New Study: Eating Disorder Diagnostic Tools Need an Overhaul
A novel study reveals that current methods for diagnosing eating disorders often overlook a wide array of behaviors employed by individuals struggling with these conditions. Researchers advocate for updated assessment tools that are more adaptable and encourage open communication with patients about their experiences.
Behaviors Beyond the Checklist
Researchers interviewed almost 1700 patients to identify a broad spectrum of behaviors absent from current diagnostic criteria for eating disorders like anorexia nervosa, bulimia nervosa, and binge eating disorder. The behaviors varied widely, including chewing gum to curb food intake and extreme actions, like consuming cotton balls to fill the stomach without adding calories.
“We’re proposing an updated eating disorder assessment tool that has a longer, more varied list of behaviors so that there’s more flexibility and a more comfortable setting for patients to share their experiences,”
—Saakshi Kakar, PhD student and lead research assistant
Existing assessment tools can capture restriction-based behaviors, such as counting calories, using diuretics, and undergoing medical interventions. However, they can often fail to encompass the full range of weight-loss strategies, according to Kakar. One in ten Americans will experience an eating disorder in their lifetime, according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD 2023).
Four Key Behavioral Categories
The study identified four main categories of behaviors related to weight loss. These included restriction-based approaches, such as dieting and calorie counting, medical interventions like bariatric surgery, and body manipulation tactics that involve inducing sweating. Additionally, the research noted food avoidance behaviors, like spitting out food or consuming non-food items.
Researchers noted that many participants had a binge eating disorder, yet they also engaged in weight-loss and compensatory behaviors. According to Kakar, current DSM-5 criteria for binge eating disorder stipulate that the behavior shouldn’t involve recurrent inappropriate compensatory actions.
A Broader View Needed
The research underscores the importance of examining all possibilities when evaluating for an eating disorder. Kakar emphasizes the necessity of open-ended conversations with patients about their weight-loss strategies. This approach can reveal behaviors that standard screening tools may miss.
The team intends to collaborate with clinicians and individuals with eating disorders to create a more detailed list of weight-loss behaviors that clinicians and researchers can utilize. The study’s limitation was that it didn’t assess the identified behaviors’ association with significant distress or impairment.