Anorexia and bulimia
Definitions An excessive concern with the control of body weight and shape along with an inadequate and unhealthy pattern of eating are the central features of eating problems in children and adolescents (Bryant-Waugh and Lask, 1995a). In both DSM IV (APA, 1994) and lCD 10 (WHO, 1992) a distinction has been made between anorexia nervosa and bulimia nervosa with the former being characterized primarily by weight loss and the latter by a cyclical pattern of bingeing and purging. Diagnostic criteria for these disorders from DSM IV and lCD 10 are set out in Figures 10.1 and 10.2. The distinction made between anorexia nervosa and bulimia nervosa, while descriptively useful, does not take full account of variations in eating problems seen in clinical practice. Many anorexic patients present with bulimic symptoms and many bulimic patients develop anorexia. For this reason, in DSM IV, a distinction is made between two subtypes of anorexia: the restricting type and the binge-purge type.