Overview
Eating disorders are patterns of consumption that are based in an unhealthy level of concern about caloric intake, weight gain, body image, or relationship to food. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) acknowledges the following conditions under “Feeding and Eating Disorders”:
-
Anorexia Nervosa: restriction of food intake driven by excessive concerns about weight gain, often accompanied by a distorted body image and a dangerously low body weight. Anorexia is further split into the restricting subtype that uses excessive diet and exercise to reduce weight while the binge-eating/purging subtype involves, as the name suggests, bingeing and purging.
-
Bulimia Nervosa: cycles of eating that involve bingeing large amounts of good followed by purging to reduce caloric intake and prevent weight gain, which is usually done through vomiting, laxatives, fasting, or extreme exercising.
-
Binge-Eating Disorder (BED): episodes of bingeing large quantities of food past the point of pleasure or comfort in a way that feels like a loss of self-control without the purging of bulimia.
-
Avoidant/Restrictive Food Intake Disorder (ARFID): limitations in the amount or types of food someone consumes to the point of health consequences, such as a general disinterest in eating, discomfort with certain textures or colors, or fear of choking or vomiting.
-
Pica: repeatedly eating non-food substances without nutritional value, such as clay, paper, hair, etc.
-
Rumination Disorder: repeatedly and involuntarily regurgitating food to be re-chewed and re-swallowed without another medical condition explaining the struggle to keep down food.
-
Other Specified Feeding or Eating Disorder (OSFED): this diagnosis is used for serious disordered eating patterns that don’t necessarily meet the criteria for other diagnoses but can still be addressed with similar approaches and understanding of etiologies. This can include atypical anorexia nervosa, purging disorder, night eating syndrome, subthreshold bulimia, and subthreshold BED.
-
Unspecified Feeding or Eating Disorder (UFED): this diagnosis is used when someone has a serious disordered eating pattern but there isn’t enough information to make a more specific diagnosis. This might be used in emergency rooms when taking someone’s history or observing them over a period of time isn’t possible, but all the hallmarks of an eating disorder are present.
While the DSM-5-TR doesn’t mention the following disorders, medical professionals still often recognize them:
-
Orthorexia Nervosa: an obsession with eating foods that are “pure” or “perfect” in some way to the point of malnutrition or distress
-
Diabulimia (ED-DMT1): for those with Type 1 diabetes who skip or restrict required amounts of insulin to spur on weight loss, which is highly dangerous.