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AN subtypes:

Restricting type

Binge-eating/purging type

• Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.
• Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
• Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.

• Recurrent episodes of binge eating that are characterized by both of the following:

  • Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances
  • A sense of lack of control overeating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
• Recurrent inappropriate compensatory behaviors to prevent weight gain (e.g., self-induced vomiting; misuse of laxative, diuretics, or other medications; fasting; or excessive exercise)
• Self-evaluation is unduly influenced by body shape and weight

• Recurrent episodes of binge eating (as defined above)
• Binge eating is associated with:

  • Eating more rapidly than usual
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when not feeling physically hungry
  • Eating alone because of feeling embarrassed by how much one is eating
  • Feeling disgusted with oneself, depressed, or very guilty afterward
• Marked distress about the binge-eating episodes

• An eating or feeding disturbance that causes clinically significant distress or impairment but does not meet the full criteria for any of the disorders in this diagnostic class. This might include (but is not limited to):

  • Atypical AN
  • BN or BED of low frequency or limited duration
  • Purging disorder
  • Night eating syndrome

• An eating or feeding disturbance (e.g., apparent lack of interest in eating or food, avoidance based on sensory characteristics of food, concern about aversive consequences of eating) associated with one or more of the following:

  • Significant weight loss or failure to achieve expected weight gain or faltering growth in children
  • Significant nutritional deficiency
  • Dependent on enteral feeding or oral nutritional supplements
  • Marked interference with psychosocial functioning