CPG for Eating Disorders

Within each guideline some variations can be accepted, as is indicated:a) There is a persistent preoccupation with eating, and an irresistible craving for food; thepatient succumbs to episodes of overeating in which large amounts of food are consumed inshort periods of time.b) The patient attempts to counteract the weight gain caused by ingested food by one or moreof the following methods: self-induced vomiting; laxative abuse, alternating periods offasting; use of drugs such as appetite suppressants, thyroid preparations or diuretics. Whenbulimia occurs in diabetic patients they may choose to neglect their insulin treatment.c) The psychopathology consists of a morbid dread of fatness and the patient sets herself orhimself a sharply defined weight threshold, well below the premorbid weight thatconstitutes the optimum or healthy weight. There is often, but not always, a history of anearlier episode of AN, the interval between the two disorders ranging from a few months toseveral years. This earlier episode may have been fully expressed, or may have assumed aminor cryptic form with a moderate loss of weight and/or a transient phase of amenorrhoea.Include:Bulimia NOS (not otherwise specified).Hyperorexia nervosa.Diagnostic criteria for atypical bulimia nervosa (F50.3)This term must be used in cases where one or more key features of BN (F50.2) are missing butthat otherwise present a rather typical clinical picture. Patients frequently have normal weight orare even slightly overweight, but they present repeated bouts of overeating followed by selfinducedvomiting or purging. Partial syndromes accompanied by depressive symptoms are notuncommon (if these symptoms fulfil the guidelines of a depressive disorder a double diagnosismust be made).Includes:Bulimia with normalweight.Diagnostic Criteria for Other Eating Disorders (F50.8) and UnspecifiedEating Disorders (F50.9)Other eating disorders must be coded using the ICD-10 F50.8 code (other eating disorders).Unspecified eating disorders must be coded using the F50.9 code (Unspecified eatingdisorders).DSM-IV-TR Diagnostic Criteria for Eating DisordersThe DSM-IV (Diagnostic and Statistical Manual of Mental Disorders IV) of the APA(American Psychiatric Association) is a classification of mental disorders that was elaboratedwith the objective of providing clear descriptions of diagnostic categories, to enable cliniciansand researchers to diagnose, study and Exchange information and address different mental230CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS