Eating Disorders

Anorexia Nervosa (AN) is a psychological disorder characterized by restriction of calories and food intake and a low weight (dependent on growth curve, age, history). 

Another characteristic of AN is shape and weight concerns, which include dissatisfaction with one's weight or how one looks in the mirror, fits in clothes, or compares to other people or previous weights and shape. Clinically, there is an over evaluation of shape and weight, meaning this aspect of one's identity is a significant factor in how they see themselves. In AN, there is often a fear or weight gain or restoration. 

AN is an insidious and dangerous illness, where medical and psychological consequences are considered some of the most severe. While age of onset is typically in adolescents, AN can develop at anytime. In adolescents the gold standard of treatment is FBT, a family based treatment. In adults, CBT-E or DBT (DBT-RO) are promising approaches. Please see About Treatment to learn more about these treatments. 

ARFID  is the newest eating disorder to be categorized in the DSM. It is a psychological disorder characterized by restriction of calories and energy intake which may result in low body weight, nutritional deficiency, and undesirable social consequences. 

The restriction of food intake in ARFID can often be accounted for by one or more of the following:

1. Sensory: texture, taste, color, sound, touch of foods make them unappealing or difficult to eat. 
2. Fear of consequences: this can include fear of choking or fear of an allergic reaction 
3. Disinterest or displeasure of eating: eating is not enjoyable, foods to do not taste appealing. 

People who have ARFID may have one, two or all of these difficulties with food. The restriction of food based on these reasons often leads to more restriction, limited intake and exposure, and a cycle of avoidance that results in low weight, limited diet, and/or nutritional deficiencies. 

Bulimia Nervosa (BN) is a psychological disorder characterized by cycles of binge eating episodes and use of compensatory behaviors after the eating episode. Binge eating episodes are distinguished from overeating in that these moments feel out of control and are usually accompanied by feelings of guilt, shame, eating rapidly or in secret, and eating until one is uncomfortably full. Compensatory behaviors may include self-induced vomiting, over exercise, restriction, use of laxatives, diuretics, or any substance used to suppress appetite or induce calorie elimination. 

Another characteristic of BN is shape and weight concerns, which include dissatisfaction with one's weight or how one look in the mirror, fit in clothes, or compare to other people or previous weights and shape. Clinically, there is an over evaluation of shape and weight, meaning this aspect of one's identity is factored in very importantly for the person suffering from this illness. 

Binge Eating Disorder (BED) is a psychological disorder characterized by cycles of binge eating episodes. Binge eating episodes are distinguished from overeating in that these moments feel out of control and are usually accompanied by feelings of guilt, shame, eating rapidly or in secret, and eating until one is uncomfortably full. These episodes may be any amount of food however, and usually they last anywhere up to 2 hours. Between binge eating episodes, there are often patterns of strict dieting or restrictive eating. This cycle of strict rules around eating and binge eating disorder is strengthened by shape and weight concerns or other life stressor and difficult emotions to regulate.  

Formerly called EDNOS (Eating Disordered No Otherwise Specified) this diagnosis refers to a host of eating disorder related symptoms, which may closely resemble AN, BN, BED, ARFID, or differently presenting eating problems. 

Often this diagnosis is made if for some reason criteria are not met for other eating disorders. This is no way signifies that OSFED is any less serious or deadly than other eating disorders. The clinical features of OSFED are commensurate with other eating disorders we treat. 

OSFED may include purging, binge eating episodes, rapid weight loss, restriction of calorie and energy intake, difficulty eating food, weight concerns, shape concerns, and body image dissatisfaction.