Good Morning and here we are at another week!
*Update- Arghhh they lost! Ahh well, the commercials at least entertained me 
What I want to discuss today is something that was brought to my attention after I wrote the post on my internship last Monday. I realized an issue had been brought up when people commented on something in particular I wrote about, but I did not elaborate at the time… and now it is time to.
From Monday’s post, Although I have never been “officially” diagnosed Anorexia because I did not meet the DSM IV weight BMI weight requirement, I did have an eating disorder, disordered eating, whatever you want to call it.
When I first started blogging, I was very specific about using the term “disordered eater” when I would refer to myself. Back in March 2010 I even wrote a lengthy post on the critical reason I said disordered eating verses eating disorder. At that time, I felt it was essential that I differentiate between the two terms when I talk about myself.
For one thing, the two distinct terms have dissimilar definitions:
- Disordered eating includes a wide range of abnormal eating. This includes the behaviors seen in eating disorders such as anorexia and bulimia, chronic restrained eating, compulsive eating and habitual dieting. It includes irregular, chaotic eating patterns. Often physical hunger and satiety are ignored.
- “Official” eating disorders are ones that are recognized as medical conditions and these have strict criteria to define these conditions. We all know that these include: Anorexia nervosa, Binge eating disorder, Bulimia nervosa, and Eating Disorders Not Otherwise Specified (ED-NOS)
The Diagnostic and Statistical Manual of Mental Disorders, better known as the DSM-IV, is the manual published by the American Psychiatric Association and covers all mental health disorders for both children and adults. This is the manual that lists known causes of these disorders, statistics in terms of gender, age of onset, and prognosis as well as some research concerning the optimal treatment approaches.
The Fourth edition of the DSM has been out for several years now and therefore a new edition is due in the next few years. There are many changes being made in the next edition of the manual, and even some that focus on eating disorders (more on this later).
Currently this is the diagnostic criteria for Anorexia:
- A refusal to maintain body weight at or above a minimally normal weight for age and height (e.g. weight loss leading to a maintenance of body weight less than 85% of that expected, or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
- Intense fear of gaining weight or becoming fat, even though underweight.
- 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.
- Experiencing a lack of menstrual cycle (amenorrhea) for three consecutive months after a female has gone through puberty.
If a person does not meet all four of these criteria, they cannot be diagnosed with Anorexia. If this situation arises, the individual could then “claim” the title of EDNOS- Eating Disorder Not Otherwise Specified. And here-in lies the issue, the point I am attempting to make in this post…
When I first realized that I truly was sick and needed help, it took me a very long to understand the seriousness of my illness. It was “caught” early, before I was extremely underweight and before my body began to break down. 
At the time I recognized that my relationship with food and my body was quite abnormal, but there was still a large part of me that was in denial about the entire situation… “what’s the big deal” kind of thing.
I was below my ideal body weight, yet not low enough to meet the less than 85% criteria for Anorexia… therefore unable to claim this title for myself. Although the pounds would have continued to come off if I had never been confronted, that serious underweight status was never reached.
I want to make it clear that it’s not that I wanted to be diagnosed with an “official” disease. I believe if I had though, I would have reacted to the necessity of recovery differently and taken the state of my existence more seriously. I clearly remember these absurd thoughts from the darkest time of my life- yes I am underweight but not like those Anorexics! Come one now it’s not that bad, everyone is over reacting!!
When I first started Amazing Asset, I was very careful to use the term “disordered eating” verses eating disorder or Anorexia. I did not want to make myself seem sicker than I was, or give myself a diagnosis that I did not deserve to have. 
I was never like some of the terrifyingly skinny people I have seen with the official diagnosis, never even close… “I was much healthier and under control, definitely not as sick as them.”
The thing is though, I was as ill… and of course the thoughts, actions and reactions continue to linger. Just because I did not reach that critical underweight criteria, does not mean I DID not or DO not have an eating disorder. Underestimating the seriousness of my illness is something I believed has prolonged my recovery process, or at least has altered the way I approach my existence with this mental disorder.
In the past few months, you may or may not have noticed that I have been using the two distinct terms (DE and ED) interchangeably. As a matter of fact, lately I have been finding myself referring to my “eating disorder” problem rather than disordered eating, throughout my posts. In the grand scheme of things a simple title does not really matter at all… either way I am dealing with rather obnoxious, nagging sickness, whether it is “official” or not.
I don’t know what prompted me to start using ED verses DE, or when exactly I did. I can recall looking back on old posts one day and noticed that I had begun to…. and then deciding that perhaps it was not that big of a deal. However, this continues to be something I struggle with, basically whether I truly have the “right” to use the very meaningful term of eating disorder…Anorexia… a real, full blown-able-to-diagnosis mental illness.
Was I… Am I…. really and truly that sick?
Although the new edition of the DSM is now not being released until 2013, there are proposed revisions for the diagnostic criteria for Anorexia which include,
- Restriction of energy intake relative to requirements to a significantly low body weight in the context of age, sex, developmental trajectory and physical health. Significantly low weight is defined as weight that is less than minimally normal, or, for children and adolescents, less that that minimally expected.
- Intense fear of gaining weight or becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
- Disturbance in the way in which one’s body weight or shape is experiences, 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 first one here is the major change… the specific number of 85% is no longer being used, and other measures are being taken into account when addressing a person’s weight. However, this leads me to question this as well, as there are countless factors that play into a person’s weight.
Despite what my disordered/eating disorder brain believes, the whole idea of BMI is a load of crap. Furthermore, the number that is seen on the dreaded scale is beyond inaccurate, something we all know and must continue to remind ourselves of. The only thing that number does for someone with a similar situation as mine, is make you feel miserable, depressed, and hopeless.
Eating disorders run rampant in our society, and even worse than that, they are increasing. Every single day both women and men are being given the “official” titles because of their behaviors and physical health. Unfortunately there are thousands of other people that are slipping under the radar of having a serious eating disorder because of this strictness.
Because of not meeting each part of the criteria, they might not think their actions are a “big deal” or even worse, a person that needs critical care might not be able to get the help without the official diagnosis. There have been and will continue to be situations where insurance companies won’t pay for a specific treatment place or program because the individual is not sick enough… according to the books anyway.
So is this proposed revision really going to make a significant difference? I’m really not sure.
I do know this though, something needs to be changed in the diagnosing process as I strongly believe this be an additional step in the right direction to attempt to end this deadly illness once and for all.
-What are your thoughts on the current DSM IV criteria for eating disorders? Do you think modifying them would help treat this sickness?
-If you do think they ought to be modified, what kind of criteria would you suggest?
-If you were ever like me and was not underweight enough or did not practice specific habits to be diagnosed with an eating disorder, do you think having an “official” title would have/will make a difference for you? A difference in how you mentally approach your situation.
-Do you feel having a “title” or something you can point to and say this is my problem, really matters?
-And completely unrelated… how was your weekend?! What (if anything) did you do for the Superbowl? Any great recipes to share?
Yes wordy post for a Monday morning, but this is something I had been meaning to address since last week! Anyway I hope you all have a great rest of your day
Good Morning and here we are at another week!
*Update- Arghhh they lost! Ahh well, the commercials at least entertained me
What I want to discuss today is something that was brought to my attention after I wrote the post on my internship last Monday. I realized an issue had been brought up when people commented on something in particular I wrote about, but I did not elaborate at the time… and now it is time to.
From Monday’s post, Although I have never been “officially” diagnosed Anorexia because I did not meet the DSM IV weight BMI weight requirement, I did have an eating disorder, disordered eating, whatever you want to call it.
When I first started blogging, I was very specific about using the term “disordered eater” when I would refer to myself. Back in March 2010 I even wrote a lengthy post on the critical reason I said disordered eating verses eating disorder. At that time, I felt it was essential that I differentiate between the two terms when I talk about myself.
For one thing, the two distinct terms have dissimilar definitions:
The Diagnostic and Statistical Manual of Mental Disorders, better known as the DSM-IV, is the manual published by the American Psychiatric Association and covers all mental health disorders for both children and adults. This is the manual that lists known causes of these disorders, statistics in terms of gender, age of onset, and prognosis as well as some research concerning the optimal treatment approaches.
The Fourth edition of the DSM has been out for several years now and therefore a new edition is due in the next few years. There are many changes being made in the next edition of the manual, and even some that focus on eating disorders (more on this later).
Currently this is the diagnostic criteria for Anorexia:
If a person does not meet all four of these criteria, they cannot be diagnosed with Anorexia. If this situation arises, the individual could then “claim” the title of EDNOS- Eating Disorder Not Otherwise Specified. And here-in lies the issue, the point I am attempting to make in this post…
When I first realized that I truly was sick and needed help, it took me a very long to understand the seriousness of my illness. It was “caught” early, before I was extremely underweight and before my body began to break down.
At the time I recognized that my relationship with food and my body was quite abnormal, but there was still a large part of me that was in denial about the entire situation… “what’s the big deal” kind of thing.
I was below my ideal body weight, yet not low enough to meet the less than 85% criteria for Anorexia… therefore unable to claim this title for myself. Although the pounds would have continued to come off if I had never been confronted, that serious underweight status was never reached.
I want to make it clear that it’s not that I wanted to be diagnosed with an “official” disease. I believe if I had though, I would have reacted to the necessity of recovery differently and taken the state of my existence more seriously. I clearly remember these absurd thoughts from the darkest time of my life- yes I am underweight but not like those Anorexics! Come one now it’s not that bad, everyone is over reacting!!
When I first started Amazing Asset, I was very careful to use the term “disordered eating” verses eating disorder or Anorexia. I did not want to make myself seem sicker than I was, or give myself a diagnosis that I did not deserve to have.
I was never like some of the terrifyingly skinny people I have seen with the official diagnosis, never even close… “I was much healthier and under control, definitely not as sick as them.”
The thing is though, I was as ill… and of course the thoughts, actions and reactions continue to linger. Just because I did not reach that critical underweight criteria, does not mean I DID not or DO not have an eating disorder. Underestimating the seriousness of my illness is something I believed has prolonged my recovery process, or at least has altered the way I approach my existence with this mental disorder.
In the past few months, you may or may not have noticed that I have been using the two distinct terms (DE and ED) interchangeably. As a matter of fact, lately I have been finding myself referring to my “eating disorder” problem rather than disordered eating, throughout my posts. In the grand scheme of things a simple title does not really matter at all… either way I am dealing with rather obnoxious, nagging sickness, whether it is “official” or not.
I don’t know what prompted me to start using ED verses DE, or when exactly I did. I can recall looking back on old posts one day and noticed that I had begun to…. and then deciding that perhaps it was not that big of a deal. However, this continues to be something I struggle with, basically whether I truly have the “right” to use the very meaningful term of eating disorder…Anorexia… a real, full blown-able-to-diagnosis mental illness.
Was I… Am I…. really and truly that sick?
Although the new edition of the DSM is now not being released until 2013, there are proposed revisions for the diagnostic criteria for Anorexia which include,
The first one here is the major change… the specific number of 85% is no longer being used, and other measures are being taken into account when addressing a person’s weight. However, this leads me to question this as well, as there are countless factors that play into a person’s weight.
Despite what my disordered/eating disorder brain believes, the whole idea of BMI is a load of crap. Furthermore, the number that is seen on the dreaded scale is beyond inaccurate, something we all know and must continue to remind ourselves of. The only thing that number does for someone with a similar situation as mine, is make you feel miserable, depressed, and hopeless.
Eating disorders run rampant in our society, and even worse than that, they are increasing. Every single day both women and men are being given the “official” titles because of their behaviors and physical health. Unfortunately there are thousands of other people that are slipping under the radar of having a serious eating disorder because of this strictness.
Because of not meeting each part of the criteria, they might not think their actions are a “big deal” or even worse, a person that needs critical care might not be able to get the help without the official diagnosis. There have been and will continue to be situations where insurance companies won’t pay for a specific treatment place or program because the individual is not sick enough… according to the books anyway.
So is this proposed revision really going to make a significant difference? I’m really not sure.
I do know this though, something needs to be changed in the diagnosing process as I strongly believe this be an additional step in the right direction to attempt to end this deadly illness once and for all.
-What are your thoughts on the current DSM IV criteria for eating disorders? Do you think modifying them would help treat this sickness?
-If you do think they ought to be modified, what kind of criteria would you suggest?
-If you were ever like me and was not underweight enough or did not practice specific habits to be diagnosed with an eating disorder, do you think having an “official” title would have/will make a difference for you? A difference in how you mentally approach your situation.
-Do you feel having a “title” or something you can point to and say this is my problem, really matters?
-And completely unrelated… how was your weekend?! What (if anything) did you do for the Superbowl? Any great recipes to share?
Yes wordy post for a Monday morning, but this is something I had been meaning to address since last week! Anyway I hope you all have a great rest of your day