Being an Anorectic versus Having Anorexia: Should the DSM Diagnostic Criteria Be Modified?

Abstract

The Diagnostic and Statistical Manual of Mental Disorders classifies “anorexia nervosa” as a mental disorder, yet individuals with anorexia often characterize it as an identity. The author describes the identity of being an anorectic and compares it with what it takes to have anorexia in the diagnostic sense. This furthers the existing scholarship on anorexia and identity, most notably by revealing a disconnect between being an anorectic and having anorexia: Some individuals inhabit the identity of being an anorectic but do not have anorexia because they do not have a significantly low body weight. The author explores whether expanding the diagnostic criteria for anorexia would be beneficial for anorectics by examining the implications of classifying the identitive phenomenon of being an anorectic in terms of a medical concept of mental disorder. In the short term, the answer depends on whether being an anorectic calls for interventions that require a diagnosis. Either way, it would be beneficial to develop nonmedical frameworks for understanding anorexia that facilitate interventions that do not require a diagnosis. Understanding being an anorectic as an identity lays the scaffolding for a nonmedical way of conceptualizing anorexia that illuminates innovative approaches to assisting anorectics.