FEEDING AND EATING DISORDERS

PRESENTED BY
BEATRIZ JOY VIRAY
 American Psychiatric Association. (2022).
Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).

American Psychiatric Association. (2023)

Eating Disorders: Guidance for Patients, Families and Friends
OVERVIEW

FEEDING AND EATING DISORDERS

Persistent disturbance of eating or eating-related behavior that results in
the altered consumption or absorption of food and that significantly
impairs physical health or psychosocial functioning
Behavior commonly associated with eating disorders include restrictive
eating or avoidance of certain foods, binge eating, purge by vomiting or
laxative misuse, and compulsive exercise.
These are serious conditions that can reduce over all quality of life. Also,
if left untreated, the physical and mental side effects can last for
decades, or even lifetime.
Obesity is not included in DSM 5-TR as a mental disorder.
OVERVIEW

FEEDING AND EATING DISORDERS

Some individuals with disorders described symptoms resembling those
typically endorsed by individuals with substance use disorder, such as
craving patterns of compulsive use. However, the relative contributions
of shared and distinct factors in the development and perpetuation of
eating and substance use disorders remain insufficiently understood.
OVERVIEW

FEEDING AND EATING DISORDERS

Current estimate show eating disorders
will affect between 2 to 3 out of every
100 people in United States at some
point during their lifetime.
This disorder is more common in women,
and often appear in teenage years and
early adulthood. However, it can affect
any person at a time, regardless of age,
gender, race, ethnicity, weight, size, or
body shape.
FEEDING AND EATING DISORDERS
Pica
Rumination Disorder
Avoidant/Restrictive Food
Intake Disorder
Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder
PICA
PICA
It is an eating disorder which a person repeatedly eat things that are not
food with no nutritional value.
The behavior persists over at least one month and is severe enough to
warrant clinical attention.
Typical substances ingested may vary with age and availability and
might include paper, paint, chips, soap, cloth, hair, string, chalk, metal,
pebbles, charcoal or coal, or clay.
Individuals with Pica do not typically have an aversion to food in general.
PICA DIAGNOSTIC CRITERIA
PICA
The behavior is inappropriate to the developmental level
of the individual and is not part of a culturally supported
practice.
Pica may first occur in childhood, adolescence, or
adulthood, although childhood onset is most common. It
is not diagnosed in children under age 2 years old.
It often occurs along with autism spectrum disorder and
intellectual disability, but can occur in otherwise typically
developing children.
A person diagnosed with pica is at risk for potential
intestinal blockages or toxic effects of substances
consumed (e.g. lead in paint chips).
GEOPHAGY
the practice of eating earth, especially
chalk or clay in famine-stricken
regions.
Southern American - Kaolin Festival
Kaolin-eating is often associated with
pregnant women
The absorbance properties of this
substance may aid with the
elimination of viruses or bacterias that
lead to digestive issues like diarrhea
RUMINATION DISORDER
RUMINATION DISORDER
Rumination disorder involves the repeated
regurgitation and re-chewing of food after
eating whereby swallowed food is brought
back up into the mouth voluntarily and is
re-chewed and re-swallowed or spat out.
Rumination disorder can occur in infancy,
childhood and adolescence or in
adulthood.
RUMINATION DISORDER
RUMINATION DISORDER
Other Syptoms:
Effortless regurgitation, typically within minutes of eating.
Belly pain or pressure relieved by regurgitation.
A feeling of fullness.
Nausea.
Losing weight without trying.
AVOIDANT/
RESTRICTIVE
FOOD
INTAKE
DISORDER
 AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER

ARFID is a recently defined eating disorder that involves a disturbance in

eating resulting in persistent failure to meet nutritional needs and
extreme picky eating.
ARFID is a recently defined eating disorder that involves a disturbance in
eating resulting in persistent failure to meet nutritional needs and
extreme picky eating.
AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER
AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER
 AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER
The impact on physical and psychological health and degree of
malnutrition can be similar to that seen in people with anorexia nervosa.
However, people with ARFID do not have excessive concerns about their
body weight or shape and the disorder is distinct from anorexia nervosa
or bulimia nervosa.
Also, while individuals with autism spectrum disorder often have rigid
eating behaviors and sensory sensitivities, these do not necessarily lead
to the level of impairment required for a diagnosis of avoidant/restrictive
food intake disorder.
 AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER
Food avoidance or restriction commonly develops in infancy or early
childhood and may continue in adulthood. It can however start at any age.
Regardless of the age of the person affected, ARFID can impact families,
causing increased stress at mealtimes and in other social eating situations.
ANOREXIA
NERVOSA
ANOREXIA NERVOSA
Anorexia nervosa is characterized by self-starvation and
weight loss resulting in low weight for height and age.
It has the highest mortality of any psychiatric diagnosis
other than opioid use disorder and can be a very serious
condition.
It usually begins during adolescence or young adulthood.
Body mass index or BMI, a measure of weight for height,
is typically under 18.5 in an adult individual with
anorexia nervosa.
ANOREXIA NERVOSA
Dieting behavior in anorexia nervosa is driven by an intense fear of gaining
weight or becoming fat. Although some individuals with anorexia will say they
want and are trying to gain weight, their behavior is not consistent with this
intent.
ANOREXIA NERVOSA
ANOREXIA NERVOSA
ANOREXIA NERVOSA
ANOREXIA NERVOSA
Over time, some of the following symptoms may develop related to starvation
or purging behaviors:

Menstrual periods cease

Dizziness or fainting from dehydration
Brittle hair/nails
Cold intolerance
muscle weakness and wasting
Heartburn and reflux (in those who vomit)
ANOREXIA NERVOSA
Over time, some of the following symptoms may develop related to starvation
or purging behaviors:

Severe constipation, bloating and fullness after meals

Stress fractures from compulsive exercise as well as bone loss resulting
in osteopenia or osteoporosis (thinning of the bones)
Depression, irritability, anxiety, poor concentration and fatigue
BULIMIA NERVOSA
BULIMIA NERVOSA
Individuals with bulimia nervosa typically alternate dieting, or eating only
low calorie “safe foods” with binge eating on “forbidden” high calorie
foods.
Binge eating is defined as eating a large amount of food in a short
period of time associated with a sense of loss of control over what, or
how much one is eating.
Binge behavior is usually secretive and associated with feelings of
shame or embarrassment.
BULIMIA NERVOSA
Persons with bulimia nervosa are excessively preoccupied with thoughts
of food, weight or shape which negatively affect, and disproportionately
impact, their self-worth.
Individuals with bulimia nervosa can be slightly underweight, normal
weight, overweight or even obese. If they are significantly underweight
however, they are considered to have anorexia nervosa binge-
eating/purging type not bulimia nervosa.
BULIMIA NERVOSA
BULIMIA NERVOSA DIAGNOSTIC CRITERIA
BULIMIA NERVOSA DIAGNOSTIC CRITERIA
BULIMIA NERVOSA

Bulimia can lead to rare but potentially fatal complications including

esophageal tears, gastric rupture, and dangerous cardiac arrhythmias.
Medical monitoring in cases of severe bulimia nervosa is important to
identify and treat any possible complications.
BINGE-EATING DISORDER
BINGE-EATING DISORDER
People with binge eating disorder have episodes of binge eating in which
they consume large quantities of food in a brief period, experience a sense
of loss of control over their eating and are distressed by the binge
behavior.
Binge eating disorder can lead to serious health complications, including
obesity, diabetes, hypertension and cardiovascular diseases.
BINGE-EATING DISORDER
BINGE-EATING DISORDER
BINGE-EATING DISORDER
TREATMENT PLAN
 TREATMENT PLAN
Testing for Nutritional Deficiencies
Cognitive Behavioral Therapy
Individual, group, or family Psychotherapy
THANK YOU