Mental health articles

eating disorders facts and myths Eating disorders are defi ned in the Diagnostic and Statistical Manual, fourth
edition (DSM-IV), as “severe disturbances in eating behaviors” (American
Psychiatric Association, 1994, p. 539). Anorexia nervosa (AN), bulimia nervosa
(BN), and binge eating disorder (BED) (still a proposed new diagnostic
category) are the major disorders. A residual category of eating disorder, not
otherwise specifi ed (ED-nos) describes disordered eating that does not meet
criteria for the other disorders. Th e criteria for each disorder are listed below.
However, in practice, it is becoming increasingly diffi cult to distinguish
between the groups. For example, many students present with all the symptoms
of AN, except that their weight mysteriously doesn’t drop, or their menses
continue despite very low weights. Attempting to defi ne clear categories
continues to be a struggle in the mental health community, and there may be
changes in the next DSM.
AN (restricting or binge-eating/purging type) is marked by the refusal
to maintain normal body weight (<85% of expected weight), intense fear of Th e restricting subtype is characterized by the absence of bingeing or purging,
while the binge-eating/purging subtype includes those behaviors.
BN (purging or nonpurging type) is defi ned by recurrent episodes of bingeing;
recurrent and inappropriate compensatory behavior to prevent weight
gain, e.g., vomiting, fasting, use of laxatives, diet pills, diuretics, enemas (purging
subtype); or excessive exercise (nonpurging subtype). To warrant the diagnosis,
these bingeing and compensatory behaviors must occur at least twice
weekly for 3 months, with self-evaluation overly infl uenced by body shape and
weight.
BED refers to recurrent episodes of bingeing which produces marked distress.
Th e bingeing episodes occur at least twice weekly for 6 months with no
inappropriate compensatory behaviors.
ED-nos refers to any problems that nearly meet criteria for the above disorders.
It also describes the chewing and spitting out, but not swallowing, of
large amounts of food (American Psychiatric Association, 1994).

Th e treatment of eating disorders continues to be a major challenge for college
counseling centers. Getting people into treatment is oft en diffi cult due
to denial of illness, fears of giving it up, and shame about the behaviors.
Th erapists struggle with how to help, given the brief, time-limited treatment
models of most college services. Finally, managing the severely ill, those
very low-weight students who are barely medically stable, places enormous
demands on staff —both therapists and administrators, who struggle with the
question of when to ask students to withdraw.

Tags: disorder, eating disorders