Feeding & Eating Disorders

Question 1

Pica

Answer 1

A: Persistent eating of non-nutritive, nonfood substance over a period of at least 1 mo
B: The eating of non-nutritive, nonfood substance is inappropriate to the developmental level of the individual
C: The eating behavior is not part of a culturally supported or socially normative practice
D: If the eating behavior occurs in the context of another mental disorder it’s sufficiently severe to warrant additional clinical attention

Question 2

Rumination Disorder

Answer 2

A: Repeated regurgitation of food over a period of at least 1 month. Regurgitated food may be re-chewed, re-swallowed or spit out
B: The repeated regurgitation is not due to an associated gastrointestinal or other medical condition
C: The eating disturbance does not occur exclusively during the course of anorexia nervosa, bulimia nervosa, binge-eating disorder or avoidant/restrictive food intake disorder
D: If the sx occur in the context of another mental disorder they are sufficiently severe to warrant additional clinical attention

Question 3

Avoidant/Restrictive Food Intake Disorder

Answer 3

A: An eating or feeding disturbance (lack of interest in food or eating, avoidance based on sensory characteristics, concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated w/ one or more of the following:
1. Significant weight loss
2. Significant nutritional deficiency
3. Dependence on enteral feeding or oral nutritional supplements
4. Marked interference w/ psychosocial functioning
B: The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice
C: The eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced
D: The eating disturbance is not due to a concurrent medical condition or not better explained by another mental disorder. When the disturbance occurs in the context of another condition or disorder, the severity exceeds that routinely associated w/ the condition or disorder & warrants additional clinical attention

Question 4

Anorexia Nervosa

Answer 4

A: Restriction of energy intake relative to requirements, leading to a significant low body weight
B: Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes w/ weight gain, even though at a significant low weight
C: 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 persistent lack of recognition of the seriousness of the current low body weight
Coding Note: Restrictive Type-During the last 3 mos, the individual has not engaged in recurrent episodes of binge eating or purging behavior. Describes presentations in which weight loss is accomplished primarily through dieting, fasting and/or excessive exercise
Binge-eating/purging type-during the last 3 mos, the individual has engaged in recurrent episodes of binge eating or purging behavior
Current severity-based on BMI

Question 5

Bulimia Nervosa

Answer 5

A: Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
1. Eating, in a discreate period of time, a large amount of food than what most individuals
2. A sense of lack of control over eating during the episode
B: Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics or other medications; fasting; or excessive exercise
C: The binge eating & inappropriate compensatory behavior both occur, on average, at least once a week for 3 mos
D: Self-evaluation is unduly influenced by body shape & weight
E: The disturbance does not occur exclusively during episodes of anorexia nervosa
Specify: Mild-an average of 1-3 episodes of inappropriate compensatory behaviors per week Moderate-an average of 4-7 episodes of inappropriate compensatory behaviors per week Severe-an average 8-13 episodes of inappropriate compensatory behaviors
Extreme-an average of 14 or more episodes of inappropriate compensatory behaviors

Question 6

Binge-Eating Disorder

Answer 6

A: Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
1. Eating, in a discrete period of time, a large amount of food
2. A sense of lack of control over eating during the episode
B: The binge-eating episodes are associated w/ 3 or more of the following:
1. Eating much more rapidly than normal
2. Eating until feeling uncomfortably full
3. Eating large amounts when not feeling physically hungry
4. Eating alone b/c of feeling embarrassed by how much one is eating
5. Feeling disgusted w/ oneself, depressed or very guilty afterward
C: Marked distress regarding binge eating is present
D: The binge eating occurs, on average, at least 1x a week for 3 mos
E: The binge eating is not associated w/ the recurrent use of inappropriate compensatory behaviors as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa
Current Severity:
Mild:1-3 binge eating episodes a week
Moderate: 4-7 episodes a week
Severe: 8-13 episodes a week
Extreme: 14 or more episodes a week