Energy intake restriction with the aim of body weight reduction or body shape change

Intense fear of weight gain

Behaviours that interfere with weight gain (eg, excessive exercise, use of laxatives or diuretics, appetite suppression medication)

BMI for age of <5th percentile, or a rapid weight loss (eg, more than 20% within 6 months) not accounted for by another medical condition or unavailability of food

These are not diagnostic, but you may also see features such as emaciation, loss of muscle strength, dry skin, lanugo hair, cold extremities, amenorrhoea, bradycardia and osteopenia

Recurrent binge eating episodes often associated with distress

Recurrent inappropriate compensatory behaviour (eg, vomiting, purging, excessive exercise, laxative use)

A preoccupation with body shape or weight

Bloating

Fullness

These are not diagnostic, but you may see Russell’s sign (knuckle calluses from induced vomiting), loss of enamel on teeth from repeated vomiting or parotid swelling

Recurrent binge eating episodes

Bingeing is often accompanied by negative emotions, for example, guilt or disgust. It may lead to weight gain and in some cases obesity

No regular inappropriate compensatory behaviour

There may be a low interest in eating or a sensory-based avoidance as examples

Intake of an insufficient quantity or variety of food to meet energy and nutritional requirements

May result in weight loss, nutritional deficiencies or other negative impacts on the physical health of the person, or impairment in other aspects of their life, for example, unable to socialise due to distress associated with eating

Not related to beliefs about weight/shape

Features of AN, BN or BED

Not clinically met by ICD-11 criteria