Gruber and Pope proposed criteria for an eating disorder seen in bodybuilders. The criteria combines both a desire to avoid fat and to maximize muscle mass. The authors are from Harvard Medical School in Boston.
Criteria:
(1) both of the following:
(1a) refusal to maintain body fat at a healthy level
(1b) desire to maximize muscle mass
(2) both of the following:
(2a) intense fear of gaining fat despite being significantly below normal
(2b) intense fear of losing muscle despite muscularity significantly above average
(3) strict adherence to a rigid diet with >=2 of the following features:
(3a) >= 5 meals per day consumed at regular intervals
(3b) diet consists mostly of high-calorie, high-protein, low-fat foods or food supplements
(3c) a significant amount of time, money and effort is spent acquiring, preparing and eating the meals
(4) at least one of the following:
(4a) disturbed/distorted experience of one's body composition
(4b) body appearance has an undue influence on self-image
(5) failure to participate in social or occupational activities because these might interfere with the timing and/or composition of meals
where:
• A healthy level of body fat in a woman is one that allows normal menstrual cycles to occur.
