Life can be hard sometimes. Times can be confusing, and you might not be taking good care of yourself. Be it the pressure of work or a deadline to submit an important project, it can give you stress and anxiety.
However, not so uncommon these days; around 13% of the world’s population suffers from mental illnesses. It could range from traces of stress to tiring sleepless nights leading to anxiety.
So was the DSM 5 Eating Disorders segment curated to make the diagnosis of mental health issues easier for the patients and professionals. DSM 5 Eating Disorders are just another section of mental issues listed in the Diagnostic and Statistical Manual.
This article will explore how they stand apart from the previous criteria and provide a candid insight into mental health disorders.
Mental health still has a stigma tied to it in the sacred society that we live in. We find it difficult to talk about our mental stability issues. Even the diagnosis for it is filled with medical complications.
When you catch a cold, you’ll have at least ten people reminding you to hold back your sneeze, but with a problem in your head, no one ever notices it. It kills you slowly, and nobody finds out.
What are Mental Disorders?
Mental Health Disorders can be widely described as conditions that affect how you feel about things around you, your thinking, your behavior and feelings towards the world, and how things work. They can last for a short period or might as well attach themselves to you, and you may have to see a mental health professional get over it.
What Causes Mental Disorders?
Mental health disorders are not like any other biological diseases that have a vial of curable antidote. The symptoms can vary largely from person to person. A huge variety of factors affect one’s mental stability. The most common reasons are the daily life experiences that make you feel a certain way.
It’s true; your everyday interactions can hover around your head for a long time and make you feel anxious about the thoughts that run through your mind. It could lead to mood swings and lower your self-esteem, eventually leading to improper social functioning.
A more common cause of these disorders is genes. One such example is a bipolar disorder which is very frequently inherited from the bloodline. Nevertheless, there are several treatment options available.
Many of such disorders are also influenced by the consumption of drugs and alcohol, which leads to the improper functioning of the brain, causing serious problems. Few of these are caused due to some medical complications.
Yet another reason for someone’s mental disorder could be an event that had a lasting impact on their memory, bringing them trauma.
Types Of Mental Health Disorders
A few common types of these disorders are:
- Anxiety Disorders such as Obsessive Compulsive Disorder, Social Anxiety Disorder, Specific Phobias, and Panic Disorder
- Post Traumatic Stress Disorder
- Bulimia Nervosa, Anorexia Nervosa, and Binge Eating Disorder
- Mood Disorders like Bipolar Disorders
- Personality Disorders as in Schizophrenia and Borderline Personality Disorder
Like there is no definite reason for a mental disorder, there also do not lie common effects. Though most disorders directly influence one’s mind, few can affect one’s diet as well. Such a disorder, we like to term it as an eating disorder.
These disorders are essentially described as drastic changes in one’s eating habits due to emotional and mental distress. Unrealistic standards of eating behaviors characterize them.
They can have a lasting and serious impact on a person’s mind and body and can even lead to serious medical conditions. These disorders can have absolute psychological and physical consequences.
These disorders are said to affect at least 9% of the world’s population. Most people who go through an eating disorder are between the ages of 13-31. Many young adults and especially women, go through these disorders. Mostly due to the unrealistic standards of perfection that the society we live in expects.
Many teenagers going through adolescence go through these disorders as well. This restrictive eating habit and eating behavior is often influenced by the things happening around them. Intense fear of peer pressure makes them worry about body dissatisfaction, eventually resulting in these disorders.
There are six common types of eating disorders, namely, Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Pica, Rumination Disorder, Avoidant Restrictive Food Intake Disorder, Purging Disorder, and Other Specified or Eating Disorders.
However, the former three remain the most major eating disorders seen among young adults and women.
What Is DSM 5?
DSM 5, short for the Diagnostic and Statistical Manual of Mental Health Disorders, the Fifth Edition is a manual of mental health issues used by several American health care professionals as an ultimate guide for diagnosing disorders. The American Psychiatric Association has exclusively formulated it.
The Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5), in its fifth edition, has included numerous changes to represent the symptoms and behaviors of patients who are dealing with such conditions throughout their life.
It essentially sets the benchmark for the diagnostic criteria to be used by professionals to diagnose various mental health disorders.
It contains descriptive details of the symptoms and full criteria for the diagnosis of a particular mental disorder. This diagnostic and statistical manual of mental disorders comes in very handy to healthcare professionals.
The first edition of DSM was published back in 1952. With several major changes and upgrades, we ultimately reached DSM 5. The previous version of the diagnostic and statistical manual was last updated in 1994, known as the DSM IV.
Since then, a lot of research has been done on the topic, and valuable information has been found on the same, so there existed a need to update the manual with the latest findings.
The DSM 5 is an all favorite. It makes it much easier for professionals to diagnose a disorder and find a suitable treatment based on the diagnosis.
The most commendable change in the DSM 5 eating disorders is recognizing binge eating disorder change in the diagnostic criteria for anorexia nervosa and bulimia nervosa. It has become very prevalent amongst professionals these days.
DSM 5 eating disorders
Under the DSM 5 eating disorders section, symptoms for all these disorders have been mentioned in detail. In the current edition of DSM 5 eating disorders, several diagnostic changes have been made in the diagnostic criteria of most eating disorders.
In the further section, we’ll look at the changes made in the criteria under the section of the DSM 5 eating disorders.
Binge Eating Disorder
Binge Eating Disorder is characterized by recurring episodes of eating large amounts of food. The frequency of eating is out of one’s control and happens in short periods.
Binge eating involves eating very quickly beyond one’s capability to take in a certain amount of food. Binge eating influences a feeling of losing control during the binge and experiencing shame, distress, or guilt later.
This uncontrolled habit can last from somewhere between a week to three months. If the diagnosis is not made at the earliest, there can be lasting health impacts.
Overeating can lead to weight gain and obesity. The uncertain increase in body weight can also lead to serious chronic illnesses like cancer, arthritis, Type 2 diabetes, heart disease, and high blood pressure.
Binge Eating Disorder in DSM 5 Eating Disorders
The previous edition of DSM IV had been described as a topic fully under research in the appendix section as it was too new to be acknowledged. DSM 5 eating disorders described Binge Eating Disorder as a completely recognized and psychiatric diagnosable disorder for the first time.
On an additional note towards the diagnosis, the frequency of a binge episode has been brought down from two days of episodes every week for six months to one episode per week for three months.
Though Bulimia Nervosa is similar to Binge Eating Disorder, symptoms for Bulimia Nervosa are different.
It is influenced due to expectation of a certain type of body weight and shape. Mentally, people believe that they have significantly low body weight and feel the need to gain weight. The compulsion of weight gain makes people take over non-purging and purging behaviors and other compensatory behaviors.
In this eating disorder, purging behaviors every two hours are followed by a sense of loss of control and compensatory behaviors like frequent laxative misuse besides taking diet pills, compulsive exercise, and induced vomiting. These behaviors can be observed at least once a week every three months.
Bulimia Nervosa in DSM 5 Eating Disorders
The frequency for Bulimia Nervosa to be diagnosed as a disorder has been widened from what was mentioned in DSM IV. While DSM IV predicted it to occur at least twice every week for at least three months, DSM 5 eating disorders stated that it could happen once a week for at least three months.
Earlier, the purging and non-purging behaviors had been classified separately; however, now they have been combined as professionals believe that people with Bulimia Nervosa can show various behaviors. Clinicians can now also tell the rate and stage of recovery based on an individual’s frequency and amount of purging.
Anorexia Nervosa is characterized by restricted meals intake due to the fear of gaining weight despite clearly being of significantly low weight. People have a common belief that they must lose weight. This leads to them starving themselves to the extent that it makes them weak and affects their health.
This kind of eating disorder is often influenced by false perceptions of body images that can lead one to think that they must lose weight despite having normal weight. It directly has an impact on one’s physical health. Anorexia nervosa can also result in feeling disturbance to the entire working of the internal organs.
Anorexia Nervosa in DSM 5 Eating Disorders
DSM 5 made two major changes to the diagnostic criteria for anorexia nervosa. According to DSM IV, a person had to be below 85% of the ideal body weight based on the body mass index(BMI).
Earlier significant weight loss had to be seen in the patients to be officially diagnosed; however, now, according to the DSM 5 eating disorders, patients with significantly low weights can be diagnosed with the disorder.
Previously, girls and women had to have three or more skipped periods to fall in the diagnostic category of anorexia nervosa. The diagnostic criteria has been removed as not all women and teen girls face skipped menstruation. Also, it allows for men to be now diagnosed with anorexia nervosa.
Other Specified Feeding or Eating Disorder(OSFED)
Concerning the criteria in the DSM 5 eating disorders, Other Specified Feeding or Eating Disorder is concerned for those individuals who experience significant distress due to symptoms similar to other disorders related to eating such as Anorexia Nervosa and Bulimia Nervosa, Binge Eating Disorder. Still, they do not meet the full diagnostic criteria.
A few examples of patients experiencing such eating disorders are:
- Atypical Anorexia Nervosa – In such a case, the individual can be diagnosed with Anorexia Nervosa and has undergone significant weight loss. However, their body weight remains within the ideal range, which is considered to be normal weight.
- Bulimia Nervosa of relatively low frequency – The individual here meets the criteria for bulimia nervosa. Still, they engage in binging activities and compensatory behaviors fewer than once every week or three months.
- Binge Eating Disorder – They meet the criteria for the disorder, but their bingeing episodes are at a frequency of once a week or lesser than three months.
- Purging disorder – The individual engages in purging behaviors such as induced vomiting and substance use, but they don’t experience binge episodes.
- Night Eating Syndrome – Experienced by individuals, followed by frequent episodes of eating due to awakening at night or overeating heavily after an evening meal.
In DSM 5 eating disorders, two new disorders have been included, namely, “Other Specified Eating Or Feeding Disorder” and “Eating disorder not otherwise specified.” They had been merged in DSM IV earlier as eating disorders not otherwise specified (EDNOS).
Other Specified Eating Or Feeding Disorder in DSM 5 Eating Disorders
This applies to people who face almost all the symptoms of anorexia nervosa, bulimia nervosa, and binge eating disorder but do not face it for an amount of time long enough. To meet the criteria, a person must necessarily feel distressed, apart from all the other criteria.
Eating Disorder Not Otherwise Specified in DSM 5 Eating Disorders
This is a broader diagnosis category, where a professional cannot diagnose a particular disorder due to a lack of enough information.
DSM 5 takes a very candid look at mental eating disorders in the DSM 5 eating disorders segment compared to its previous versions. Several improvements to the old edition make it much easier for mental health professionals to diagnose an eating disorder based on a broad and wide range of criteria.
On a further note, eating disorders can be confusing and complicated for an individual, but it does not mean that one cannot get through it.
If an individual is well aware of the symptoms beforehand, they can seek professional help at the earliest. If body positivity is advocated from early childhood, young adults may not find themselves in such disorders.
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1. Are eating disorders common?
Millions of people are affected by these disorders. Females between the ages of 12 and 35 end up with the most eating disorder diagnoses. According to estimates, 0.5 to 3.7 percent of females will get anorexia in their lifetime, 1.1 to 4.2 percent of females will develop bulimia, and 2-5 percent of men and women will develop binge eating disorder. Importantly, people may struggle with one type of eating or feeding disorder (described above) for a period of time before developing signs of another eating or feeding disease. According to eating disorder specialists, eating disorders can cause symptoms and habits to migrate over time.
2. What factors contribute to the development of an eating disorder?
There is no simple solution to this situation. Do not condemn yourself if you or your child suffers from an eating disorder, because our understanding of the underlying causes of eating disorders has evolved dramatically over time.
These disorders were formerly assumed to mainly affect:
- High-achieving, affluent, Caucasian youth with demanding families.
- They are now thought to be caused by a combination of physiological, psychologic, and social variables. Men and women of all ages, socioeconomic, ethnic, and cultural groups are affected.
- Adolescent girls were considered to starve themselves to avoid the physical changes and social pressures that come with maturing into women.
3. Can these disorders cause medical problems?
Following are common medical complications of disorders related to eating:
- Stomachaches or constipation
- Irregular periods
- Severe dental cavities
- Vomiting and diarrhea
- High blood pressure
- Heart disease
- Increased risk for cancer
Edited by Pooja Motwani
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