Eating Disorder Not Otherwise Specified

Detailed Diagnostic Criteria

Detailed diagnostic criteria are taken from the Diagnostic Statistical Manual, 4th edn. (DSM-IV).

Includes disorders of eating that do not meet the criteria for any specific eating disorder. Examples include:

  1. For females, all of the criteria for anorexia nervosa are met except that the individual has regular periods.
  2. All of the criteria for anorexia nervosa are met, however, despite significant weight loss the individual's current weight is in the normal range.
  3. All of the criteria for bulimia nervosa are met except that the binge eating and inappropriate compensatory mechanisms occur less than 2 times a week or for less than 3 months.
  4. The regular use of inappropriate compensatory behavior by an individual of normal body weight after eating small amounts of food
  5. Repeatedly chewing and spitting out, but not swallowing, large amounts of food.

Prevalence of Eating Disorders

 According to Keel (2005) and Wilson, Grilo & Vitousek (2007), the prevalence of eating disorders is as follows:

Anorexia

  • The female-to-male ratio is 10:1
  • The percentage of women who have had anorexia at some point in their lifetime (lifetime prevalence) is 0.5%

Bulimia

  • The lifetime prevalence for women is between 1-3%
  • The lifetime prevalence for men is between 0.1-0.3%

Binge-Eating Disorder

  • 3 % of adults
  • Higher in obese persons

Typical Course of Eating Disorders 

Keel (2005), Steinhausen (2002) and Wilson, Grilo & Vitousek (2007) describe the typical onset and course of eating disorders:

Anorexia

  • Onset: usually early to late adolescence
  • Approximately 50% recover (an absence of all clinical symptoms)
  • 33% improve but remain symptomatic
  • 20% the illness becomes chronic and remitting
  • 5% of those diagnosed eventually die – this is the highest mortality of any psychiatric disorder.
    • The leading cause of death is medical complications.
    • The second most common cause is suicide.
  • 51% of patients hospitalized eventually require a second hospitalization
  • 10-50% of individuals with anorexia cross over to bulimia 

Bulimia

  • Onset: late adolescence to early adulthood
  • 50% of individuals recover and maintain recovery
  • 30% improve but remain symptomatic
  • 20% of individuals continue to meet full criteria for bulimia
  • The rate of relapse is 30%
  • Cross-over rates to either anorexia or binge-eating are very low, because those with bulimia are more likely to continue to suffer from bulimia 

Binge-Eating Disorder

  • Onset: usually either childhood or late adolescence/early adulthood
  • Individuals who seek treatment are typically older than anorexia or bulimia patients
  • Individuals tend to be significantly overweight and obese