Eating disorders in adolescent females with and without type 1 diabetes: cross sectional study -- Jones et al. 320 (7249): 1563 Data Supplement

Diagnostic criteria for eating disorders
Anorexia nervosa*

Refusal to maintain body weight at or above a minimally normal weight for age and height

Intense fear of gaining weight or becoming fat, even though underweight

Disturbance in the way in which body weight or shape is experienced; undue influence of body weight and shape on self evaluation, or denial of the seriousness of current low body weight

In postmenarchal females, amenorrhea—that is absence of at least three consecutive menstrual cycles (a woman is considered to have amenorrhea if her periods occur only after hormone administration) Bulimia nervosa*

Recurrent episodes of binge eating

Recurrent inappropriate compensatory behaviour to prevent weight gain, such as self induced vomiting; misuse of laxatives, diuretics, or other drugs (including insulin); fasting; or excessive exercise

Binge eating and inappropriate compensatory behaviours both occur, on average, at least twice a week for three months

Self evaluation is unduly influenced by body shape and weight

Disturbance does not occur exclusively during episodes of anorexia nervosa Eating disorder not otherwise specified

All the criteria for anorexia nervosa except amenorrhea; or

All criteria for anorexia nervosa, except that the subject does not report a fear of weight gain or a disturbance in the way in which her body weight or shape is experienced; or

All criteria for bulimia nervosa except that the subject does not report self evaluation being unduly influenced by shape or weight; or

All the criteria for bulimia nervosa except that binge eating and purging behaviour occurred at least once a week for past 3 months, or twice a week over the previous four weeks; or

Regular inappropriate compensatory behaviour in the absence of binge eating—for example, recurrent self induced vomiting or insulin omission for shape and weight control at least once a week for past three months or twice weekly over previous four weeks; or

Recurrent episodes of objective binge eating (at least once a week for past three months or twice weekly over past four weeks) Subthreshold disorders

Occasional (a minimum of three episodes) binge eating or purging over past three months; or

Repeated chewing and spitting out of food to prevent weight gain (at least once a week over the preceding three months or twice a week over the past four weeks); or

Regular extreme dietary restraint (<2.1 MJ/day) or excessive exercising (more than 120 minutes, 5 times a week) for purpose of weight loss over past 4 weeks in absence of binge eating

*Minimum of four symptoms needed for diagnosis