Eating Disorders
HB 1432 added Anorexia Nervosa and Bulimia to the list of mental illnesses covered by the Illinois parity law. The bill was passed in 2008 and became effective January 1, 2009.
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Eating Disorders – anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified (EDNOS) – are severe, biologically-based illnesses with significant emotional, physical, financial and social burdens and costs. More than 12 million lifetime cases of eating disorders have been identified in the U.S. population. Eating disorders cause immeasurable suffering for victims and their families and affect individuals of all ages, genders, ethnicities, and socio-economic levels.
What Else You Need Know about Eating Disorders:
*Anorexia nervosa is the third most common chronic illness in adolescent females.
*The mortality rate of anorexia nervosa is nearly 12 times greater than the annual death rate due to all causes of death
among females between the ages of 15 and 24.
*Suicide is a major cause of death in anorexia nervosa, with estimated deaths resulting from suicide ranging between 27
42%. The prevalence of suicide attempts by bulimics is 23% to 39%.
*The likelihood of dying from anorexia increases with the duration of the illness.
*Anorexia nervosa typically begins in adolescence with the average age of onset between 14 and 18 years.
*Children as young as seven years old have been diagnosed with an eating disorder.
*The prevalence of anorexia and bulimia in adolescence is 0.5-1% and 1-3% respectively.
*Eating disorders impair an individual’s ability to work and function, resulting in lost productivity and creating a huge
financial burden on victims and families.
*The lifetime prevalence of DSM IV anorexia nervosa is .9% in women and 3% in men; the lifetime prevalence of DSM IV
bulimia nervosa is 1.5% in women and .5% in men.
Psychiatric Criteria for Eating Disorders:
Eating Disorder diagnoses are categorized as psychiatric disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV TR). These diagnoses include Anorexia Nervosa, Bulimia Nervosa, and Eating Disorder Not Otherwise Specified (EDNOS). Eating Disorders are brain disorders. For example, neurobiological features, such as serotonin neuronal systems, are implicated as contributing to the development and maintenance of Bulimic and Anorexic behaviors. The diagnostic criteria for Anorexia Nervosa and Bulimia Nervosa, as defined in the DSM-IV-TR, are provided in Table 1.
Individuals with Anorexia Nervosa maintain a significantly low body weight through restricting food intake and over exercise, regardless of physical harm. Individuals with Bulimia Nervosa engage in frequent binge overeating and compensatory behaviors through self-induced vomiting or use of laxatives, diet pills, or other means. Individuals with Eating Disorder NOS have disturbed eating behaviors that are characteristic of anorexia or bulimia, but do not meet all of the specific criteria for one particular diagnosis. For example, those who are severely below their healthy body weight and who restrict their food intake, but do not have disruption in their menstrual cycle, meet criteria for Eating Disorder NOS.
Table 1. DSM-IV-TR criteria for Anorexia Nervosa and Bulimia Nervosa |
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Anorexia Nervosa
1. Refusal to maintain body weight at or above a minimally normal weight for age and height.
2. Intense fear of gaining weight or becoming fat, even though underweight.
3. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or
shape on self-evaluation, or denial of the seriousness of the current low body weight.
4. In postmenarcheal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles. |
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Bulimia Nervosa
1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: (a
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; (b) 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).
2. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting;
misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise.
3. The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3
months.
4. Self-evaluation is unduly influenced by body shape and weight.
5. The disturbance does not occur exclusively during episodes of Anorexia Nervosa. |
Physical Health Implications of Eating Disorders: Outside of mortality, Eating Disorders severely impact the medical health of individuals. Complications associated with Eating Disorders include kidney damage, pancreatic damage, dehydration, electrolyte imbalance, amenorrhea, reproductive complications, osteopenia, osteoporosis, hypertension, cardiac arrhythmia, cardiac arrest, bradycardia, hypokalemia, and seizures.
For information regarding eating disorders, please contact: National Association of Anorexia Nervosa and Associated Disorders, www.anad.org
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