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Appendix B DSM-IV-TR DIAGNOSTIC CRITERIA FOR EATING DISORDERS, APA Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) Anorexia Nervosa 1. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less 85% of that expect ed; or failure to make expected weight gain during a period of growth, leading to body weight less than 85% of that expected. 2. Intense fear of gaining weight or becoming fat, even though underweight. 3. 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 denial of the seriousness of the current low body weight. 4. In postmenarchial females, the absence of at least three consecutive menstrual cycles. Sub–types: Restricting Type: during the current episode of Anorexia Nervosa, the person has not regularly engaged in binge–eating or purging behavior (i.e. self–induced vomiting or the misuse of laxatives, diuretics or enemas) Binge–Eating/Purging Type: During the current episode of Anorexia Nervosa, the person has regularly engaged in binge–eating or purging behavior (i.e., self–induced vomiting or the misuse of laxatives, diuretics or enemas) Bulimia Nervosa 1. Recurrent episodes of binge eating characterized by BOTH of the following: a. Eating in a discrete amount of time (within a 2 hour period), an amount that is definitely larger than most people would eat during a similar time period. b. Sense of lack of control over eating during an episode. 2. Recurrent inappropriate compensatory behavior in order to prevent weight gain (self– induced vomiting, misuse of laxatives or diuretics, starvation, or compulsive exercising). 3. The binge eating and inappropriate compensatory behaviors both occur, on average, at  least twice a week for three months. 4. Self–evaluation is unduly influenced by body shape and weight. 5. The disturbance does not occur exclusively during episodes of anorexia nervosa. Sub–types: Purging type: during the current episode of bulimia nervosa, the person has regularly engaged in self–induced vomiting or the misuse of laxatives, diuretics, or enemas Nonpurging type: during the current episode of bulimia nervosa, the person has used 39