The DSM-5 is changing the diagnostic criteria for eating disorders (ED). Amenorrhea is no longer required as there are many exceptions among ED women, and this criterion is useless for assessing males. The focus is now on behaviour which results in being significantly underweight, rather than a deliberate attempt to lose weight or fear of being fat.
I think this means that some people with "orthorexia", a term coined by Steven Bratman for people who are so preoccupied with "healthy" eating that it interferes with their lives, could now be diagnosed with anorexia nervosa if they are significantly underweight.feeling that she needed to go on "cleansing" diets and even fasts although she was seriously underweight.
In people with a genetic predisposition, starvation makes them feel more alert and energetic. While everyone around them can see they are disturbingly thin, they feel perfectly healthy. Thus well-meaning attempts to improve health through low calorie diets or fasting can actually trigger anorexia. Unfortunately part of the nature of the illness is not recognizing it is an illness.
One study found that 30% of raw foodist women suffer from amenorrhea (they stop menstruating). The researchers concluded "The consumption of a raw food diet is associated with a high loss of body weight. Since many raw food dieters exhibited underweight and amenorrhea, a very strict raw food diet cannot be recommended on a long-term basis." While some raw foodists are concerned about their weight loss and amenorrhea, others are deeply in denial, even insisting that menstruation is a sign of ill health.
I'm posting this not to criticize anyone, but because it saddens me that some good people in the vegan community seem to be endangering their health.