Additional Eating and Weight Disorders
The Eating and Weight Disorders Program also provides diagnosis and treatment for the following conditions.
Pica is characterized by persistent eating of non-nutritive substances and eating of non-nutritive substances inappropriate to the developmental level of the individual. The eating behavior is not part of a culturally supported or socially normative practice. If occurring in the presence of another mental disorder (e.g. autism spectrum disorder) or during a medical condition (e.g. pregnancy), it has to be severe enough to warrant independent clinical attention.
Rumination disorder is characterized by repeated regurgitation of food (occurring for a period of at least one month); the regurgitated food may be re-chewed, re-swallowed, or spit out.
The repeated regurgitation is not due to a medication condition (e.g. gastrointestinal condition). If occurring in the presence of another mental disorder (e.g. intellectual developmental disorder), it is severe enough to warrant independent clinical attention.
Avoidant/Restrictive Food Intake Disorder (ARFID)
ARFID occurs across the age spectrum and is as common in males and females. It is characterized by a persistent failure to meet appropriate nutritional and/or energy needs associated with significant loss of weight (or failure to achieve expected weight gain or faltering growth in children); significant nutritional deficiency; dependence on enteral feeding or oral nutritional supplements to maintain one’s necessary caloric intake. Subjects with ARFID have marked interference with psychosocial functioning. The eating disturbance is not attributed to a medical condition, or better explained by another mental health disorder. ARFID can co- occur with other medical or psychiatric conditions/disorders, however to reach diagnostic threshold the behavior needs to exceed what is usually associated, and warrant additional clinical attention.
Other Specified Feeding or Eating Disorder (OSFED)
According to the DSM-5 criteria, OSFED are feeding or eating behaviors that cause clinically significant distress and impairment in areas of functioning, but do not reach threshold for any of the other feeding and eating disorders. The following are further examples for OSFED:
- Atypical Anorexia Nervosa: All criteria are met, except despite significant weight loss, the individual’s weight is within or above the normal range.
- Binge Eating Disorder (of low frequency and/or limited duration): All of the criteria for BED are met, except at a lower frequency and/or for less than three months.
- Bulimia Nervosa (of low frequency and/or limited duration): All of the criteria for Bulimia Nervosa are met, except that the binge eating and inappropriate compensatory behavior occurs at a lower frequency and/or for less than three months.
- Purging Disorder: Recurrent purging behavior to influence weight or shape in the absence of binge eating.
- Night Eating Syndrome: Recurrent episodes of night eating. Eating after awakening from sleep, or by excessive food consumption after the evening meal. The behavior is not better explained by environmental influences or social norms. The behavior causes significant distress/impairment. The behavior is not better explained by another mental health disorder (e.g. BED).
Obesity and Weight Management
Obesity in adults is defined as having a body mass index (BMI), or a ratio of weight (in kg) to height (in m2) equal to or exceeding a value of 30. For children and adolescents, obesity is typically defined as a BMI above the 95th percentile, based on the specific age range (healthy BMI varies by age). The Centers for Disease Control and Prevention report that, among adults, rates of obesity have doubled to nearly 30 percent in the past two decades.
Across the age spectrum, obesity can lead to several serious medical conditions, including diabetes, heart disease, and sleep apnea. The clinical and research communities remain committed to discovering approaches to eliminating obesity. Studies show that for children and adolescents, effective treatment involves the family, particularly parents, in the weight loss process. For adults the LEARN® or Diabetes Prevention Programs can help establish gradual and sustainable weight loss.