Breaking down the criteria for the 5 types of eating disorders.
I want to make sure that you are AWARE of the five categories of eating disorders according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 is the publication used by those in the mental health field to define and classify symptoms and make diagnoses.
I’ve observed a lot of confusion among individuals when it comes to eating disorders. Often people think they have an eating disorder, when in fact they just struggle with eating and food, but it’s not actually severe enough to be considered an eating disorder. Other times people actually meet the criteria for an eating disorder, but they don’t realize it. My intention is to help eliminate confusion so you can take empowered action to get the right help and support you need to improve your relationship with food, eating and your body, regardless of whether or not you struggle with an eating disorder.
The 5 Eating Disorders
Binge Eating Disorder
Binge Eating Disorder (BED) is classified as eating an objectively large amount of food in a very short period of time. “Objectively large” is about 2–3 times what is considered a normal amount of food for a person your age and size to consume, and a “very short time” is about a 1–2 hour window. BED is also classified by having an experience or sensation of loss of control while eating. This is different from someone choosing to overeat. With BED, the experience is one in which you cannot stop, even though you may want to.
People with BED are often very distressed about their binges, frequently feeling a sense of guilt or shame afterward, which leads to them usually keeping their disorder a secret, sometimes even stealing or hiding food. The criteria for BED is that an episode would occur once a week over the course of three months. It is more common than a lot of people realize.
Bulimia is categorized as having a binge episode followed by some kind of compensatory behavior to “make up for” or “undo” that eating episode. The compensatory behavior that most people think of when they think of bulimia is throwing up (purging) after eating (this was what I used to do), but that’s not the only behavior that qualifies. Laxative misuse, diet pill misuse and overexercising all also meet the classification as well. Like with BED, these episodes also would occur at least once a week over the course of three months to meet the criteria.
Anorexia nervosa is one of the most well-known eating disorders thanks to it being easier to spot than others. It is categorized as having a very severe restriction of caloric intake to the point where someone has significantly low body weight. This is typically a very high health risk. Those with anorexia also have an extreme fear of gaining weight along with some distortion around the severity of their eating disorder. A lot of people with this disorder may think that they’re much bigger than they actually are or not think that they have a problem. Sometimes individuals with anorexia will purge after eating as well.
Avoidant/Restrictive Intake Feeding Disorder
Avoidant/Restrictive Intake Feeding Disorder (ARFID) is classified as a disorder in which someone struggles to get enough calories or adequate nutrients for their body, but it’s not related to a fear of getting fat or how they view their body. There is another reason behind their struggle to eat normally. For example, I once worked with someone who had a fear of swallowing because they were afraid they were going to choke to death. ARFID is also sometimes described as extreme picky eating. It comes into play for those who have an extreme aversion to things like food textures, smells, etc., if this aversion prevents the person from consuming enough calories and nutrients to support their survival.
Other Specified Feeding & Eating Disorders
The last of the five eating disorder categories I am talking about today is Other Specified Feeding & Eating Disorders. This includes things like general purging, where instead of binging first like with bulimia, you purge after a normal-size snack or meal. Nighttime eating syndrome is another example of this eating disorder category, where someone might get up in the night and eat and/or binge while they’re still asleep and not be aware of it while it’s happening. Also included here are atypical anorexia as well as lower-frequency cases of BED and bulimia, where the episodes may not be happening as often as once a week over three months, but are still happening regularly.
If you wonder whether you meet the criteria for these conditions, then I encourage you, rather than self-diagnose, to seek professional help, support and treatment. There is no shame in asking for help! You deserve to feel happy, healthy and free from suffering and pain.
Here are some resources to get you started:
- Eating Disorder Hotline (available 24 hours): 1-877-743-8255
- National Eating Disorder Association (NEDA): 1-800-931-2237; nationaleatingdisorders.org; @neda
- National Association of Anorexia Nervosa & Associated Disorders (ANAD): www.anad.org; @anadhelp
You can also join the online community I’m building, Support for H.E.R., which is designed to be a safe space for women to come together and support one another in achieving healthy eating recovery.
You are worthy. You are deserving. You are loved!
Watch me discuss the five eating disorders in the video below.