When we chatted with University of Chicago psychiatrists about the proposed changes to the DSM-V – the diagnostic manual for mental disorders – there was one much talked-about piece missing: eating disorders. Many media outlets writing about the DSM-V draft mentioned a change in the chapter on eating disorders that sounds small but could be highly clinically significant, the addition of binge eating disorder as the chapter’s third discrete condition alongside anorexia nervosa and bulimia nervosa. Unlike those two more-established disorders, which can result in dangerous weight loss, binge eating disorder could produce weight gain. Inclusion of binge eating in the chapter on eating disorders thereby could signal a shift toward medically treating overeating, like undereating, as a mental illness.
Daniel Le Grange, professor of psychiatry and behavioral neuroscience and director of the eating disorders center at the University of Chicago Medical Center, said that may be true – researchers and physicians in his field are looking more and more at uncontrollable overeating as a disorder. But binge eating disorder itself is not an entirely new condition; instead, it has long existed in the diagnostic limbo of “eating disorders not otherwise specified,” a catch-all term for less common or less discrete conditions. Still, if the DSM-V draft recommendations are approved, binge eating disorder may receive more attention from doctors and scientists, leading to treatment advances in an area where effective treatments, even for anorexia and bulimia, are relatively new and sometimes lacking in supporting evidence.
In this week’s Dr. FAQ, Le Grange talks about the proposed changes to the DSM-V chapter on eating disorders and binge eating disorder in general. He also explains what treatments are currently used for eating disorders, and what is known about the causes of those conditions (spoiler alert: very little). Finally, Le Grange talks about the eating disorders research being conducted at the University of Chicago, including his work on the Maudsley Approach, a family-based treatment for eating disorders in adolescent patients. Le Grange will be speaking at a conference for families of adolescents with eating disorders in Chicago on April 26th.