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Anorexia Nervosa (AN)

Detailed Diagnostic Criteria

Detailed diagnostic criteria are taken from the Diagnostic Statistical Manual, 5th edition (DSM-V).

  1. Restriction of energy intake relative to requirements, leading to a significant low body weight in the context of age, sex, developmental trajectory, and physical health (less than minimally normal/expected).
  2. Intense fear of gaining weight or becoming fat or persistent behavior that interferes with weight gain.
  3. Disturbance in the way in which one's body weight, size, or shape is experienced (i.e. body image disturbance); denial of the seriousness of the current low body weight.
  4. Subtypes:
    • Restricting Type: During the last 3 months, the person has not regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)
    • Binge-Eating/Purging Type: During the last 3 months, the person has regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas). 

Prevalence of Anorexia

 According to Keel (2005) and Wilson, Grilo & Vitousek (2007), the prevalence of eating disorders is as follows: 

  • The female-to-male ratio is 10:1
  • The percentage of women who have had anorexia at some point in their lifetime (lifetime prevalence) is 0.5%

Typical Course of Anorexia Nervosa

Keel (2005), Steinhausen (2002) and Wilson, Grilo & Vitousek (2007) describe the typical onset and course of eating disorders; Leigh (2019) provides recovery statistics:

  • Onset: usually early to late adolescence
  • Approximately 21% make a full recovery (an absence of all clinical symptoms).
  • 75 % improve but remain symptomatic
  • 20% the illness becomes chronic and remitting
  • 5% of those diagnosed eventually die – this is the highest mortality of any psychiatric disorder.
    • The leading cause of death is medical complications.
    • The second most common cause is suicide.
  • 51% of patients hospitalized eventually require a second hospitalization
  • 10-50% of individuals with anorexia cross over to bulimia

Last updated:  18 March 2021