psychiatric disorders
Anorexia Nervosa
Diagnosis of Anorexia Nervosa
Clinical criteria Not recognizing the seriousness of the low body weight and restrictive eating are prominent features of anorexia nervosa. Patients resist evaluation and treatment; they are usually brought to the physician’s attention by family members or by intercurrent illness. for diagnosis of anorexia nervosa ( Diagnosis reference ) include the following: Restriction of food intake resulting in a significantly low body weight Fear of excessive weight gain or obesity (stated specifically by the patient or manifested as behavior that interferes with weight gain) Body image disturbance (misperception of body weight and/or appearance) or denial of the seriousness of illness In adults, low body weight is defined using the body mass index (BMI). BMI of<17 kg/m2is considered significantly low; BMI 17 to<18.5 kg/m2may be significantly low depending on the patient's starting point. For children and adolescents, the BMI percentile for age is used; the 5th percentile is usually given as the cutoff. However, children above the 5th percentile who have not maintained their projected growth trajectory may also be considered to meet the criterion for low body weight; BMI percentile for age tables and standard growth charts are available from the Centers for Disease Control and Prevention (seeCDC Growth Charts). Separate BMI calculators are available for children and adolescents. Patients may otherwise appear well and have few, if any, abnormalities in blood tests. The key to diagnosis is identifying persistent active efforts to avoid weight gain and an intense fear of fatness that is not diminished by weight loss. Another psychiatric disorder, such as Schizophrenia or primary Rarely, an unrecognized severe physical disorder may cause substantial weight loss. Disorders to consider include Overview of Malabsorption (eg, due to inflammatory bowel disease or celiac disease), new-onset type 1 1.Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision, DSM-5-TRTM, Feeding and eating disorders. 