Revision of the DSM Designates Binge Eating as Official Disorder

A group of psychiatrists last week recommended that binge eating, but not obesity, should become an official psychiatric diagnosis.

The recommendation was part of the American Psychological Association’s review of the DSM (Diagnostic and Statistical manual of Mental Disorders).  Listing a condition in the DSM has important and far-reaching implications for patients and mental health care providers, since insurance companies often use the DSM to determine which mental disorders and treatments they will insure.  Doctors and therapists use the DSM to determine how to treat patients.

A working group studying eating disorders made its report last week, recommending that binge eating be defined as episodes of eating amounts larger than most people would and feeling a lack of control during the time the eating was occurring.  The proposed definition would also require that the binge eating occur at least once weekly for a period of three months and that the patient feels distress as a result of the behavior.

In explaining their recommendation, the working group noted that binge eating tends to run in families and has a specific demographic pattern.  Men are more likely to experience binge eating, the condition tends to start later in life, and the condition appears to be associated with other personality disturbances.

Obesity, on the other hand, was not recommended to be listed as a psychiatric disorder.  The researchers explained that obesity is a physical condition with multiple causes, rather than a single behavioral explanation.  Some causes of obesity might be mental health related, but others (like the high availability of high-calorie food in American society) are part of the environment rather than the individual’s mental state, and genetics may also play a role.  As a result, the group leaves “obesity” as a medical condition rather than a psychiatric one.

In other news, the group recommended that the definition of anorexia nervosa no longer require that a girl cease menstruating in order to be diagnosed with the disorder.  The trait does not apply to many patients (including girls and women on birth control pills and men and boys).

The next revision of the DSM will be released in 2013.  The working group’s recommendations are still subject to final approval.