Thursday, December 5, 2013

New ways to diagnose eating disorders

The Diagnostic and Statistical Manual of Mental Disorders is the standard classification of mental health used by medical professionals in the United States.  The most current edition DSM-V was published in 2013.  The edition previous to this one, the DSM-IV-TR was published in 2000.

The current edition describes the latest diagnostic criteria for many disorders, including eating disorders.
Initially, in the DSM-IV-TR, binge eating was identified as an area for concern.  The disorder was relatively new and the criteria was undefined.  Now, the newest DSM-V has included binge-eating as a fully recognized disorder.

This should provide increased support for people struggling with binge-eating, in the support of coverage and treatment options as well.  This could also open up new dialogue in the treatment and support for obese individuals.

Beyond the addition of binge-eating, the DSM-V made two influential changes to the way anorexia nervosa is diagnosed.

Previously, the standards were not all-inclusive for people who were clearly suffering, but hadn’t yet
lost enough weight to be officially diagnosed.  Now, in order for a person to qualify for a diagnosis of anorexia nervosa, rather than using a percentage of their ideal body weight, they have to have reached a “significantly low weight”.  This allows treatment professionals to specify the severity of the disorder in relation to BMI, versus height-weight charts, which do not address lean muscle mass to fat ratio.

In the diagnosis of anorexia nervosa, amenorrhea (the absence of a menstrual cycle) is no longer listed as a criterion for females.  Studies found few psychological differences between those with anorexia who do and do not menstruate.  Instead, it’s now described as a frequently occurring symptom.

In regards to the diagnosis of bulimia, patients must demonstrate binge eating and compensatory behaviors at least once per week for at least three months, whereas the DSM-IV-TR required at least twice per week.

The newest edition of DSM-V also stipulates that any type of compensatory behavior is a detriment to a patient’s health. Rather than separating the behaviors into subcategories, treatment professionals must recognize that many sufferers engage in a variety of compensatory behaviors.

The newest edition also provides criteria to diagnose if the patient is in partial or full remission from bulimia, and/or how severe their disorder is.

The category of an “eating disorder not otherwise specified” continues to be published in the DSM-V, and refers to patients who do not fit all of the standards for a specific disorder, but still experience distress in their daily lives.

Clearly, it is difficult for every single patient to fit every single category, every single time.  For that
reason, it is important that the DSM manuals be updated frequently, in order to best reflect the research and findings that can help patients improve their quality of life.


American Psychiatric Association (2013). Feeding and Eating Disorders.  Retrieved Dec 4, 2013 from

Eating Disorders Victoria. (2013).  Diagnostic and Statistical Manual of Mental Disorders.  Retrieved Dec 4, 2013 from

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