Drunkorexia

This disorder is most common, but not limited to, college aged women. They severely limit the intake of nutritious food either to drink alcoholic beverages without gaining weight, or to become drunk more quickly, or both. Aside from the usual health problems associated with malnutrition and excessive drinking, those with drunkorexia are at risk for alcohol poisoning and the unwanted consequences of impulsive sexual behavior.