This is a brief video on eating disorders in the DSM-5, specifically focused on similarities and differences between anorexia, bulimia, and binge-eating disorder.
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ADDITIONAL TAGS: Eating disorders in the DSM-5 Anorexia nervosa Bulimia nervosa Binge- eating disorder Preoccupation with weight and body image resulting in low food absorption → low BMI (BMI 18.5) Restrictive: patient severely limits food intake Binge eating/purging: food intake followed by compensation (vomit, laxative/diuretic, and/or exercise) Coexist with perfectionism; depression Associated medical issues: starvation, osteoporosis → fractures, amenorrhea, anemia, electrolyte disturbances (refeeding syndrome, hypophosphatemia), hypothyroidism (euthyroid sick syndrome) with low T3/T4 but low/nl TSH, IUGR/prematurity in pregnancy, Treat with psychotherapy, low dose olanzapine (SSRIs ineffective unlike bulimia) Anorexia nervosa Bulimia nervosa Binge- eating disorder Anorexia nervosa Binge eating followed by compensatory behavior: Purge: vomit, laxative, diuretic Teeth and enamel erosion, esophageal tears, parotitis, thickened knuckles Non-purge: exercise or diet Patients are normal weight or overweight (BMI 18.5) Treat with psychotherapy and SSRIs (fluoxetine); bupropion is contraindicated Anorexia nervosa Bulimia nervosa Binge- eating disorder Bulimia nervosa The erosion on the lower teeth was caused by bulimia. For comparison, the upper teeth were restored with porcelain veneers. Binge eating WITHOUT compensatory behavior Therefore does not fit qualifications of bulimia At least three of the following: Eating quickly Eating alone out of embarrassment Eating until uncomfortably full Binge eating when not hungry Feelings of guilt/depression/disgust after eating Patients are often overweight / obese and suffer from metabolic syndrome, cardiovascular disease, and diabetes Treatment: psychotherapy, strict diet/exercise, stimulants and orlistat (pancreatic lipase inhibitor) may help Anorexia nervosa Bulimia nervosa Binge- eating disorder Binge-eating disorder Anorexia nervosa Bulimia nervosa Binge- eating disorder Anorexia nervosa Low food absorption (either restrict diet or binge/purge) → Low BMI Bulimia nervosa Binge then purge Tx: SSRIs Binge-eating disorder Binge WITHOUT purge Tx: stimulants, orlistat Binge eating Tx: psychotherapy Compensatory behavior Signs of purging/vomiting Bupropion contraindicated nl/high BMI
