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Recognizing Anorexia Nervosa
Recognizing Anorexia Nervosa outlines the ICD-11 diagnostic features to support therapists in identifying anorexia nervosa disorder in their clients.
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Overview
Anorexia nervosa is characterized by a persistent restriction of food intake resulting in significantly low body weight, an intense fear of gaining weight, and distorted body image or an undue influence of body shape and weight on self-evaluation. The disorder may also involve persistent behaviors that interfere with weight gain, even when underweight. In some cases, the individual may not recognize the seriousness of their low body weight. Physical consequences can include hormonal changes, cardiovascular abnormalities, and multi-systemic medical complications.
Recognizing Anorexia Nervosa presents the ICD-11 diagnostic criteria to help clinicians identify anorexia nervosa in clients.
Why Use This Resource?
Anorexia nervosa can be complex to diagnose. This resource helps clinicians:
- Accurately identify diagnostic features aligned with ICD-11 criteria.
- Differentiate anorexia nervosa from other medical or psychiatric conditions.
- Support clinical decision-making in assessments, treatment planning, and referrals.
Key Benefits
Clear
Provides a clear description of anorexia nervosa.
Focused
Details the essential and additional clinical features for accurate recognition.
Informed
Drawn from the International Classification of Diseases, 11th Revision (ICD-11: World Health Organization, 2019).
Who is this for?
Anorexia Nervosa (AN)
Individuals showing restrictive behaviours, underweight status, and body image distortion.
Integrating it into your practice
01
Understand
Review the key features of anorexia nervosa.
02
Recognize
Identify symptoms of anorexia nervosa in clients.
03
Engage
Discuss whether clients identify with symptoms of anorexia nervosa.
Theoretical Background & Therapist Guidance
Psychiatric diagnostic frameworks serve multiple purposes. Classification of mental disorders enables clinicians and researchers to speak a common language when describing patterns of experience and behavior, guide appropriate treatment interventions, and act as a coding system for insurance purposes. The success of these classification frameworks has varied across diagnoses but in the best cases has led to improved understanding and treatment of conditions, as well as helping many service users who find such classification valuable (Perkins et al, 2018).
Diagnostic frameworks are not without controversy. They have been criticized on grounds of reliability, validity, and distortions due to commercial interests (Zigler & Phillips, 1961; Frances & Widiger, 2012; Bell, 2017). Perhaps most importantly there are instances where they have had, and continue to have, extremely negative effects upon service users (Perkins et al, 2018). Diagnosis is not the only way of understanding people and their experiences. Many clinicians and their clients find that attending to personal stories and narratives is a helpful approach, and psychological formulation is one technique for bringing together information about what has happened to an individual and the sense that they have made of it (British Psychological Society, 2018).
Notwithstanding the above caveats, the ‘Recognizing...’ series from Psychology Tools is designed to aid clinicians in the recognition and understanding of common mental health problems.
What's inside
- Summary of essential diagnostic criteria for anorexia nervosa.
- Description of physical indicators and medical complications associated with the disorder.
- Guidance for recognising atypical presentations, including absence of explicit fear of weight gain.
FAQs
Yes, in children and adolescents, a failure to gain weight in line with developmental expectations may satisfy diagnostic criteria, especially if other behaviours and concerns are present.
ICD-11 specifies that the low body weight must not be better explained by another medical condition or lack of food availability. Intentional behaviours to prevent weight restoration are key.
No, purging may be present but are not required. Restrictive eating or other weight-control behaviours, such as excessive exercise or use of stimulant medication, may also meet the criteria.
How This Resource Improves Clinical Outcomes
Utilizing this resource can help therapists:
- Recognize common mental health difficulties.
- Distinguish between different mental health disorders.
- Apply this knowledge to enhance case conceptualizations, treatment recommendations, and treatment plans.
References And Further Reading
- Bell, V. (2017). We need to get better at critiquing psychiatric diagnosis. Retrieved from https://mindhacks.com/2017/09/19/why-we-need-to-get-better-at-critiquing-diagnosis/
- British Psychological Society (2018). Understanding psychiatric diagnosis in adult mental health. Retrieved from: https://web.archive.org/web/20180214095228/https://www1.bps.org.uk/system/files/user-files/Division%20of%20Clinical%20Psychology/public/DCP%20Diagnosis.pdf
- Frances, A. J., & Widiger, T. (2012). Psychiatric diagnosis: lessons from the DSM-IV past and cautions for the DSM-5 future. Annual Review of Clinical Psychology, 8, 109-130.
- Perkins, A., Ridler, J., Browes, D., Peryer, G., Notley, C., & Hackmann, C. (2018). Experiencing mental health diagnosis: a systematic review of service user, clinician, and carer perspectives across clinical settings. The Lancet Psychiatry, 5(9), 747-764.
- World Health Organization. (2019). International Classification of Diseases, 11th Revision (ICD-11). Geneva: World Health Organization.
- Zigler, E., & Phillips, L. (1961). Psychiatric diagnosis: A critique. The Journal of Abnormal and Social Psychology, 63(3), 607.
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