Not a Glutton

The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM) Version 5 will be out in the Spring of 2013.  In it Binge Eating Disorder (BED) will be added for the first time, defined as this: 

• Criteria include frequent overeating—at least once a week for three months— combined with lack of control, marked feelings of distress, and are associated with three or more of the following:
• eating much more rapidly than normal
• eating until feeling uncomfortably full
• eating large amounts of food when not feeling physically hungry
• eating alone because of feeling embarrassed by how much one is eating.

Dr. Allen Frances of Psychology Today lists the 10 worst issues in DSM 5 and one of those issues includes BED: 

Excessive eating 12 times in 3 months is no longer just a manifestation of gluttony and the easy availability of really great tasting food. DSM 5 has instead turned it into a psychiatric illness called Binge Eating Disorder.

For an MD, Dr. Frances appears to know very little about eating disorders and more about giving moral judgements upon overeaters, essentially calling them gluttons. 

BED isn't overeating at a fine restaurant or at a great meal, it's compulsive overeating past the point of fullness, without taste or enjoyment. It's similar to bulimia but without vomiting. 

Now as far as BED being listed in the DSM, I have mixed feelings. On one hand, having suffered from BED, it's nice to see it acknowledge as something real instead of "Stop eating so much, fattie." However I am wary that its being added opens up a psychological issue to diet drugs. Something I have repeatedly mentioned never work.  And I worry because the American Psychiatric Association which is not known to be fat positive is adding not adding BED because how it affects the self esteem and well being of the person, but because the worst case scenario is they might become fat. 

Comments

[Maryjane Heyer]

Bottom line is the APA serves the pharmaceutical industry. They won't add a disorder if there's not a chance they can medicate it.