MHM Magazine

Issue 2 | 2022 | MENTAL HEALTH MATTERS | 19 MHM was found to be independently associated with the highest mortality rates of all psychiatric disorders. The main types of ED’s include Anorexia Nervosa (AN), Bulimia Nervosa (BN), Eating disorder not otherwise specified (EDNOS) & Binge Eating Disorder (BED). There are also other Feeding and eating conditions that have been noted in the Diagnostic and Statistical Manual – V (DSM-V). Certain criteria have to be met before a formal diagnosis is made. Each diagnosis will show limitation to two areas of life (e.g. social, occupational, personal). • AN – Shows evidence of a restriction of energy intake that leads to significant weight loss as well as the intense fear of gaining weight or becoming fat. The individual will also have a distorted body image. There are two types of AN (Restricting and Binge eating/ purging subtype). Restricting type is the restriction of calorie intake without binge eating or purging behaviour in the last three months. Binge eating/purging type notes that the person has engaged in recurrent episodes of binge eating or purging behaviour (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas) in the last three months • BN - The recurrent episodes of binge eating coupled with inappropriate compensatory behaviour (e.g. self- induced vomiting; misuse of laxatives, diuretics, or other medications, fasting; or excessive exercise). The episode is described by eating a significantly large amount of food within a discreet period of time (e.g. two hours). This should not be mistaken as overeating. During this episode the person will feel a sense of lack of control over eating. • Binge eating disorder (BED) - This is a relatively new diagnosis which also notes recurrent episodes of binge eating as per BN but it does not have the compensatory behavior. The DSM-V has now made provision for other Feeding and Eating Conditions Not Elsewhere Classified . These are summarized as follows: Atypical Anorexia Nervosa • All of the criteria for Anorexia Nervosa are met, except that, despite significant weight loss, the individual’s weight is within or above the normal range. Subthreshold Bulimia Nervosa (low frequency or limited duration) • All of the criteria for Bulimia Nervosa are met, except that the binge eating and inappropriate compensatory behaviours occur, on average, less than once a week and/ or for less than for three months. • Subthreshold Binge Eating Disorder (low frequency or limited duration) • All of the criteria for Binge Eating Disorder are met, except that the binge eating occurs, on average, less than once a week and/or for less than for 3 months. Purging Disorder • Recurrent purging behaviour to influence weight or shape, such as self- induced vomiting, misuse of laxatives, diuretics, or other medications, in the absence of binge eating. Self-evaluation is unduly influenced by body shape or weight or there is an intense fear of gaining weight or becoming fat. Night Eating Syndrome • Recurrent episodes of night eating, as manifested by eating after awakening from sleep or excessive food consumption after the evening meal. There is awareness and recall of the eating. The night eating is not better accounted for by external influences such as changes in the individual’s sleep/wake cycle or by local social norms. The night eating is associated with significant distress and/or impairment in functioning. The disordered pattern of eating is not better accounted for by Binge Eating Disorder, another psychiatric disorder, substance abuse or dependence, a general medical disorder, or an effect of medication.