Management of eating disorders for people with higher weight: clinical practice guideline

Table 1 Overview of DSM-5 diagnostic criteria for eating disorders

	Anorexia nervosa	Bulimia nervosa	Binge-eating disorder	Avoidant/restrictive food intake disorder (ARFID)	Other specified feeding or eating disorder (OSFED)
Overvaluation weight &/or shape	Required	Required	May be present	Not present	May be present
Fear of fatness and/or behaviour preventing weight gain	Required	May be present	May be present	None but food is restricted	May be present
Underweight	Required^a	Not present	Not present	May be present	May be present
Unmet nutritional and/or energy needs	Required	May be present	May be present	Required	May be present, likely in atypical anorexia nervosa
Weekly binge eating	May be present	Required	Required with distress and 3/5 descriptors^c	Not present	May be present, likely in night eating syndrome
Weekly compensation^b	May be present	Required	Not present	Not present	Likely in atypical anorexia nervosa and purging disorder but is not compensatory to binge eating
Remission specifier^d	Partial/full	Partial/full	Partial/full	In remission	None
Severity specifier	BMI scale	Frequency of compensation	Frequency of binge eating	None	None

If anorexia nervosa is present, by definition no other eating disorder will be present. If avoidant/restrictive food intake disorder (ARFID) is present, by definition anorexia nervosa and bulimia nervosa are not present. Unspecified Feeding or Eating Disorder (UFED) has no specific criteria
^aIn the ICD-11 people with anorexia nervosa who are not underweight (i.e., atypical anorexia nervosa in the DSM-5) can be classified under anorexia nervosa, and this is adopted when referring to treatment of anorexia nervosa in these guidelines (see also “Background to eating disorders and how they occur” section)
^bWeekly compensation can include, but is not limited to severe dietary restriction, driven exercise and/or purging
^cDescriptors include: eating much more rapidly than normal; eating until feeling uncomfortably full; eating large amounts of food when not feeling physically hungry; eating alone because of feeling embarrassed by how much one is eating; or feeling disgusted with oneself, depressed, or very guilty afterward
^dIf the criteria are no longer met, the specifier indicates whether the eating disorder is in partial or full remission

ISSN: 2050-2974