Highlights:
- new title and organization
- avoidant/restrictive food intake disorder added
- modified Anorexia and Bulimia
- Binge-eating disorder added
- changes try to address overuse of NOS
1)Anorexia Nervosa
- low body weight replaces below 85% as expected
- dropped amenorrhea
- restriction of energy intake
- intense fear of gaining weight
- lack recognition of the seriousness of the current low body weight
a. Restricting Type
- during last 3 months, not engaged in episodes of binge eating or purging
- weight loss is accomplished through dieting, fasting, or excessive exercise
b. Binge-eating/purging type
- during last 3 months, engaged episode in binge-eating or purging behavior
2) Bulimia Nervosa
- binging behaviors now once a week for 3 months *twice a week
- dropped purging and non-purging subtypes
- recurrent episode of binge eating
- eating in a discrete period of time, amount of food is larger
- lack of control over eating
- to prevent weight gain, self induced vomiting, misuse of laxatives or other medications, fasting, or excessive exercise
- rule out: anorexia nervosa
3) Pica
- eating of nonnutritive, nonfood substances at least 1 month
- not part of culture and socially normative practice
- warrant additional clinical attention if occurs with other disorder
4) Rumination Disorder
- repeated reurgitation of food for 1 month. May be re-chewed, re-swallowed, or spit out
- rule out: gastrointestinal or other medical condition, anorexia, bulimia, binge eating, or avoidant/restrictive food intake disorder
- warrant additional clinical attention if occurs with other disorder
5) Avoidant/Restrictive Food Intake Disorder
- lack of interest in eating
- food avoidance based on sensory characteristics of food
- significant weight loss, significant nutritional deficiency
- rule out: anorexia, bulimia, other medical condition and mental disorder
- warrant additional clinical attention if occurs with other disorder
6) Binge-Eating Disorder
- recurrent episode of binge eating
- eating in a discrete period of time, amount of food is larger
- lack of control over eating
- 3 or more of the following: eating rapidly than normal, eating until uncomfortably full, large amount of food even not hungry, eating alone to avoid embarrassment, feeling guilty afterwards
- occurs once a week for 3 months
-rule out: bulimia nervosa, anorexia nervosa
7) Other Specified and Unspecified Feeding or Eating Disorder
- characteristic of feeding and eating cause significant distress
a. Atypical Anorexia Nervosa - same as anorexia nervosa except significant weight loss
b. Bulimia Nervosa - same as bulimia, but low frequency or limited duration
c. Binge-eating Disorder - same as binge eating but low frequency or limited duration
d. Purging Disorder - recurrent purging behavior to influence weight or shape, but in the absence of binge eating
e. Night Eating Syndrome - eating after awakening from sleep or excessive food consumption after the evening meal
