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The ICD-10-CM code depends on the subtype (see below). 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 persistent lack of recognition of the seriousness of the current low body weight.Ĭoding note: The ICD-9-CM code for anorexia nervosa is 307.1, which is assigned regardless of the subtype. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.Ĭ. Significantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents, less than that minimally expected.ī. Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. DSM-5 Diagnostic Criteria for Anorexia NervosaĪ. Most patients with bulimia nervosa benefit from psychotherapy such as cognitive behavior therapy and/or treatment with a selective serotonin reuptake inhibitor.Īntipsychotic medications are generally not effective in the treatment of eating disorders.
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In patients with eating disorders, assess for psychiatric comorbidities, including depression and suicide risk, anxiety disorders, and substance use disorders.Īn interdisciplinary team approach is needed for the treatment of eating disorders, and often includes a family physician, a psychotherapist or psychiatrist, a dietitian, an eating disorder specialist, and school personnel.Ī minimum weight restoration target for patients with anorexia nervosa is 90% of the average weight expected for the patient's age, height, and sex.įamily-based treatment (the Maudsley method) is effective for treating anorexia nervosa in adolescents. Initial evaluation of patients with eating disorders requires assessing medical stability and whether hospitalization is required. SORT: KEY RECOMMENDATIONS FOR PRACTICE Clinical recommendation 3 This article focuses on anorexia nervosa and bulimia nervosa.
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Other feeding and eating disorders in the DSM-5 include pica, rumination disorder, and avoidant/restrictive food intake disorder. The disorder is not associated with self-induced vomiting or other compensatory behaviors hence, patients are typically overweight or obese. 3, 4 The DSM-5 includes a diagnostic category for binge-eating disorder, which is characterized by a loss of control and the feelings of guilt, shame, and embarrassment.
#Dsm 5 anorexia manual#
2 Revisions in the recently published Diagnostic and Statistical Manual of Mental Disorders, 5th ed., (DSM-5) may facilitate more specific eating disorder diagnoses. 1 Additionally, many patients have been classified as having the residual category of eating disorder not otherwise specified. They are anorexia nervosa and bulimia nervosa. Treatment is most effective when it includes a multidisciplinary, team-based approach.Įating disorders have traditionally been classified into two well-established categories. The use of psychotropic medications is limited for anorexia nervosa, whereas treatment studies have shown a benefit of antidepressant medications for patients with bulimia nervosa. Family-based treatment is helpful for adolescents with anorexia nervosa, whereas short-term psychotherapy, such as cognitive behavior therapy, is effective for most patients with bulimia nervosa. In patients with frequent purging or laxative abuse, the presence of electrolyte abnormalities requires prompt intervention. For low-weight patients with anorexia nervosa, virtually all physiologic systems are affected, ranging from hypotension and osteopenia to life-threatening arrhythmias, often requiring emergent assessment and hospitalization for metabolic stabilization.
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Anorexia nervosa and bulimia nervosa occur most often in adolescent females and are often accompanied by depression and other comorbid psychiatric disorders. In addition to the role of environmental triggers and societal expectations of body size and shape, research has suggested that genes and discrete biochemical signals contribute to the development of eating disorders. The recently published Diagnostic and Statistical Manual of Mental Disorders, 5th ed., includes updated diagnostic criteria for anorexia nervosa (e.g., elimination of amenorrhea as a diagnostic criterion) and for bulimia nervosa (e.g., criterion for frequency of binge episodes decreased to an average of once per week). Eating disorders are life-threatening conditions that are challenging to address however, the primary care setting provides an important opportunity for critical medical and psychosocial intervention.