Diagnostic Changes for Eating Disorders in the DSM-V

Considered the “bible” of the psychiatric and mental health world, the American Psychiatric Association’sDiagnostic & 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 foreating disordersunderwent 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.

Binge Eating Disorder

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).

Diagnostic Criteria for Binge-Eating Disorder

Anorexia Nervosa

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.

Diagnostic Criteria for Anorexia Nervosa

Bulimia Nervosa

Diagnostic Criteria for Bulimia Nervosa

Other Types of Feeding or Eating Disorders

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:

Diagnostic Criteria Is a Work in Progress

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.

A Word From Verywell

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 thesymptoms of any eating disorder, please consult with a physician, dietitian, or mental health professional for assessment and treatment.

The Different Causes of Eating Disorders

3 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Vo M, Accurso E, Goldschmidt A, Le grange D.The Impact of DSM-5 on Eating Disorder Diagnoses.Int J Eat Disord. 2017;50(5):578-581. doi:10.1002%2Feat.22628Harrington B, Jimerson,M, Haxton C, Jimerson, D.Initial Evaluation, Diagnosis, and Treatment of Anorexia Nervosa and Bulimia Nervosa.Am Fam Physician. 2015;91(1):46-52.Grilo C, Ivezaj V, White M.Evaluation of the DSM-5 severity indicator for bulimia nervosa.Behav Res Ther. 2015;67:41-4. doi:10.1016%2Fj.brat.2015.02.002Additional ReadingAmerican Psychiatric Association.Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC. 2013.American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed., Text Revision). Washington, DC. 2000.

3 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Vo M, Accurso E, Goldschmidt A, Le grange D.The Impact of DSM-5 on Eating Disorder Diagnoses.Int J Eat Disord. 2017;50(5):578-581. doi:10.1002%2Feat.22628Harrington B, Jimerson,M, Haxton C, Jimerson, D.Initial Evaluation, Diagnosis, and Treatment of Anorexia Nervosa and Bulimia Nervosa.Am Fam Physician. 2015;91(1):46-52.Grilo C, Ivezaj V, White M.Evaluation of the DSM-5 severity indicator for bulimia nervosa.Behav Res Ther. 2015;67:41-4. doi:10.1016%2Fj.brat.2015.02.002Additional ReadingAmerican Psychiatric Association.Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC. 2013.American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed., Text Revision). Washington, DC. 2000.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Vo M, Accurso E, Goldschmidt A, Le grange D.The Impact of DSM-5 on Eating Disorder Diagnoses.Int J Eat Disord. 2017;50(5):578-581. doi:10.1002%2Feat.22628Harrington B, Jimerson,M, Haxton C, Jimerson, D.Initial Evaluation, Diagnosis, and Treatment of Anorexia Nervosa and Bulimia Nervosa.Am Fam Physician. 2015;91(1):46-52.Grilo C, Ivezaj V, White M.Evaluation of the DSM-5 severity indicator for bulimia nervosa.Behav Res Ther. 2015;67:41-4. doi:10.1016%2Fj.brat.2015.02.002

Vo M, Accurso E, Goldschmidt A, Le grange D.The Impact of DSM-5 on Eating Disorder Diagnoses.Int J Eat Disord. 2017;50(5):578-581. doi:10.1002%2Feat.22628

Harrington B, Jimerson,M, Haxton C, Jimerson, D.Initial Evaluation, Diagnosis, and Treatment of Anorexia Nervosa and Bulimia Nervosa.Am Fam Physician. 2015;91(1):46-52.

Grilo C, Ivezaj V, White M.Evaluation of the DSM-5 severity indicator for bulimia nervosa.Behav Res Ther. 2015;67:41-4. doi:10.1016%2Fj.brat.2015.02.002

American Psychiatric Association.Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC. 2013.American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed., Text Revision). Washington, DC. 2000.

American Psychiatric Association.Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC. 2013.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed., Text Revision). Washington, DC. 2000.

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