Anorexia nervosa

1. There is weight loss or, in children, a lack of weight gain, leading to a body weight at least 15% below the normal or expected weight for age and height.
2. The weight loss is self-induced by avoidance of “fattening foods.”
3. There is self-perception of being too fat, with an intrusive dread of fatness, which leads to a self-imposed low weight threshold.
4. A widespread endocrine disorder involving the hypothalamic-pituitary-gonadal axis is manifest in women as amenorrhea and in men as a loss of sexual interest and potency. (An apparent exception is the persistence of vaginal bleeding in anorexic women who are on replacement hormonal therapy, most commonly taken as a contraceptive pill.)
5. The disorder does not meet Criteria A and B for bulimia nervosa.

Comments
The following features support the diagnosis but are not essential elements: self-induced vomiting, self-induced purging, excessive exercise, and use of appetite suppressants and/or diuretics.
If onset is prepubertal, the sequence of pubertal events is delayed or even arrested (growth ceases; in girls the breasts do not develop, and there is a primary amenorrhea; in boys the genitals remain juvenile). With recovery, puberty is often completed normally, but the menarche is late.
Atypical anorexia nervosa
Researchers studying atypical forms of anorexia nervosa are recommended to make their own decisions about the number and type of criteria to be fulfilled.
Bulimia nervosa

1. There are recurrent episodes of overeating (at least twice a week over a period of 3 months) in which large amounts of food are consumed in short periods.
2. There is persistent preoccupation with eating and a strong desire or a sense of compulsion to eat (craving).
3. The patient attempts to counteract the “fattening” effects of food by one or more of the following:
   1. self-induced vomiting;
   2. self-induced purging;
   3. alternating periods of starvation;
   4. use of drugs such as appetite suppressants, thyroid preparations, or diuretics; when bulimia occurs in diabetic patients, they may choose to neglect their insulin treatment.
4. There is self-perception of being too fat, with an intrusive dread of fatness (usually leading to underweight).

Atypical bulimia nervosa
Researchers studying atypical forms of bulimia nervosa, such as those involving normal or excessive body weight, are recommended to make their own decisions about the number and type of criteria to be fulfilled.
Overeating associated with other psychological disturbances
Researchers wishing to use this category are recommended to design their own criteria.
Vomiting associated with other psychological disturbances
Researchers wishing to use this category are recommended to design their own criteria.
Other eating disorders
Eating disorder, unspecified