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Diagnostic criteria for eating disorders is too narrow, researchers say

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Anorexia affects about 1% of preteen and teenage girls and bulimia about 2% to 5%, according to estimates. But those numbers may minimize the true prevalence of the illnesses, researchers from Stanford University reported Monday. In a study examining the accuracy of the diagnostic criteria for eating disorders, they found the definitions may be too strict and rule out people who need treatment.

The researchers examined 1,310 females ages 8 to 19 with diagnoses of anorexia, bulimia or a catch-all term ‘eating disorder not otherwise specified.’ This latter category has been criticized as misleading because it could be construed by doctors, patients and family members as not as serious as the other diagnoses. In the study population, about two-thirds of the patients had been given the diagnosis of ‘eating disorders NOS.’ Still 60% of those women met medical criteria for hospitalization. This group was also sicker, on average, than patients who received the diagnosis of bulimia.

For example, some of the patients diagnosed as ‘eating disorders NOS’ had been overweight but had lost a lot of weight quickly. They were still at a normal weight, which may escape the concern of family members and health professionals, the researchers said. However, some of these women had serious malnutrition.

The study concludes that the diagnostic criteria for eating disorders should be reevaluated. Doctors ‘erroneously treat these criteria in a very black-and-white way,’ the lead author of the study, Dr. Rebecka Peebles, said in a news release.

The study was published Monday in the journal Pediatrics.

-- Shari Roan

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