What are the DSM-5 diagnostic criteria for anorexia nervosa?

Updated: Jun 10, 2019
  • Author: Bettina E Bernstein, DO; Chief Editor: Caroly Pataki, MD  more...
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Diagnostic criteria for anorexia nervosa in the DSM-5 include the following [11] :

  • Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health; significantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents, less than that minimally expected

  • Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though the patient’s weight is already significantly low

  • 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 persistent lack of recognition of the seriousness of the current low body weight

The DSM-5, which was published in May 2013, revised the definition of anorexia from the DSM-IV to focus more on behaviors, such as calorie restricting, and removed the qualification of low weight being less than 85% ideal body weight. Additionally, the criterion of amenorrhea in postmenarchal females was completely removed from the definition. (See Clinical Presentation.)

The prevalence of subthreshold eating conditions supports the notion that eating disorders tend to exist along a spectrum and that, if defined by a broader range of symptoms, might be better recognized by doctors. (See Workup, Treatment, and Medication.) [16]

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