Considered the "bible" of the psychiatric and mental health world, the American Psychiatric Association's Diagnostic & Statistical Manual of Mental Disorders (DSM) sets the criteria needed to diagnose certain mental disorders. Diagnostic changes in new editions carry significant weight with mental health professionals, and with the release of the fifth edition (DSM-V), criteria for eating disorders underwent major changes. In several cases, it's now easier for clinicians to diagnose someone with an eating disorder compared to the earlier edition DSM-IV-TR, which was published in 2000 and had more finite definitions. Here's a brief synopsis of the changes in the DSM-V for diagnosing eating disorders. For the first time, the DSM-V includes binge eating disorder as a fully recognized and diagnosable disorder. The DSM-IV-TR had previously included binge eating disorder as a provisional list of criteria “for research purposes.” Essentially, the previous edition had viewed binge eating disorder as too new to decipher the appropriate criteria. BED was only listed in the appendix and had to be diagnosed with the non-specific “EDNOS” (Eating Disorder Not Otherwise Specified). Ideally, this change should provide more validity to those who are struggling with binge eating—in which people typically eat more quickly than normal, eat until they're uncomfortably full, or eat alone out of shame at least once a week for more than three months. BED is also characterized by a feeling of a loss of control during the binge, as well as experiencing shame, distress or guilt afterwards. There is typically not purging to counter the binge eating. Hopefully, it will provide them with more coverage and treatment options, as well. The DSM-V made two major changes to the way anorexia nervosa—a condition associated with restricted food intake, fear of weight gain, and distorted body image—is diagnosed, broadening its definition:
Body Mass Index (BMI) is a dated, biased measure that doesn’t account for several factors, such as body composition, ethnicity, race, gender, and age. Despite being a flawed measure, BMI is widely used today in the medical community because it is an inexpensive and quick method for analyzing potential health status and outcomes. Bulimia nervosa is characterized by purging (self-inducing vomiting or using laxatives) or non-purging (fasting or excessive exercise) behaviors, and the DSM-V's definition has changed in three significant ways:
The DSM-V update also included two other forms of eating disorder: "other specified feeding or eating disorder" and "eating disorder not otherwise specified," which had been previously lumped together in the DSM-IV-TR as eating disorder not otherwise specified (EDNOS). Here are the ways they differ, according to the new edition:
It's important to note that the DSM is always, and always has been, a work in progress. There continue to be debates and disagreements among professionals about even the most current diagnostic criteria. However, the definitions included in the DSM do provide researchers and clinicians with a language for talking about and describing sets of symptoms many people are struggling with and that need treatment. Eating disorders can be a complicated, emotional journey for both the person living with the disorder as well as their family and loved ones. While recovery can be a physical and mental struggle, it is possible. If you or someone you know is experiencing some or all of the symptoms of any eating disorder, please consult with a physician, dietitian, or mental health professional for assessment and treatment.
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
|