Weight Restored, Eating Well, But No Menses in Sight? Huh?

It is to be expected that the Diagnostic and Statistical Manual of Mental Disorders, at least when it comes to anorexia nervosa, relies heavily on measures that are hard to quantify and measure objectively. The big exception is amenorrhea: the absence of menses (commonly known as “periods”) for three consecutive months. As I’ve mentioned before, this criterion will be removed from the next edition of the DSM, thankfully. But for now, it is still there.

Perhaps because it is easy to measure objectively, the resumption of menses is often taken to be a marker of “health” and “recovery.”  It is a common goal in treatment for patients to reach a “menstruating weight.”

[Conversely, not losing one’s menstrual cycle is often perceived by the patient that they are not “sick enough.” Their eating disorder is not legitimate because clearly they are eating enough for their menstrual cycle to continue, and thus … Continue reading →