Anorexia Nervosa
Anorexia nervosa, also referred to as anorexia, is a complex eating disorder that affects millions of people each year in the United States and around the world. Anorexia is characterized by a preoccupation with body weight or shape and limiting food intake, resulting in unhealthy weight loss. It may also be accompanied by other behaviors such as throwing up or vomiting after meals, the use of substances like diet pills, or intense exercising. Though it often develops during teenage years or adolescence, anorexia does not discriminate between age, gender, race or class.
Bulimia Nervosa
Bulimia nervosa, also referred to as bulimia, is a serious eating disorder that has potentially fatal medical and psychological consequences. It is characterized by repeated instances of eating significantly more food than what most people would eat in a short period of time, followed by one or more behaviors to attempt to compensate for the food eaten. These behaviors, also known as purging or compensatory behaviors, might include throwing up or vomiting, intense exercising, or the use of substances like diet pills or laxatives. Bulimia is associated with significant impairment in the individual's life and occurs, on average, once per week for at least three months.
Binge Eating Disorder
Binge eating disorder (BED) is the most common eating disorder in the United States, affecting an estimated 3.5% of women, 2% of men, and 1.6% of adolescents. It is characterized by recurring instances of binge eating, which can be described as eating large amounts of food in a short period of time accompanied by a loss of control. The binge eating occurs, on average, at least once per week for at least three months. Unlike anorexia and bulimia, people suffering with BED do not engage in purging or compensatory behaviors, such as throwing up or exercising intensely to counter the food eaten.
Orthorexia Nervosa
While Orthorexia is not officially recognized in the DSM-5, providers are seeing this more frequently in their practices and eating disorder treatment centers. Because it is potentially a precursor to developing a full-blown eating disorder, it is vital that therapists and dietitians know how to identify orthorexia. Orthorexia is a proposed distinct eating disorder characterized by extreme or excessive preoccupation with eating healthy food. The orthorexic client obsesses about healthy eating instead of obsessing about losing weight and being thin.
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OSFED
Eating Disorder Not Otherwise Specified (EDNOS) was a diagnosis in The Diagnostic & Statistical Manual (DSM-IV), the old version of the DSM. This eating disorder encompassed all other eating disorders and abnormal eating patterns that did not meet the strict criteria for anorexia nervosa, bulimia nervosa, binge eating disorder or avoidant-restrictive food intake disorder (ARFID). EDNOS was changed to Other Specified Feeding and Eating Disorder (OSFED) which is now included in the current version of the DSM, known as The Diagnostic & Statistical Manual (DSM-V).
Avoidant Restrictive Food Intake Disorder (ARFID)
Avoidant restrictive food intake disorder, or ARFID, is a new diagnosis added to the DSM -5 in the category of eating or feeding disturbance. ARFID is characterized by an apparent lack of interest in eating or food, avoidance based on the characteristics of food, concern about aversive consequences of eating, as manifested by persistent failure to meet appropriate nutritional and or energy needs. There is often significant weight loss or failure to achieve expected weight gain, significant nutritional deficiency, dependence on enteral feeding or oral nutrition supplements, and marked psychosocial functioning.
Trauma
Traumatic lifetime experiences like death, illness, loss, abandonment or perception of abandonment, bullying, and forms of abuse significantly impact the psyche and physiological state of the individual. Trauma is also a subjective experience and individuals with a sensitive temperament are likely to have the experience of trauma from experiences that others may not perceive as traumatic. Exposure to prolonged states of stress caused by trauma can impact functioning and health and immunity, as well as lead to the development of an eating disorder and co-occurring disorders like depression and substance abuse.
Depression
Depression is the leading cause of disability in the United States for individuals 15-44 years of age. Lost wages, medications, psychotherapy treatment, suicide treatment, co-occurring mental health disorders and associated medical diseases all contribute to this disability cost. Major depressive disorder is characterized by a sad mood, inability to concentrate, loss of interest and other symptoms that affect how an individual thinks and feels. This disorder can result in stress at home, poor workplace performance, and turmoil in relationships.
Anxiety
Anxiety disorders consist of generalized anxiety disorder, social anxiety disorder, specific phobias, panic disorder and agoraphobia and are characterized by an intense state of worry and fear resulting from a threatening event or life stressor. Anxiety can be normal in cases of everyday stress or serious life stressors and individuals usually overcome this worry once the stressor dissipates however in individuals with anxiety disorder, their state of worry becomes more intensified over time.
Reactive Attachment Disorder
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5) symptoms of Reactive Attachment Disorder (RAD) must be evident before five years of age and the child must have a developmental age of at least nine months. The child often shows consistent emotionally withdrawn behavior towards caregivers; specifically he/she minimally responds or seeks comfort when he/she is emotionally distressed. The second criterion includes a limited positive affect, episodes of unexplained irritability, sadness or emotional turmoil during nonthreatening interactions with caregivers and minimal social or emotional responsiveness to others. The third criterion is characterized by a pattern of insufficient care such as neglect, physical or sexual abuse, or repeated changes between primary caregivers.
Self Harm or Self-Injury
Self-injury is the purposeful action of inducing physical harm to oneself and is a very severe sign of emotional distress. According to the Statistical and Diagnostic Manual of Mental Disorders, Fifth Edition (DSM-5), self-harm is formally known as nonsuicidal self-injury disorder (NSSID) as these self-destructive behaviors are performed without any intention of suicide. Adolescents are at the highest risk for self-harm injury as many studies state that roughly 15% of teenagers and 17-35% of college students have inflicted self-harmful behaviors on themselves. This disorder is increasing among the young population and can have severe consequences if not treated appropriately. Cutting, burning, skin carving, biting, poisoning, purposeful interference with wound healing, extreme skin picking and hair pulling are all examples of self-injury or self-harm.
Bipolar Disorder
Bipolar affective disorder or manic-depressive illness is a mood disorder characterized by periods of profound depression that alternate with periods of excessive elation and irritable mood known as mania. Individuals will suffer from extreme mood swings that interfere with personal relationships, occupational function, and daily activities. It is common for bipolar disorder to be apart of a co-occurring disorder, which refers to mental health illnesses that co-occur with substance abuse disorders such as opioid, alcohol or cocaine abuse. Bipolar disorder can often co-occur with anxiety disorders such as generalized anxiety disorder and panic disorder and when these disorders co-occur, there is a higher likelihood of substance abuse and suicide attempts. Bipolar disorder can be characterized into three types: bipolar disorder type I (BPI), bipolar disorder type II (BPII) and cyclothymia and differences depend on the frequency, duration and severity of the alternating symptoms.
