CE Course 8 - Tables

Table I. Diagnostic criteria for eating disorders

Anorexia Nervosa

  • Body weight < 85% of expected weight
  • Intense fear of gaining weight
  • Undue emphasis on body shape or weight
  • Amenorrhea (in girls and in women after menarche) for three consecutive months

Bulimia Nervosa

  • Recurrent binge eating (at least two times per week for three months duration)
  • Recurrent, inappropriate, compulsive behavior to prevent weight gain such as self-induced vomiting, abuse of laxatives, diuretics or other medications, or excessive exercise
  • Persistent overconcern with body shape and/or weight
  • Absence of anorexia nervosa

Binge Eating Disorder

  • Recurrent episodes of binge eating. An episode is characterized by:
  1. Eating a larger amount of food than normal during a short period of time (within any two hour period).
  2. Lack of control over eating during the binge episode (i.e., the feeling that one cannot stop eating).
Binge eating episodes are associated with three or more of the following:
  1. Eating until feeling uncomfortably full.
  2. Eating large amounts of food when not physically hungry.
  3. Eating much more rapidly than normal.
  4. Eating alone because you are embarrassed by how much you are eating.
  5. Feeling disgusted, depressed, or guilty after overeating.
  • Marked distress regarding binge eating is present
  • Binge eating occurs, on average, at least two days a week for six months
  • The binge eating is not associated with the regular use of inappropriate compensatory behavior (i.e. purging, excessive exercise, etc.) and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.

Adapted from American Psychiatric Association. Eating Disorders. In: Diagnostic and Statistical Manual of Mental Disorders, (DSM-IVTR), fourth edition, Washington, DC: American Psychiatric Association, 2000, p.583-97.




Table II. Complications of anorexia nervosa

Orofacial Tooth enamel erosion
Dental caries
Parotid gland enlargement
Dentinal hypersensitivity
Angular cheilitis
Xerostomia
Palatal trauma
Cardiovascular Hypotension
Prolong QT
Arrhythmias
Cardiomyopathy
Mitral valve prolapse
Gastrointestinal Delayed gastric
Decreased intestinal
Constipation
Endocrine and Metabolic Hypokalemia
Hyponatremia
Hypoglycemia
Hypothermia
Euthyroid sick syndrome
Hypercortisolism
Amenorrhea
Delay in puberty
Arrested growth
Osteopenia/osteoporosis
Renal
Reproductive Infertility
Low-birth weight infant
Integumentary Dry skin and hair
Hair loss
Lanugo (fine body hair)
Neurologic Peripheral neuropathy
Ventricular enlargement
Hematologic Anemia
Leukopenia
Thrombocytopenia
Adapted from: Liburd JDA: Eating disorder: anorexia. eMedicine Journal, 2001:2(9):1-13. Altshuler BD: Eating disorder patients: recognition and intervention. J Dent Hyg 1990;64:119-124.


Table III. Staging criteria for anorexia nervosa

Early or Mild Stage

Weight 90% or less of average weight for height

No symptoms or signs of excessive weight loss

Use of potentially harmful weight-controlled methods or a strong drive to lose weight

Established or
Moderate Stage

Definitely distorted body image that has not diminished with weight loss

Weight goal less than 85% of average weight for height associated with a refusal to gain weight

Symptoms or signs of excessive weight loss associated with denial that any problems exist

Use of unhealthy means to lose weight, such as eating fewer than 1000 cal/day, purging, or excessive exercise

Reference: Kriepe RE, Birndorf SA: Eating disorders in adolescents and young adults. Medical Clinics of North America 2000; 84(4):1027-1049.


Table IV. SCOFF Questionnaire

  • Do you make yourself SICK because you feel uncomfortably full?
  • Do you worry you have lost CONTROL over how much you eat?
  • Have you recently lost more than ONE stone in a three-month period? (stone = UK measurement of weight, equals approximately 14 pounds)
  • Do you believe yourself to be FAT when others say you are too thin?
  • Would you say that FOOD dominates your life?
One point for each “yes” response. Ascore greater than two indicates a likely case of anorexia nervosa or bulimia nervosa.
Reference: Moreno MA, Judd R: Eating disorder: bulimia. eMedicine Journal 2001:2(6):1-14.

Table V. Non–food Substances Ingested in Pica

Clay
Dirt
Sand
Stone
Pebbles
Hair
Feces
Lead
Laundry starch
Vinyl gloves
Light bulbs
String
Plastic
Pencil erasers
Ice
Fingernails
Paper
Paint chips
Coal
Chalk
Wood
Plaster
Needles
Burnt matches
Reference: Ellis CR, Schnoes CJ: Eating disorder: pica. eMedicine Journal, 2001;2(6):1-2.