National Eating Disorders Awareness Week

According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM), “The Eating Disorders are characterized by severe disturbances in eating behavior.” DSM goes on to say that obesity is included as a general medical condition in the International Classification of Deceases (IC), but it has not been included in DSM because “… it has not been established that it is consistently associated with a psychological or behavioral syndrome.” If such factors are important in the etiology of a “particular” case of obesity, it should be noted as “Psychological Factors Affecting Medical Condition.”


I’m left wondering what this means. What condition or conditions are they talking about? The DSM is used for psychological diagnosis (and, of course, for insurance reimbursement). So, does an obese person have to have a major mental disorder in order to have the obesity treated OR does the mental health practitioner have to diagnose a medical condition in order to begin a behavioral weight control program?


The above musing aside, Eating Disorders are real AND potentially life threatening. Eating disorders do not (at least yet) include disorders of over-eating with persistent weight gain. Eating disorders include:

  • Anorexia nervosa – a refusal to maintain a minimally normal body weight.
  • Bulimia nervosa – repeated episodes of binge eating followed by inappropriate compensatory behaviors (vomiting, purging, excessive exercise, fasting, misuse of medications).


Bulimia is more common than anorexia and, unlike individuals with anorexia, individuals with bulimia are often of normal weight. Both anorexia and bulimia are most prevalent in developed countries. Both disorders are more prevalent among girls/women than among boys/men. However, boys and men do develop both disorders. These are not just “women’s diseases.”


There is no one “cause” of eating disorders. There are multiple causes and one may weight more heavily than another in an individual case. The causes can be grouped into four loose categories:

  • Psychological factors
  • Interpersonal factors
  • Social factors
  • Familial factors

National Eating Disorders Association


Treatment for eating disorders involves psychological counseling and attention to medical and nutritional needs. It is crucial that treatment be coordinated with a team approach. Eating disorders affect not only weight. They affect the whole body, including the kidneys, heart, GI tract and teeth. Untreated eating disorders can have long term effects and are potentially fatal.


February 22 – 28 is National Eating Disorders Awareness week.


Or more information on eating disorders access:



Mary Lou Bernardo, PhD, MSN


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