Empirical classification of eating disorder not otherwise specified: Support for DSM-IV changes

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Abstract

Using cluster analytic procedures, this study identified three subgroups of subjects who had been diagnosed as eating disorder not otherwise specified. These three subgroups were quite similar in symptom profiles to the descriptions of subthreshold anorexia nervosa, nonpurging bulimia nervosa, and binge eating disorder which are being considered in the new DSM-IV diagnostic scheme for eating disorders. The three atypical subgroups were contrasted with established groups of anorexia and bulimia nervosa on psychopathological variables specific to eating disorders. The subthreshold anorexia group differed from anorexia nervosa only in terms of weight status. Nonpurging bulimia differed from bulimia nervosa only in the relative absence of self-induced vomiting as a purgative habit. Subjects in the binge eating group were extremely obese and expressed considerable concern with binge eating but did not report frequent use of vomiting or intense dieting to control obesity. Binge eaters were dissatisfied with body size but were not driven to achieve thinness. These findings were interpreted as being supportive of proposed changes in diagnostic criteria for eating disorders.