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Eating Disorder

Eating Disorder is a topic covered in the 5-Minute Emergency Consult.

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Anorexia Nervosa (AN)
  • Restriction of intake, leading to markedly low body weight for age, height, and/or developmental trajectory
  • Intense fear of gaining weight or becoming fat, or behavior that prevents weight gain
  • Severe body image disturbance, undue influence of body weight and shape on self-evaluation, or denial of seriousness of low body weight
  • Lifetime prevalence: 0.5% of females in US
  • Typical age of onset for AN is bimodal at 13–14 yr and 17–18 yr

Bulimia Nervosa (BN)
  • Recurrent episodes of binge eating characterized by:
    • Eating an unusually large amount of food in a discrete period of time
    • A sense of loss of control over eating during the episode
  • Recurrent inappropriate compensatory behaviors used to prevent weight gain:
    • Self-induced vomiting
    • Misuse of laxatives or enemas
    • Diuretics
    • Diet pills
    • Fasting
    • Excessive exercise
  • Bingeing and compensation occur on average at least once a week for 3 mo
  • Self-evaluation that is excessively influenced by weight or body shape
  • Lifetime prevalence: 2% of females in US
  • Commonly onset in late adolescence or early adulthood.

Binge Eating Disorder (BED)
  • Recurrent episodes of binge eating characterized by:
    • Eating a larger than usual amount of food in a discrete period of time
    • A sense of loss of control over eating during the episode
  • Binge eating episodes associated with 3 or more of the following:
    • 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 embarrassment about how much one is eating
    • Feeling disgusted with oneself, depressed, or very guilty after overeating
  • Marked distress over binge eating
  • Occurs on average at least once a week for 3 mo
  • No compensatory behavior
  • Lifetime prevalence: 3.5% of females and 2% males in US
  • Onset in late adolescence or early adulthood.


  • Twin studies have supported a strong genetic component.
  • Cultural emphasis on thinness as a valued attribute has been implicated
  • Temperament or personality attributes of perfectionism, anxiety, and behavioral rigidity have been described
  • Family conflict or stress is a frequent element
  • Neurochemical (serotonin) and neuroendocrinologic (leptin, HPA axis) abnormalities have been reported
  • Dieting is a frequent immediate precipitant

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Rosen, Peter, et al., editors. "Eating Disorder." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307202/all/Eating_Disorder.
Eating Disorder. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307202/all/Eating_Disorder. Accessed April 20, 2019.
Eating Disorder. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307202/all/Eating_Disorder
Eating Disorder [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 20]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307202/all/Eating_Disorder.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Eating Disorder ID - 307202 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307202/all/Eating_Disorder PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -