Eating Disorder, Unspecified: What is it?
The eating disorders (eating disorders) They encompass those mental disorders centered on food, the perception of the body and the fear of gaining weight. Typical ACTs are anorexia nervosa and the bulimia.
However, when all the criteria for them are not met, but significant symptoms do appear, we speak of an unspecified eating disorder. In this article we will know eight of them. We will also talk about the causes and treatments of eating disorders.
Eating disorders (eating disorders): what are they?
Eating disorders (EDs) are mental disorders that can be very serious. In them, the main concerns of the patient are food and the perception of the body silhouette.
The eating disorders par excellence are anorexia nervosa and bulimia. In both there is an excessive fear of gaining weight; are similar disorders, although with diverse symptoms. The difference between these two disorders, broadly speaking, is that in anorexia nervosa the weight body mass is usually lower than in bulimia (and by extension the Body Mass Index [BMI] also).
Furthermore, in bulimia, the presence of binge eating and inappropriate compensatory behaviors (vomiting, use of laxatives, diuretics ...) appears as a diagnostic criterion, something that does not occur in anorexia. This does not mean that these symptoms cannot appear in anorexia.
Eating disorder, unspecified
However, symptoms of one of these two eating disorders may occur, but not all. That is, it may happen that a person meets some diagnostic criteria for bulimia or anorexia (or for another ED), but does not meet all of them.
In this case, we speak of an unspecified eating disorder (ASDN), a type of disorder that affects 3-5% of the population. In addition, the terms “atypical anorexia nervosa” or “bulimia” have also been frequently used. Atypical ”to refer to the existence of an Eating Disorder not specified.
On the other hand, in addition to the cases discussed, unspecified eating disorder also encompasses those cases in which the patient is in the initial phase of an eating disorder, or in the process of recovering from same.
They are disorders that can be as serious as another specified eating disorder, or even more. That is why they should always be given the importance they deserve.
What disorders does this category include?
We are going to see the types of Unspecified Eating Disorder included in the DSM-IV-TR (Diagnostic Manual of Mental Disorders).
1. Anorexia nervosa with regular menstruation
In this type of unspecified eating disorder, all the diagnostic criteria for anorexia nervosa appear, minus the criterion that refers to absent (amenorrhea) or irregular menstruation. In this case, the patient has a regular menstruation. It is worth mentioning that the amenorrhea criterion present in the DSM-IV-TR is eliminated in the 5th edition of the manual (DSM-5).
2. Anorexia nervosa with normal weight
The second type of Unspecified Eating Disorder refers to the presence of anorexia nervosa (with all its criteria), but that does not meet the criterion that indicates that the weight is less than expected in relation to the age, height and height of the patient.
That is, although the patient has lost a considerable amount of weight, at the present time her weight is normative (it is within the parameters of normality).
3. Atypical bulimia
Another type of unspecified eating disorder is atypical bulimia., in which the diagnostic criteria for it are met, minus the criteria for the frequency and duration of binges and inappropriate compensatory behaviors; in this case, they are given less than 2 times a week (the criterion requires a minimum of 2 times a week), or they last less than 3 months.
It could also be the case of an atypical bulimia where some other criterion other than the one mentioned is not met, but all the others are met.
4. Regular inappropriate compensatory behaviors
This unspecified eating disorder involves the appearance of inappropriate compensatory behaviors on a regular basis, after eating small amounts of food. The patient who suffers from it has a weight within normality according to her age, height and height.
However, other symptoms of some other eating disorder do not appear so that bulimia or anorexia can be diagnosed, for example.
5. Chew without swallowing
It may be the case that the patient chews the food and later expels it, without swallowing anything. This occurs with large amounts of food, and forms another type of unspecified eating disorder.
6. Compulsive disorder
The so-called compulsive disorder in the DSM-IV-TR (proposed for investigation in Appendix B thereof, and included finally as “binge-eating disorder” in DSM-5), it constitutes another non-eating disorder specified.
This is characterized in that the person who suffers from it eats large amounts of food without subsequently applying any compensatory behavior inappropriate (typical of bulimia nervosa).
Other unspecified ACTs
Beyond the diagnostic reference manuals (DSM), and in clinical practice, we can find two more types of eating disorders not specified that, although they do not appear as official diagnoses in the manuals themselves, they do exist (and are increasingly given more frequently) in the population.
We talk about the vigorexia and the orthorexia. But what does each of them consist of?
1. Vigorexia
Vigorexia is the pathological obsession to be muscular or muscular. It affects men more frequently than women, and it is a (relatively) recent-onset disorder that is increasing in prevalence.
This obsession with the muscular body translates into behaviors such as repeatedly looking in the mirror throughout the day (be it at the gym, the one at home, the one in the shop windows ...), and in eating only those substances that promote muscle growth (proteins and carbohydrates carbon). That is, the person reduces their fat intake (or eliminates it completely) to avoid losing muscle.
People with vigorexia are so obsessed with looking muscular that, paradoxically by what is believed, they can feel ashamed of being seen or watched (for example in the gym), since they feel that they never have “enough muscle to they wish ”.
2. Orthorexia
The second new unspecified eating disorder, and also recently appearing, is orthorexia. Unlike the previous one, in this case the obsession is to eat only healthy foods (ie, biologically "pure" foods). Unlike the “classic” eating disorders (bulimia and anorexia), where the obsession lies in the amount of food (which is the minimum), in orthorexia the obsession is with the quality of the food (which must be the best and the most healthy).
Thus, people with orthorexia make diet and healthy food the center and main objective of their lives; everything revolves around it. If they must get up first to cook, they do it; if they have to go to a wedding, they take a tupperware so they don't eat anything that is not healthy, etc. All these behaviors become pathological and only feed the obsession with health.
They are people who can spend several hours a day thinking about the diet they should do, the foods they should cook, etc. All these symptoms end up causing significant psychological discomfort, as well as physical, since end up abandoning products and foods essential for a correct and healthy functioning of the organism.
Causes
The causes of both eating disorders and unspecified EDs are often multifactorial, encompassing social, personal, biological, hormonal factors, etc.. However, there are usually specially related causal factors; Social pressure to be thin and fashions are at the root of anorexia, for example, especially among women.
On the other hand, binge-eating behaviors, for example, are related to poor coping mechanisms, characterized by impulsivity and an anxious personality.
Treatment
Ideally, the treatment of eating disorder unspecified should follow the treatment for eating disorder that most closely resembles eating disorder itself does not specified. On the other hand, it will always be advisable to address dysfunctional thoughts related to food, weight and body silhouette, through cognitive behavioral therapy.
Behavior therapy, meanwhile, is also widely used in these types of disorders, through Token Economy, positive reinforcement, differential reinforcement, etc.
Bibliographic references:
Ackard D, Fulkerson J, Neumark-Sztainer D. (2007). Prevalence and utility of DSM-IV eating disorder diagnostic criteria among youth. International Journal of Eating Disorders.; 40(5): 409-17.
APA (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid. Pan American.
Muñoz, R. and Martínez, A. (2007). Orthorexia and vigorexia: new eating disorders? Eating Disorders, 5: 457-482.