Friday, February 8, 2008

Eating disorder diagnostic criteria investigated

Will diagnostic criteria for eating disorders change?
According to this new study out of Rhode Island hospital and Brown University, researchers found that the majority of eating disorder individuals fell into the category of "EDNOS" or eating disorder not otherwise specified. This essentially means that these individuals did not fall strictly into the categories of anorexia or bulimia defined by the DSM-IV-TR.

This really doesn't surprise me at all. Experts have debated for years about the official criteria for eating disorders. Many have said it needed to be changed and the definition broadened as this study shows. I read awhile back that some eating disorder experts have suggested the removal of the "amenorrhea" criteria in anorexia for the new DSM-V, set to be published tentatively in 2012. In many cases, amenorrhea has been shown not to be that reliable of an indicator for anorexia. In this archived article from The New York Times, there is wide discussion about the "future of EDNOS." It will also be interesting to see whether other new subtypes will be considered such as "purging" disorder which made news back in September 2007 by Dr. Keel from University of Iowa.

Authors are even weighing in on naming and labeling, including Aimee Liu. On her website, she is actually having a naming contest asking people to think of a new name for "eating disorder." She will then address the Academy for Eating Disorders for "official" consideration.

If you speak to those with eating disorders, many get upset about the whole diagnostic criteria for eating disorders feeling that it's basically just a "label" and should not matter. Others feel that without an official diagnosis, their illness is not validated. Unfortunately, insurance companies want a label. To them, that label is important. It gives them the power to say what coverage they can allow whether or not it is actually sufficient for your treatment. Further, without a pure recognized "biological" basis, many insurance companies will not cover as much for treatment. Researchers are gaining ground on this area, but it has a long way to go. Many states have some form of a mental health parity law, but it varies state to state. This site gives a nice rundown of each state.

Whew, lots of information there. I went a little off tangent, but all of this relates to one another vastly as these are the issues of today.

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