Eating Disorders

A Case Against Eating Disorder Not Otherwise Specified (EDNOS)

Tetyana 7 Comments

This study is a follow up on the previous study (last entry) which examined the problems with the EDNOS classification, the frequency of transitions between eating disorders and how the DSM should be changed to reflect the clinical reality of eating disorders (and what is the clinical reality?)

In this study, Eddy and colleagues followed 246 women who were initially diagnosed with either AN or BN, for an average of 9 years. The main goal was to study the growing disparity between (1) the consensus that eating disorders are not stable overtime and how (2) the current diagnostic criteria which do not adequately address this, by following the clinical presentation of EDs overtime and providing suggestions for the upcoming DSM-V.

EDNOS is an often ignored category in research–in main part because it is difficult to study such a heterogeneous group. Nonetheless, Eddy et al. summarize some interesting findings … Continue reading →

The Instability of Eating Disorder Diagnoses

Tetyana 5 Comments

Eating disorders are rarely static. Symptoms fluctuate, waxing and waning as circumstances change. Often, these fluctuations lead to diagnostic crossover–between subtypes of one disorder or to a different eating disorder altogether. The heterogeneity of symptom severity and frequency led to the establishment of the “eating disorder not otherwise specified” diagnosis in the Diagnostic and Statistical Manual. Essentially, it is everything that doesn’t quite fit into the “anorexia nervosa” or “bulimia nervosa” categories. (For example, I would guess that it is a common diagnosis for patients who fail to meet the “amenorrhea” criterion for the AN diagnosis.)

ED-NOS is a category for everything that doesn’t conform to some rather arbitrary criteria required for bulimia nervosa and anorexia nervosa, meaning: it is the diagnosis for a lot of people. Okay, that’s not very scientific, I know, but I wouldn’t trust these numbers anyway–usually people who fall into this category don’t feel “sick … Continue reading →

The Genetics of Anorexia Nervosa

Tetyana 11 Comments

Is it the culture of thinness, obsession with dieting or just bad mothering? When it comes to determining the causes of anorexia nervosa, the answer appears to be none of the above. Increasingly, the evidence is pointing to genetics playing an important role in predisposing individuals to anorexia nervosa. Among clinicians and researchers, the notion that genetic factors are important in the development of anorexia nervosa seems uncontested. In this short review, Dr. Cynthia Bulik and colleagues summarize some of the findings in the genetics of anorexia nervosa.

Currently (DSM-IV), to be diagnosed with anorexia nervosa, a patient must show:

  • An inability to maintain normal weight (<85% of what is expected)
  • Intense fear of weight gain and/or becoming fat, though underweight
  • Obsession with body weight and shape, giving it undue importance in evaluating self-esteem/self-worth
  • Amenorrhea (missing 3 or more consecutive periods)
  • There are two AN-subtypes: restricting type (AN-R) and
… Continue reading →