Diagnosing an Eating Disorder

Written by Valencia Higuera | Published on December 22, 2014
Medically Reviewed by George Krucik, MD, MBA on September 24, 2012

Diagnosing an Eating Disorder

People who have an eating disorder may eat too little or eat unusually large amounts of food. Additionally, they may be extremely preoccupied with their shape or weight.

Eating disorders can affect anyone. However, females are more likely than males to have this illness, according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD). In fact, only an estimated 10 to 15 percent of people with anorexia or bulimia are males.

There are four main types of eating disorders.

  • Anorexia nervosa: People with this condition don’t eat enough and they may have an extremely thin appearance.
  • Bulimia nervosa: People with this condition overeat, and then purge to avoid gaining weight. They may also abuse laxatives and diet pills.
  • Binge eating: People with this condition eat uncontrollably, but they don't purge.
  • EDNOS: This term refers to “eating disorders not otherwise specified”. According to the ANAD, 52 percent of people with an eating disorder have EDNOS.

The exact cause of eating disorders is unknown, but several factors can contribute to the disease. Eating disorders may begin in the teen and young adult years when many people are preoccupied with their self-image. This illness can run in families. Some emotional disorders, like obsessive-compulsive disorder and depression, increase the risk for an eating disorder.

Because eating disorders can have serious, life-threatening complications, it’s important to get help for these conditions. But before a doctor can treat anorexia, bulimia, or binge eating, they have to diagnose the condition.

Some people may deny a problem, but certain signs can indicate a problem with food.

Doctors use physical evaluations and psychological evaluations to diagnose eating disorders. They’ll also make sure you meet the diagnostic criteria for an eating disorder as outlined in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association (APA).

Physical Evaluations

Physical Exam

During a physical exam, your doctor may check your height, weight, and vital signs. Since eating disorders can cause high or low blood pressure, slow breathing, and slow pulse rates, doctors also listen to lungs and heart.

An examination of your abdomen may take place. Additionally, your doctor may check your skin and hair for dryness, or look for brittle nails. Doctors may ask about any other possible problems, like a sore throat or intestinal issues, which can be complications of bulimia.

Laboratory Tests

Since eating disorders damage the body and cause problems with vital organs, doctors may run many laboratory tests. These can include a complete blood count, a liver, kidney and thyroid function tests, and a urinalysis.

Your doctor may also order an X-ray to look for broken bones, which can be a sign of bone loss from anorexia or bulimia. An electrocardiogram can check for heart irregularities. Your doctor may examine your teeth for signs of decay, which is another symptom of an eating disorder.

Psychological Evaluations

Doctors don’t diagnose eating disorders based entirely on a physical exam. A psychological evaluation by a mental health doctor is also required.

Your doctor will ask several questions related to your eating habits. Their goal is to understand your attitude toward food and eating, plus get an idea of how you perceive your body. These questions can become personal, especially when the discussions focus on your dieting, binging, purging, or extreme exercise habits. It's important to answer honestly. This way, your doctor can make an accurate diagnosis and recommend an effective treatment plan.

Review Diagnostic Criteria for Eating Disorders

To be diagnosed with an eating disorder, you must meet the criteria for a specific type of disorder. Signs and symptoms of eating disorders vary, but may include:

Anorexia Nervosa

Symptoms of anorexia nervosa include:

  • thin appearance
  • insomnia
  • extreme tiredness
  • dizziness or fainting spells
  • bluish nails
  • brittle hair and nails
  • constipation
  • dry skin
  • irregular heart rhythm

Bulimia Nervosa

Symptoms of bulimia nervosa include:

  • fear of gaining weight
  • extreme use of weight loss supplements
  • forced vomiting
  • extreme exercising
  • regularly using laxatives, diuretics, or enemas

Binge Eating

Symptoms of binge eating include:

  • eating unusual large portions of food
  • eating until uncomfortably full
  • insists on eating alone to hide disorder
  • constantly dieting, but not losing weight
  • depression and anxiety

Conclusions

In the United States, 20 million women and 10 million men suffer from eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder at some point in their life, according to the National Eating Disorders Association (NEDA). It's a serious illness that can lead to life-threatening complications like organ failure and death. But with a timely diagnosis, you can receive necessary treatment and live a long, healthy life.

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Show Sources

  • Eating Disorders. (2011). National Institute of Mental Health - U.S. Department of Health and Human Services. Retrieved May 21, 2012, from www.nimh.nih.gov/health/.../eating-disorders/eating-disorders.pdf
  • Eating Disorders. (2012). American Psychiatric Association. Retrieved September 25, 2012, from http://www.dsm5.org/proposedrevisions/pages/eatingdisorders.aspx

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