Chapter 34Assessment of Eating Disorders

1. Are you unhappy with your body weight and shape?
2. Are you dieting? Have you dieted much in the past?
3. Have you lost weight?
4. Some people eat large quantities of food in an out-of-control way. Has this ever happened to you?

If Yes, Continue to:

5. Many people, after eating this way, feel very badly about themselves. Do you ever feel badly about yourself after eating in this way?
6. Many people then try to compensate for this eating or to get rid of the food somehow. Has this ever happened to you?
7. How often do you currently exercise? Do you feel comfortable missing a day here and there? Does your exercise feel out of control?
8. Have others expressed concerns about your eating, exercising or weight?
9. Are you concerned about your health?

1. What is the most you have ever weighed? When was that?
2. What is the least you have ever weighed? When?
3. What do you think you should weigh?
4. When you look in the mirror do you think you should gain weight, lose weight or stay the same?
5. How often do you exercise each week? How long does each session last?
6. [For Females]: Is your menstrual cycle regular?

1. Has your weight fluctuated much over the last few years?
2. Some people eat large quantities of food in an out-of-control way. Does this ever happen to you?
3. Many people, after eating this way, feel very badly. Do you ever feel badly about yourself after eating in this way?
4. Many people then try to compensate for this eating by getting rid of the food or compensating for it somehow. Has this ever happened to you? Have you ever tried to make yourself sick/vomit? Have you ever taken laxatives? Have you ever exercised to make up for a meal/snack/binge?
5. How often do you exercise each week? How long does each session last?
6. What is your motivation for exercising?
7. Do you feel your exercise is out of control?

1. Many people eat large quantities of food in an out-of-control way. Does this ever happen to you? How often?
2. How long does each eating session last?
3. Many people, after eating in this way feel very badly. Do you ever feel badly about yourself after eating this way (e.g. experience guilt, shame or despair)?
4. Many people then try to compensate for this eating by getting rid of the food or compensating for it somehow. Has this ever happened to you (e.g. making yourself sick / exercising / using laxatives)?
5. Have you undergone any surgery to help with your weight concerns (e.g. bariatric surgery)?

• A. Eating or feeding disturbance (e.g. lack of interest; avoidance based on sensory characteristics; concerns about adverse consequences of eating) manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one or more of: significant weight loss (or faltering growth in children); significant nutritional deficiency; dependence on enteral feeding or oral nutritional supplements; or marked interference with psychosocial functioning
• B. Disturbance not better explained by lack of available food, or associated culturally sanctioned practice
• C. Disturbance does not occur exclusively in course of Anorexia Nervosa or Bulimia Nervosa, and no evidence of disturbance in the way one’s body weight or shape is experienced
• D. Disturbance not attributable to concurrent medical condition or better explained by another mental disorder.
• Specify if in remission: Criteria not met for sustained period of time.

• A. Restriction of energy intake relative to requirements leading to significantly low body weight (less than minimally normal or minimally expected for children/adolescents) in context of age, sex, developmental trajectory and physical health.
• B. Intense fear of gaining weight or of becoming fat, or persistent behaviour that interferes with weight gain, event though at a significantly low weight.
• C. Disturbance in the way 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.
• D. Specify Restricting or Binge-eating/Purging Type:
  • a. Restricting type: During last 3 months, individual has not engaged in recurrent episodes of binge-eating or purging behaviour (i.e. self-induced vomiting or misuse of laxatives, diuretics or enemas). Weight loss accomplished primarily through dieting, fasting, and/or excessive exercise.
  • b. Binge-Eating/Purging Type: During last 3 months, individual has engaged in recurrent episodes of binge-eating or purging behaviour.
• Specify if in partial or full remission: Partial Remission = Criterion A no longer met for sustained period but either Criterion B or C continue to be met; Full Remission = Criteria not met for sustained period.
• Specify current severity: Mild (BMI >17); Moderate (BMI 16-17); Severe (BMI 15-16); Extreme (BMI <15)

• A. Recurrent episodes of binge eating (i.e. eating in a discrete <2hr period of time an amount of food definitely larger than what most individuals would eat in a similar period of time under similar circumstances, with a sense of lack of control overeating during the episode)
• B. Recurrent inappropriate compensatory behaviours to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise.
• C. Binge eating and inappropriate compensatory behaviours both occur average of ≥1/week x 3 months
• D. Self evaluation is unduly influenced by body shape and weight.
• E. The disturbance does not occur exclusively during episodes of anorexia nervosa.
• Specify if in partial or full remission: Partial Remission = Some criteria continue to be met for a sustained period of time; Full Remission = Criteria not met for sustained period of time.
• Specify current severity: Mild (1-3 episodes of compensatory behaviours/week); Moderate (4-7/week); Severe (8-13/week); Extreme (14+/week)

• A. Recurrent episodes of binge eating (i.e. eating in a discrete <2hr period of time an amount of food definitely larger than what most individuals would eat in a similar period of time under similar circumstances, with a sense of lack of control overeating during the episode)
• B. Binge Eating episodes associated with 3+ of the following: (1) Eating much more rapidly than normal; (2) Eating until feeling uncomfortably full; (3) Eating large amounts of food when not feeling physically hungry; (4) Eating alone because of feeling embarrassed by how much one is eating; (5) Feeling disgusted with oneself, depressed, or very guilty afterward.
• C. Marked distress regarding binge eating is present.
• D. Binge eating occurs, on average, at least once a week for 3 months.
• E. Binge eating not associated with recurrent use of inappropriate compensatory behaviour as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.
• F. Specify if in partial or full remission: Partial Remission = <1 episode/week for sustained period of time; Full Remission = Criteria not met for sustained period of time.
• G. Specify current severity: Mild (1-3 binge eating episodes/week); Moderate (4-7/week); Severe (8-13/week); Extreme (14+/week)