We are talking about this subtype of TCAs.
Eating disorders (ED) encompass those mental disorders focused on food, the perception of the body and the fear of gaining weight. Typical eating disorders are anorexia nervosa and bulimia.
However, when not all criteria are met for them, but significant symptoms do appear, we are talking about an unspecified eating disorder. In this article we will know eight of them. We will also talk about the causes and treatments of eating disorders.
Eating disorders (eating disorders): what are they?
Eating disorders (EDs) are mental disorders that can be very serious. In them, the main concerns of the patient are food and the perception of the body silhouette.
The eating disorders par excellence are anorexia nervosa and bulimia. In both there is an excessive fear of getting fat; they are similar disorders, although with diverse symptoms. The difference between these two disorders, broadly speaking, is that in anorexia nervosa the body weight is usually lower than in bulimia (and by extension the Body Mass Index [BMI] as well).
Furthermore, in bulimia, the presence of binge eating and inappropriate compensatory behaviors (vomiting, use of laxatives, diuretics …) appears as a diagnostic criterion, something that does not occur in anorexia. This does not mean that these symptoms cannot appear in anorexia.
Eating disorder, unspecified
However, it can happen that symptoms of one of these two eating disorders appear, but not all. That is, it may happen that a person meets some diagnostic criteria for bulimia or anorexia (or for another ED), but not all.
In this case, we are talking about an unspecified eating disorder (ASDN), a type of disorder that affects 3-5% of the population. Furthermore, the terms “atypical anorexia nervosa” or “atypical bulimia” have also frequently been used to refer to the existence of an unspecified Eating Disorder.
On the other hand, in addition to the cases mentioned, unspecified eating disorder also encompasses those cases in which the patient is in the initial phase of an eating disorder, or in the process of recovering from it.
They are disorders that can be as serious as another specified eating disorder, or even more. That is why they should always be given the importance they deserve.
What disorders does this category include?
We are going to see the types of Unspecified Eating Disorder included in the DSM-IV-TR (Diagnostic Manual of Mental Disorders).
1. Anorexia nervosa with regular menstruation
In this type of unspecified eating disorder, all the diagnostic criteria for anorexia nervosa appear, except for the criteria that refer to absent (amenorrhea) or irregular menstruation. In this case, the patient has a regular menstruation. It is worth mentioning that the amenorrhea criterion present in the DSM-IV-TR is eliminated in the 5th edition of the manual (DSM-5).
2. Anorexia nervosa with normal weight
The second type of Unspecified Eating Disorder refers to the presence of anorexia nervosa (with all its criteria), but does not meet the criteria that indicate that the weight is less than expected in relation to age, height and size of the patient.
In other words, although the patient has lost a considerable amount of weight, at the present time his / her weight is normative (it is within the parameters of normality).
3. Atypical bulimia
Another type of unspecified eating disorder is atypical bulimia, in which the diagnostic criteria for it are met, minus the criteria for the frequency and duration of binge eating and inappropriate compensatory behaviors; in this case, they are given less than 2 times a week (the criterion requires a minimum of 2 times a week), or they last less than 3 months.
It could also be the case of an atypical bulimia where some other criteria other than the one mentioned are not met, but all the others are met.
4. Regular inappropriate compensatory behaviors
This unspecified eating disorder involves the appearance of inappropriate compensatory behaviors on a regular basis, after ingesting small amounts of food. The patient who suffers from it has a weight within normality according to his / her age, height and height.
However, no other symptoms of any other eating disorder appear so that bulimia or anorexia can be diagnosed, for example.
5. Chew without swallowing
It may be the case that the patient chews the food and later expels it, without actually swallowing anything. This occurs with large amounts of food, and forms another type of unspecified eating disorder.
6. Compulsive disorder
The so-called compulsive disorder in DSM-IV-TR (proposed for investigation in Appendix B of the same, and finally included as “binge-eating disorder” in DSM-5), constitutes another unspecified eating disorder.
This is characterized because the person who suffers from it eats large amounts of food without subsequently applying any inappropriate compensatory behavior (typical of bulimia nervosa).
Other unspecified TCAs
Beyond the diagnostic reference manuals (DSM), and in clinical practice, we can find two more types of unspecified eating disorders that, although they do not appear as official diagnoses in the same manuals, do exist (and each time occur more frequently) in the population.
We speak of vigorexia and orthorexia. But what does each one of them consist of?
Vigorexia is the pathological obsession to be muscular or muscular. It affects men more frequently than women, and it is a (relatively) recent-onset disorder that is increasing in prevalence.
This obsession with the muscular body translates into behaviors such as repeatedly looking in the mirror throughout the day (be it the gym, the home, the shop windows …), and eating only those substances that favor the growth of the body. muscle (protein and carbohydrates). That is, the person reduces their fat intake (or eliminates it completely) to avoid losing muscle.
People with vigorexia are so obsessed with looking muscular that, paradoxically by what is believed, they can feel ashamed of being seen or looked at (for example in the gym), since they feel that they never have “enough muscle to they wish ”.
The second new unspecified eating disorder, and also recently appearing, is orthorexia. Unlike the previous one, in this case the obsession is to eat only healthy foods (that is, biologically “pure” foods). Unlike the “classic” eating disorders (bulimia and anorexia), where the obsession lies in the quantity of food (keep it the minimum), in orthorexia the obsession is in the quality of the food (which should be the best and the healthier).
Thus, people with orthorexia make diet and healthy food the center and main objective of their lives; everything revolves around it. If they must get up first to cook, they do it; if they have to go to a wedding, they take a tupperware so they don’t eat anything that isn’t healthy, etc. All these behaviors become pathological and only feed the obsession with health.
They are people who can spend several hours a day thinking about the diet they should do, the foods they should cook, etc. All these symptoms end up causing significant psychological discomfort, as well as physical, since they end up abandoning products and essential foods for a correct and healthy functioning of the body.
The causes of both eating disorder and eating disorder not otherwise specified, usually multifactorial, encompassing social, personal, biological, hormonal, etc. factors. However, there are usually causal factors that are especially related; Peer pressure to be thin and fashions are at the root of anorexia, for example, especially among women.
On the other hand, binge-eating behaviors, for example, are related to poor coping mechanisms, characterized by impulsivity and an anxious personality.
Ideally, eating disorder unspecified should follow the eating disorder treatment that most closely resembles the eating disorder unspecified itself. On the other hand, it will always be advisable to address dysfunctional thoughts related to food, weight and body silhouette, through cognitive behavioral therapy.
Behavior therapy, for its part, is also widely used in these types of disorders, through token economy, positive reinforcement, differential reinforcement, etc.
Ackard D, Fulkerson J, Neumark-Sztainer D. (2007). Prevalence and utility of DSM-IV eating disorder diagnostic criteria among youth. International Journal of Eating Disorders .; 40 (5): 409-17.
APA (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid. Pan American.
Muñoz, R. and Martínez, A. (2007). Orthorexia and vigorexia: new eating disorders? Eating Disorders, 5: 457-482.