Eating Disorders

Abstract

Three main features define the grouping of eating disorders (ED): (a) a definite and persistent disturbance of eating or eating-related behavior, (b) an altered consumption or absorption of food, and (c) significant impairment of physical health and/or psychosocial functioning. In 2013 DSM-5 revised the diagnostic classification of feeding and eating disorders (FED). Feeding disorders are not related to body weight and shape concerns, while eating disorders usually include abnormal eating habits as well as prominent concerns about body weight and shape. Obesity is not included in the current classifications of mental disorders and is not considered as an eating disorder per se. However, some nonhomeostatic eating patterns may be related to the development and perpetuation of obesity. Furthermore, interactions between obesity and eating disorders (ED) are relevant, and both medical and surgical interventions for obesity require an accurate assessment of eating behavior before, during, and after treatment. This chapter describes the clinical features of the eight DSM-5 diagnostic categories of the FED grouping. Then it looks at binge eating disorder and many other eating patterns that often occur in association with obesity. The impact of DSM-5 on the epidemiology of FED is reviewed. The last section of the chapter talks about some recent practice guidelines for treatment of FED and the role of pharmacologic agents.