TITLE / QUESTION: (100 marks):
a) Provide and differentiate the diagnostic criteria and hallmark features of Anorexia Nervosa, Bulimia Nervosa and Binge-eating disorder (20)
b) Critically discuss how South African black females are no longer perceived to be “immune”
from eating disorders (60...
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A) Provide and differentiate the diagnostic criteria and hallmark features of Anorexia Nervosa,
Bulimia Nervosa and Binge-eating disorder.
Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge-Eating Disorder (BED) are three distinct
eating disorders, each with unique diagnostic criteria and hallmark features. Understanding these
differences is critical for accurate diagnosis and effective treatment.
Anorexia Nervosa (AN) is characterized by a significant restriction of energy intake relative to
requirements, leading to a markedly low body weight in the context of age, sex, developmental
trajectory, and physical health. The diagnostic criteria for AN include an intense fear of gaining
weight or becoming fat, even though underweight, and a disturbance in the way one’s body weight
or shape is experienced. This disorder is subdivided into two subtypes: the restricting type, where
weight loss is achieved through dieting, fasting, and/or excessive exercise, and the
binge-eating/purging type, where the individual engages in recurrent episodes of binge eating or
purging behavior (e.g., vomiting, misuse of laxatives, diuretics, or enemas).
The hallmark features of AN include extreme weight loss, emaciation, a relentless pursuit of thinness,
and a distorted body image. Individuals with AN often exhibit a preoccupation with food, dieting,
and body size. They may also engage in ritualistic behaviors, such as cutting food into tiny pieces or
weighing themselves frequently. Physical signs of AN can include bradycardia, hypotension,
amenorrhea, and other medical complications associated with starvation.
Bulimia Nervosa (BN) involves recurrent episodes of binge eating, characterized by consuming an
amount of food that is definitely larger than what most individuals would eat in a similar period
under similar circumstances, accompanied by a sense of lack of control over eating during the
episode. These episodes are followed by inappropriate compensatory behaviors to prevent weight
gain, such as self-induced vomiting, misuse of laxatives, diuretics, fasting, or excessive exercise. The
diagnostic criteria for BN specify that these behaviors occur, on average, at least once a week for
three months. Additionally, self-evaluation is unduly influenced by body shape and weight.
The hallmark features of BN include cycles of binge eating and compensatory behaviors. Unlike AN,
individuals with BN are often within the normal weight range or may be slightly overweight. They
typically feel a lack of control during binge-eating episodes and experience feelings of shame, guilt,
or distress afterwards. Physical signs can include dental erosion, enlarged salivary glands, and
gastrointestinal problems due to recurrent vomiting and laxative abuse.
Binge-Eating Disorder (BED) is characterized by recurrent episodes of binge eating without the
regular use of inappropriate compensatory behaviors seen in BN. The diagnostic criteria for BED
include eating, in a discrete period, an amount of food that is definitely larger than what most people
would eat in a similar period under similar circumstances, and experiencing a lack of control over
eating during the episode. These episodes are associated with three (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 feeling embarrassed by how much one
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