Anorexia nervosa differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]
Overview
Anorexia nervosa must be differentiated from other diseases such as major depressive disease, social anxiety disorder, substance use disorder,and schizophrenia.[1]
Differential Diagnosis
- Addison's disease
- Avoidant/restrictive food intake disorder[1]
- Binge eating disorder
- Body dysmorphic disorder
- Body image
- Bulimia nervosa
- Cachexia
- Calorie restriction
- Celiac disease
- Defensive vomiting
- Eating disorder
- Eating disorder not otherwise specified
- Inflammatory bowel disease
- Major depressive disorder[1]
- Malnutrition
- Medical conditions [1]
- Acquired immunodeficiency syndrome
- Gastrointestinal disease
- Hyperthyroidism
- Occult malignancies
- Muscle dysmorphia ('reverse' anorexia nervosa)
- Orthorexia nervosa
- Pro-ana
- Purging disorder
- Refeeding syndrome
- Schizophrenia[1]
- Social anxiety disorder (social phobia), obsessive-compulsive disorder, and body dysmorphic disorder[1]
- Substance use disorders
- Wannarexia — a term for people who want to be anorexic
Diagnostic Issues and Controversies
The distinction between the diagnoses of anorexia nervosa, bulimia nervosa and eating disorder not otherwise specified (EDNOS) is often difficult to make in practice and there is considerable overlap between patients diagnosed with these conditions. Furthermore, seemingly minor changes in a patient's overall behavior or attitude (such as reported feeling of 'control' over any bingeing behavior) can change a diagnosis from 'anorexia: binge-eating type' to bulimia nervosa. It is not unusual for a person with an eating disorder to 'move through' various diagnoses as his or her behavior and beliefs change over time.[2]
Additionally, it is important to note that an individual may still suffer from a health- or life-threatening eating disorder (e.g., subclinical anorexia nervosa or EDNOS) even if one diagnostic sign or symptom is still present. For example, a substantial number of patients diagnosed with EDNOS meet all criteria for diagnosis of anorexia nervosa, but lack the three consecutive missed menstrual cycles needed for a diagnosis of anorexia.[3]
Feminist writers such as Susie Orbach and Naomi Wolf have criticised the medicalisation of extreme dieting and weight-loss as locating the problem within the affected women, rather than in a society that imposes concepts of unreasonable and unhealthy thinness as a measure of female beauty.
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.
- ↑ Gowers S, Bryant-Waugh R. (2004) Management of child and adolescent eating disorders: the current evidence base and future directions. J Child Psychol Psychiatry, 45 (1), 63-83. PMID 14959803
- ↑ Lask B, and Bryant-Waugh, R (eds) (2000) Anorexia Nervosa and Related Eating Disorders in Childhood and Adolescence. Hove: Psychology Press. ISBN 0-86377-804-6.