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Anorexia Nervosa Binge-Eating Purging

Anorexia nervosa is a medical condition that causes a person to view themselves as overweight, even when they are not. Their obsession with weight can consume them, causing them to significantly restrict the calories they take in, weigh themselves frequently, and often exercise excessively in an attempt to lose more weight. Doctors further divide anorexia nervosa into subtypes, which includes the binge eating/purging subtype.1

A person with anorexia is often dangerously underweight. The lack of nutrition can cause multiple health symptoms, including bone thinning, heart damage, low blood pressure, and multi-organ failure that can prove deadly.2  Identifying and intervening whenever possible for a person with anorexia nervosa is vital to saving their life. Keep reading to find out more about how medical professionals can identify anorexia nervosa binge-eating purging.

How the DSM-5-TR Defines Anorexia Nervosa

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision (DSM-5-TR) is the manual by which doctors diagnose mental health disorders.1 These criteria are very important because they ensure that a doctor in New York State diagnoses a person in the same manner as a person in Arizona. With consistent diagnosis can come more consistent treatment.

The DSM-5-TR defines anorexia nervosa with three major criteria:

  • Restriction: A person with anorexia nervosa will significantly restrict their calorie intake, which leads them to develop a low body weight relative to their size, gender, and age.
  • Fear: Those with anorexia fear gaining weight. They will engage in behaviors to avoid gaining weight, even though these fears are unfounded.
  • Lack of recognition: Many people who suffer with anorexia nervosa cannot recognize or acknowledge that they are underweight or have a medical problem. Even when they are severely underweight, they will not recognize the severity of their condition.

The DSM-5-TR further defines anorexia nervosa by severity — a person with a body mass index (BMI) of less than 15 is classified as having an “extreme” disorder.1

What Are the DSM-5-TR Criteria for Anorexia Nervosa Binge-Eating/Purging Type?

The DSM-5-TR criteria further divides anorexia nervosa into a restricting type or binge-eating/purging type. To meet these purging anorexia criteria, a person must have engaged in the following within the past three months:1

  • induced vomiting
  • misused laxatives as a means to lose weight
  • used diuretics (water pills) to reduce their weight
  • used enemas to go to the bathroom and lose more weight via their stool

The other DSM-5-TR criteria subtype for anorexia nervosa is the restricting type.1 People with this condition do not engage in binge eating or purging behaviors. Instead, they usually try to lose weight by dieting, refraining from eating, or engaging in excessive exercise routines.

Help for Those With Anorexia Nervosa Binging-Eating Purging Disorder

Because a person with anorexia nervosa binge-eating purging disorder often does not recognize they have the condition, it can be very difficult to get them to seek diagnosis and treatment. Unfortunately, they are also at risk for mental health disorders, including depression and anxiety.3 They also experience higher rates of suicide than a person who does not have anorexia nervosa.3

Learning how to recognize anorexia nervosa via the DSM-5-TR symptoms can help medical professionals identify those who need to seek help. Treatments for anorexia nervosa include medical care and monitoring as well as therapy, nutritional counseling, and taking medications to treat underlying medical conditions.3

While the process for treating eating disorders like anorexia nervosa can be difficult on the part of the individual and their family, treatment can work and a person can live a healthier, happier life.

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Written by Rachel Nall, RN, MSN, CRNA


1Mustelin, L., Silen, Y., Raevuori, A., Hoek, H.W., Kaprio, J., & Keski-Rahkonin, A. (2016). The DSM-5 diagnostic criteria for anorexia nervosa may change its population prevalence and prognostic value. Journal of Psychiatric Research. 77, 85-91. doi: 10.1016/j.jpsychires.2016.03.003

2Gibson, D., Workman, C., & Mehler, P.S. (2019). Medical complications of anorexia nervosa and bulimia nervosa. Medical complications of anorexia nervosa and bulimia nervosa. The Psychiatric Clinics of North America. 42(2): 263-274. doi: 10.1016/j.psc.2019.01.009

3Moskowitz, L., & Weiselberg, E. (2017). Anorexia nervosa/atypical anorexia nervosa. Current Problems in Pediatric and Adolescent Health Care. 47(4): 70-84. doi: 10.1016/j.cppeds.2017.02.003