AED Version 4
Included FREE with the Kipu EMR.
The Academy for Eating Disorders is a global professional association committed to leadership in eating disorders research, education, treatment, and prevention. Our goal is to provide global access to knowledge, research and best treatment practice for eating disorders. For the public via its website, AED provides education on eating disorder symptoms and treatment recommendations. AED helps researchers connect and collaborate with each other and keep abreast of recent developments in eating disorders research
The AED Assessment
A brief, simple, and validated questionnaire is available to primary care providers to determine if their patients are exhibiting symptoms of an eating disorder.
The Academy for Eating Disorders is committed to disseminating information regarding these disorders to both educate, prevent and assist those in need. Below are facts about eating disorders for concerned friends, family members, healthcare providers, and individuals struggling with their eating. Eating disorders affect individuals irrespective of age, weight, gender, and race/ethnicity. It is important to keep in mind that there is significant symptom overlap among the eating disorder categories listed below, and that individuals can move from one diagnostic category to another over time. Kipu includes the AED Version 4 assessment within the EMR to manage treatment for these conditions:
ANOREXIA NERVOSA (AN)
AN is characterized by failure to maintain an adequate body weight, body image disturbance, and excessive dietary restriction(1). It may be accompanied by periodic binge eating and purging (e.g., self-induced vomiting, laxative use). It affects approximately 4 out of every 1000 women in any 12 month period and 9 out of 1000 at some point in their lives. Men are affected less often than women; the exact ratio of women to men who are affected by AN is difficult to determine, but estimates range from 3:12 to 10:11, and these may be underestimates because men are less likely to seek treatment and healthcare providers may fail to assess or diagnose eating disorders in males.
AN typically begins during early- to mid-adolescence(4), and warning signs include sudden weight loss, extreme dieting, food rituals (e.g., taking very small bites, eating foods in a certain order), hair loss, dry skin or hair, brittle nails, growth of fine, downy hair on the face and body. Certain medical conditions may co-occur with AN and include bone loss, difficulties with temperature regulation, loss of menstrual periods, low heart rate, and low blood pressure.
Similarly, certain psychological conditions and features that often coincide with AN include anxiety, depression, social isolation, and perfectionism(6). Approximately 50-60% of individuals with AN recover over time, with better recovery rates observed in younger patients and those with a shorter duration of illness when diagnosed. For adolescents with AN, a form of family-based treatment has been shown to be successful in improving recovery from the illness. Unfortunately, the risk of death in AN is increased due to medical complications and suicide.
BULIMIA NERVOSA (BN)
BN is characterized by binge eating (consuming large amounts of food while feeling out of control) accompanied by compensatory behaviors to prevent weight gain, and body image disturbances(1). These compensatory behaviors may include self-induced vomiting, laxative, diuretic, or enema use or excessive exercise, fasting, or the misuse of certain medications such as insulin. Estimates of what percent of individuals are affected by BN vary between 1-1.5% over the course of their lives(2,3) to 1-1.5% of women in any 12 month period. Men are affected less often than women; the exact ratio of women to men who are affected by BN is difficult to determine, but estimates range from 3:12 to 10:11. These may be underestimates because men are less likely to seek treatment and healthcare providers may fail to assess or diagnose eating disorders in males. The typical age of onset is mid- to late-adolescence(9), and early warning signs include the disappearance of large amounts of food, frequent trips to the bathroom after meals, calluses on knuckles from using fingers to induce vomiting, and swelling of the face. Certain medical conditions that may accompany BN include electrolyte imbalance, esophageal ulcers, and tooth decay.
Psychological conditions and features that often co-occur include anxiety, depression, substance use, and difficulties with impulse control. Approximately 70% of individuals with BN recover over time, and patients with fewer accompanying psychiatric problems seem to fare better. Treatments for BN in adults include cognitive-behavioral therapy, which has been successful in improving recovery from the illness, and the anti-depressant medication fluoxetine, which has been FDA-approved for the treatment of adults with BN. Unfortunately, risk of death is increased in BN, particularly death due to suicide.
BINGE-EATING DISORDER (BED)
BED is characterized by binge-eating without compensatory behaviors. It affects 16 out of every 1000 women in any 12 month period and 35 out of 1000 at some point in their lives. Estimates for men are that approximately 8 out of 1000 are affected in any 12 month period and 20 out of 1000 at some point in their lives. The typical age of onset is during adolescence or young adulthood, but most individuals don’t present for treatment until middle adulthood.
Warning signs include sudden weight gain and the disappearance of large amounts of food. Specific medical conditions that co-occur with BED include obesity(14) and other related conditions (e.g., type II diabetes, hypertension) and gastric problems. Related psychological conditions include anxiety, depression, and substance use. Approximately 70-80% of individuals with BED recover over time, and those with fewer interpersonal problems appear to have a better likelihood of recovery. For adults with BED, cognitive-behavioral and interpersonal treatments have been successful in increasing recovery from the illness while behavioral weight loss treatment may be helpful with weight loss.
AVOIDANT AND RESTRICTIVE FOOD INTAKE DISORDER (ARFID)
ARFID is characterized by an avoidance of eating that leads to a failure to meet nutritional or energy needs. This avoidance may be due to concerns regarding uncomfortable consequences of eating, displeasure with the tastes and/or textures of foods, or a number of other reasons. Importantly, this avoidance must not be explained by a normal culture practice or a food allergy. The results of this avoidance may be that the individual loses a significant amount of weight, or for children, fails to gain weight as expected, experiences a deficiency in important nutrients, requires food supplements or special feedings, or experiences substantial impairment in his/her life as a result of the avoidance (e.g., is unable/unwilling to socialize with others if food is involved).
Although many of these features may be present in anorexia nervosa, a corresponding fear of weight gain and disturbance in body image is not present in ARFID. Information on the prevalence of AFRID are not yet available; however, ARFID most commonly begins in infancy or early childhood. Although picky-eating in young children is not unusual, warning signs of ARFID include such “pickiness” leading to a failure to gain weight as expected or the necessity of administering nutritional supplements in order to avoid experiencing a nutritional deficiency. ARFID may negatively affect family functioning, especially around mealtime. Related psychological conditions include anxiety disorders, autism spectrum disorder, obsessive-compulsive disorder, and attention deficit-hyperactivity disorder.
The Academy for Eating Disorders is a global professional association committed to leadership in eating disorders research, education, treatment, and prevention. Our goal is to provide global access to knowledge, research and best treatment practice for eating disorders. For the public via its website, AED provides education on eating disorder symptoms and treatment recommendations. AED helps researchers connect and collaborate with each other and keep abreast of recent developments in eating disorders research. . AED's main event is the annual International Conference on Eating Disorders (ICED), a scientific conference that spans research and education from basic science to the treating clinician; ICED is attended by leading international researchers and includes presentations and discussions on the cutting edge of research in the field. Media are invited to attend the ICED.
To generate knowledge and integrate collective expertise about eating disorders
To provide platforms for the promotion of understanding, sharing of knowledge, and research-practice integration in the field of eating disorders
To build capacity in the next generation of eating disorders professionals
To foster innovation and best practice by recognizing excellence in the field of eating disorders
In order to ensure that eating disorders are addressed on a unified global basis, build constructive, mutual relationships with all professionals and professional organizations working in the field of eating disorders
Increase awareness among policy regulators and funders of the importance of ED research and treatment
Build the capacity and sustainability of AED so we can carry out our important work
The AED works with our partners and members all over the world to increase knowledge, sharing of information and encourages research to better serve the patient population, especially in countries where there is little or no information available to treat those struggling with eating disorders.