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:
- For females, all of the criteria for anorexia nervosa are met except that the individual has regular periods.
- All of the criteria for anorexia nervosa are met, however, despite significant weight loss the individual's current weight is in the normal range.
- 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.
- The regular use of inappropriate compensatory behavior by an individual of normal body weight after eating small amounts of food
- 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:
- 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%
- The lifetime prevalence for women is between 1-3%
- The lifetime prevalence for men is between 0.1-0.3%
- 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:
- 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
- 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
- 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