Operationalizations in the CIDI of Criteria for Subclinical Anorexia and Bulimia
| Criteria | Operationalization from CIDI |
|---|---|
| Subclinical Anorexia | |
| Intense fear of gaining weight or becoming fat, even though underweight | Yes on EA6:
At the time you weighed (weight reported in EA2) were you very afraid that you might gain weight? |
| Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low-body weight | Yes on at least one of the following four questions:
EA10: Did you feel like you were heavier than you should have been or heavier than you wanted to be? EA10b: Did you think some parts of your body were too fat? EA10c: Did you feel like your self-esteem or confidence depended on your ability to stay thin or to lose even more weight? EA10d: Did anyone tell you that your low weight was bad for your health? |
| Full Syndrome Bulimia | |
| Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: | |
| (1) Eating, in a discrete period of time (e.g., within any 2-h period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances. | (1) Yes on EA16:
The next question is about “eating binges” when a person eats a large amount of food during a short period like 2 h. By a “large amount” I mean eating so much food that it would be like eating two or more entire meals in one sitting, or eating so much of one particular food—like candy or ice cream—that it would make most people feel sick. With that definition mind, did you ever have a time in your life when you went on eating binges at least twice a week for several months or longer? |
| (2) A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating). | (2) Yes on at least one of the following four questions indicative of loss of control:
EA17a: Did you eat until you felt uncomfortably full? EA17b: Did you usually continue to eat even when you did not feel hungry? EA17c: Did you usually eat alone because you were embarrassed by how much you ate? EA17h: Did you often get upset both during and after binges that your eating was out of your control? |
| Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting, or excessive exercise. | Yes on at least one of the following:
Did you ever do any of the following things regularly after binging in order to control your weight: EA23a: Did you fast by not eating at all or only taking liquids for 8 h or longer? EA23b: Did you take water pills, diuretics, or weight-control medicines? EA23c: Did you make yourself vomit? EA23d: Did you take laxatives or enemas? EA23e: Did you exercise excessively? |
| Self-evaluation is unduly influenced by body shape and weight. | Yes on EA17f:
Did you feel like your self-esteem and confidence depended on your weight and body shape? |
| The disturbance does not occur exclusively during episodes of anorexia nervosa. | In cases that met criteria for anorexia nervosa, as defined above, there was evidence that bulimia nervosa was present at times when anorexia nervosa was absent, as evidenced by:
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