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Eating Disorder Treatment in Norman, Oklahoma

Eating Disorders affect a significant portion of the population. These mental illnesses have serious, life-threatening complications that are both medical and psychiatric in nature.

Below is information about the various types of eating disorders, including their definitions. These definitions are quoted from the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV).

These definitions focus on the psychiatric side of the disorders. However, all eating disorders have significant medical complications. It is believed that most individuals with eating disorders who die, do so because of the medical complications.

Medical Obesity Treatment in Norman, Oklahoma

In the United States, over 37 percent of adults and 17 percent of children are struggling with obesity. Despite an aggressive media and medical campaign to “fight obesity”, these numbers continue to rise. The dieting industry is a multi-billion dollar business, but if the fix were this easy, why do millions of people continue to struggle?

Diets are actually disordered eating, and do not work! Ninety-five percent of all dieters regain their lost weight and more in 1-5 years. Dieting can actually be dangerous to your health. It leads to a slower metabolism, which actually makes it even harder for your body to lose weight. It also often leads to decreased intake of essential vitamins and minerals, decreased muscle mass, thinning hair, impaired concentration/memory loss, decreased coordination, dehydration, electrolyte imbalances, slowed heart rate, fainting, and physical weakness. Yo-yo dieting also increases risk of heart disease, and can damage a person’s metabolism for the long-term. Clearly, dieting does not improve obesity or health.

At Living Hope Eating Disorder Treatment Center, we strive to help patients struggling with obesity. We take the non-dieting approach to normalizing eating behaviors that typically results in sustained weight loss, helping individuals find true health.

Anorexia Treatment in Norman, Oklahoma

According to the DSM-5 criteria, to be diagnosed as having Anorexia Nervosa a person must display:

  • Persistent restriction of energy intake leading to significantly low body weight (in context of what is minimally expected for age, sex, developmental trajectory, and physical health).
  • Either an intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain (even though significantly low weight).
  • Disturbance in the way one's body weight or shape is experienced, undue influence of body shape and weight on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.

Subtypes

  • Restricting type: During the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior
  • Binge-Eating/Purging Type: During the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting, misuse of laxatives, diuretics, or enemas)

Quick Facts

  • Anorexia Nervosa affects approximately 1% of the United States population, with a much higher percentage of teenage and college aged people affected.
  • Anorexia Nervosa has the highest mortality rate of any psychiatric disorder, with the risk of premature death being 6-12 times higher in this population as compared to the general population.
  • The average age at the onset of anorexia is 17 years old. Females are 10 times more likely to have anorexia than males.
  • According to the 2007 Youth Risk Behavior Survey, 35% of adolescent girls believed that they were overweight, and 60% were attempting to lose weight.

Binge Eating Treatment in Norman, Oklahoma

According to the DSM-5 criteria, to be diagnosed as having Binge Eating Disorder a person must display:

  • Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
    • Eating, in a discrete period of time (e.g. within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
    • o A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating).
  • The binge eating episodes are associated with three or more of the following:
    • eating much more rapidly than normal
    • eating until feeling uncomfortably full
    • eating large amounts of food when not feeling physically hungry
    • eating alone because of feeling embarrassed by how much one is eating
    • feeling disgusted with oneself, depressed or very guilty afterward
  • Marked distress regarding binge eating is present
  • Binge eating occurs, on average, at least once a week for three months
  • Binge eating not associated with the recurrent use of inappropriate compensatory behaviors as in Bulimia Nervosa and does not occur exclusively during the course of Bulimia Nervosa, or Anorexia Nervosa methods to compensate for overeating, such as self-induced vomiting.

Note: Binge Eating Disorder is less common but much more severe than overeating. Binge Eating Disorder is associated with more subjective distress regarding the eating behavior, and commonly other co-occurring psychological problems.

Bulimia Treatment in Norman, Oklahoma

According to the DSM-5 criteria, to be diagnosed as having Bulimia Nervosa a person must display:

  • Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
    • Eating in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
    • A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating).
  • Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise.
  • The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months.
  • The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months.
  • Self-evaluation is unduly influenced by body shape and weight.
  • The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

Food Addiction Treatment in Norman, Oklahoma

Compulsive Overeating, also known as food addiction, consists of an individual having an obsessive/compulsive relationship to food that typically leads to weight gain. Individuals have frequent episodes of uncontrolled eating that can last for hours to days.

  • Studies suggest that one in five women have reportedly experienced compulsive overeating at some time in their life.
  • Unlike many of the other eating disorders, compulsive eating disorder is almost equally prevalent in men and women, as well as across all ethnic groups.
  • Compulsive Overeating has a higher prevalence in the overweight and obese populations.
  • Compulsive overeating also has significant medical complications, and often leads to diseases such as diabetes and hypertension.
  • As with other eating disorders, Compulsive Overeating is a serious condition that cannot be cured by willpower alone. However, with proper medical, psychiatric, and dietary treatment, it can be overcome.

Eating Disorder Not Otherwise Specified (EDNOS) is the diagnosis of a patient who does not fit another eating disorder category by strict definitions. Its prevalence has not fully been studied, but it is estimated that this population is larger than both anorexia and bulimia combined.

A study by Fairburn (1) confirmed that EDNOS is the most common eating disorder encountered in the adult outpatient setting. Examples of EDNOS include:

  1. All of the criteria for Anorexia Nervosa are met except the individual has regular menses.
  2. All of the criteria for Anorexia Nervosa are met except that, despite substantial weight loss, the individual’s current weight is in the normal range.
  3. All of the criteria for Bulimia Nervosa are met except binges occur at a frequency of less than twice a week or for a duration of less than 3 months.
  4. An individual of normal body weight who regularly engages in inappropriate compensatory behavior after eating small amounts of food (i.e. self-induced vomiting after the consumption of two cookies).
  5. An individual who repeatedly chews and spits out, but does not swallow, large amounts of food.
  6. Binge eating disorder is also currently included under this category by the DSM-IV. However, the new DSM-V will be released in 2013, and binge eating disorder is being strongly considered for an individual diagnosis with its own CPT code. However, this has not been officially decided yet.

These are just examples of what can fall under the EDNOS category, and are not an all-encompassing list. Up to 50% of individuals who seek treatment for an eating disorder do not meet the strict criteria listed in the DSM-IV.

The term “not otherwise specified” or “NOS” does not mean that these disorders are any less serious than other eating disorders. Indeed, a major study on the severity of EDNOS, (Fairburn et al 2007) found that it is very close to Bulimia Nervosa in its nature, duration, and severity. This study also found EDNOS to be common, severe, and persistent.

Pica: Treatment in Norman, Oklahoma

According to the DSM-5 criteria, to be diagnosed with Pica a person must display:

  • Persistent eating of non-nutritive substances for a period of at least one month.
  • The eating of non-nutritive substances is inappropriate to the developmental level of the individual.
  • The eating behavior is not part of a culturally supported or socially normative practice.
  • If occurring in the presence of another mental disorder (e.g. autistic spectrum disorder), or during a medical condition (e.g. pregnancy), it is severe enough to warrant independent clinical attention.

Note: Pica often occurs with other mental health disorders associated with impaired functioning.

Rumination Disorder: Treatment in Norman, Oklahoma

According to the DSM-5 criteria, to be diagnosed as having Rumination Disorder a person must display:

  • Repeated regurgitation of food for a period of at least one month Regurgitated food may be re-chewed, re-swallowed, or spit out.
  • The repeated regurgitation is not due to a medication condition (e.g. gastrointestinal condition).
  • The behavior does not occur exclusively in the course of Anorexia Nervosa, Bulimia Nervosa, BED, or Avoidant/Restrictive Food Intake disorder.
  • If occurring in the presence of another mental disorder (e.g. intellectual developmental disorder), it is severe enough to warrant independent clinical attention.

Avoidant/Restrictive Food Intake Disorder (ARFID) Treatment in Norman, Oklahoma

According to the DSM-5 criteria, to be diagnosed as having ARFID a person must display:

  • An Eating or Feeding disturbance as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:
    1. Significant loss of weight (or failure to achieve expected weight gain or faltering growth in children).
    2. Significant nutritional deficiency
    3. Dependence on enteral feeding or oral nutritional supplements
    4. Marked interference with psychosocial functioning
  • The behavior is not better explained by lack of available food or by an associated culturally sanctioned practice.
  • The behavior does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way one’s body weight or shape is experienced.
  • The eating disturbance is not attributed to a medical condition, or better explained by another mental health disorder. When is does occur in the presence of another condition/disorder, the behavior exceeds what is usually associated, and warrants additional clinical attention.

Other Specified Feeding or Eating Disorder (OSFED) Treatment in Norman, Oklahoma

According to the DSM-5 criteria, to be diagnosed as having OSFED a person must present with a feeding or eating behaviors that cause clinically significant distress and impairment in areas of functioning, but do not meet the full criteria for any of the other feeding and eating disorders.

A diagnosis might then be allocated that specifies a specific reason why the presentation does not meet the specifics of another disorder (e.g. Bulimia Nervosa- low frequency). The following are further examples for OSFED:

  • Atypical Anorexia Nervosa: All criteria are met, except despite significant weight loss, the individual’s weight is within or above the normal range.
  • Binge Eating Disorder (of low frequency and/or limited duration): All of the criteria for BED are met, except at a lower frequency and/or for less than three months.
  • Bulimia Nervosa (of low frequency and/or limited duration): All of the criteria for Bulimia Nervosa are met, except that the binge eating and inappropriate compensatory behavior occurs at a lower frequency and/or for less than three months.
  • Purging Disorder: Recurrent purging behavior to influence weight or shape in the absence of binge eating
  • Night Eating Syndrome: Recurrent episodes of night eating. Eating after awakening from sleep, or by excessive food consumption after the evening meal. The behavior is not better explained by environmental influences or social norms. The behavior causes significant distress/impairment. The behavior is not better explained by another mental health disorder (e.g. BED).

Unspecified Feeding or Eating Disorder (UFED) Treatment in Norman, Oklahoma

According to the DSM-5 criteria this category applies to where behaviors cause clinically significant distress/impairment of functioning, but do not meet the full criteria of any of the Feeding or Eating Disorder criteria. This category may be used by clinicians where a clinician chooses not to specify why criteria are not met, including presentations where there may be insufficient information to make a more specific diagnosis (e.g. in emergency room settings).