Eating Disorders (also Feeding Disorders) are a group of disorders characterized by physiological and psychological disturbances in appetite or food intake.
The Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM-V) classifies the following as eating disorders:
Binge Eating Disorder
Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
- Eating, in a discrete period of time (e.g. within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
- A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating).
The binge eating episodes are associated with three or more of the following:
- eating much more rapidly than normal
- eating until feeling uncomfortably full
- eating large amounts of food when not feeling physically hungry
- eating alone because of feeling embarrassed by how much one is eating
- feeling disgusted with oneself, depressed or very guilty afterward
Marked distress regarding binge eating is present
Binge eating occurs, on average, at least once a week for three months
Binge eating not associated with the recurrent use of inappropriate compensatory behaviors as in Bulimia Nervosa and does not occur exclusively during the course of Bulimia Nervosa, or Anorexia Nervosa methods to compensate for overeating, such as self-induced vomiting.
Note: Binge Eating Disorder is less common but much more severe than overeating. Binge Eating Disorder is associated with more subjective distress regarding the eating behavior, and commonly other co-occurring psychological problems.
- Persistent eating of non-nutritive substances for a period of at least one month.
- The eating of non-nutritive substances is inappropriate to the developmental level of the individual.
- The eating behavior is not part of a culturally supported or socially normative practice.
- If occurring in the presence of another mental disorder (e.g. autistic spectrum disorder), or during a medical condition (e.g. pregnancy), it is severe enough to warrant independent clinical attention.
Note: Pica often occurs with other mental health disorders associated with impaired functioning.
- Repeated regurgitation of food for a period of at least one month Regurgitated food may be re-chewed, re-swallowed, or spit out.
- The repeated regurgitation is not due to a medication condition (e.g. gastrointestinal condition).
- The behavior does not occur exclusively in the course of Anorexia Nervosa, Bulimia Nervosa, BED, or Avoidant/Restrictive Food Intake disorder.
- If occurring in the presence of another mental disorder (e.g. intellectual developmental disorder), it is severe enough to warrant independent clinical attention.
Avoidant/Restrictive Food Intake Disorder (ARFID)
- An Eating or Feeding disturbance as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:
- Significant loss of weight (or failure to achieve expected weight gain or faltering growth in children).
- Significant nutritional deficiency
- Dependence on enteral feeding or oral nutritional supplements
- Marked interference with psychosocial functioning
- The behavior is not better explained by lack of available food or by an associated culturally sanctioned practice.
- The behavior does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way one’s body weight or shape is experienced.
- The eating disturbance is not attributed to a medical condition, or better explained by another mental health disorder. When is does occur in the presence of another condition/disorder, the behavior exceeds what is usually associated, and warrants additional clinical attention.
Other Specified Feeding or Eating Disorder (OSFED)
- present with a feeding or eating behaviors that cause clinically significant distress and impairment in areas of functioning, but do not meet the full criteria for any of the other feeding and eating disorders.
Unspecified Feeding or Eating Disorder (UFED)
- behaviors that cause clinically significant distress/impairment of functioning, but do not meet the full criteria of any of the feeding or eating disorder criteria.