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Psychiatry1088 papers

Eating disorder

Last edited: 4/13/2026

Overview

Eating disorders encompass a range of mental health conditions characterized by abnormal eating habits and severe disturbances in eating behavior, including anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant/restrictive food intake disorder (ARFID). These disorders often involve distorted body image and significant emotional distress 1251527.

Diagnosis

  • Key Criteria: Distorted body image, extreme concern with body weight/shape, and disordered eating behaviors (e.g., restrictive eating, binge eating, purging) 12527.
  • Recommended Tests: Nutritional assessment, anthropometric measurements (BMI, weight), psychological evaluations (e.g., EDI, EDE-Q), and medical workup (electrolytes, thyroid function, ECG) 11227.
  • Special Considerations: ARFID diagnosis requires exclusion of other psychiatric disorders and significant impact on daily functioning 51030.
  • Management

  • First-Line Treatments: Psychotherapy (cognitive-behavioral therapy, family-based therapy for adolescents), nutritional counseling, and medical monitoring 81227.
  • Adjunctive Treatments: Medication (e.g., SSRIs for bulimia nervosa), hospitalization for severe malnutrition or medical complications 1227.
  • Specific Drug Classes: Fluoxetine (SSRI) for bulimia nervosa; dosages vary but typically start at 20-60 mg/day 12.
  • Special Populations

  • Pregnancy: Enhanced monitoring for complications like hyperemesis gravidarum, intrauterine growth restriction, and preterm birth; multidisciplinary care essential 3738.
  • Pediatrics: Early intervention with family-based therapy (e.g., Maudsley approach) is crucial 112.
  • Comorbidities: Consider gastrointestinal symptoms and their impact on diagnosis and management; collaboration with gastroenterologists recommended 91516.
  • Key Recommendations

  • Early Identification and Intervention: Prioritize early detection and prompt treatment to improve outcomes 212 (Evidence: Strong).
  • Multidisciplinary Approach: Utilize a team including psychiatrists, dietitians, and medical doctors for comprehensive care 1227 (Evidence: Strong).
  • Psychotherapy as First-Line: Cognitive-behavioral therapy and family therapy are effective first-line treatments, especially for adolescents 812 (Evidence: Strong).
  • Monitoring in Special Populations: Pregnant women and pediatric patients require heightened surveillance and tailored interventions 37381 (Evidence: Moderate).
  • Education and Training: Enhance medical professionals' knowledge and skills in diagnosing and managing eating disorders, particularly in non-specialist settings 31 (Evidence: Moderate).
  • References

    1 Lane R, Millard LAC, Salway R, Stone CJ, Skinner AL, Brady SM et al.. The Feasibility of Smartwatch Micro-Ecological Momentary Assessment for Tracking Eating Patterns of Malaysian Children and Adolescents in the South-East Asian Community Observatory Child Health Update 2020: Cross-Sectional Study. Journal of medical Internet research 2026. link 2 Sapouna ME, Lappas A, Samara M, Bozikas VP, Christodoulou N. Barriers to the use of telepsychiatry for the treatment of eating disorders: A systematic review and thematic synthesis. Psychiatrike = Psychiatriki 2025. link 3 Moccia L, Anesini MB, Callovini T, Janiri D, Policola C, Cintoni M et al.. Understanding Orthorexia Nervosa: A Systematic Review of Meta-analytical Findings. Current nutrition reports 2025. link 4 Spanos KE, Wright TS, DeAngelis C, Essayli JH. Assessing Obstetrics and Gynecology (OBGYN) Clinicians' Knowledge, Practice, and Attitudes toward Anorexia Nervosa, Atypical Anorexia Nervosa, and Amenorrhea. Journal of pediatric and adolescent gynecology 2025. link 5 Bertrand V, Tavolacci MP, Bargiacchi A, Leblanc V, Déchelotte P, Stordeur C et al.. Analysis of feeding and eating disorders in 191 children according to psychiatric or gastroenterological recruitment: The PEDIAFED cohort study. European eating disorders review : the journal of the Eating Disorders Association 2024. link 6 Ogawa M, Komura H, Ono Y, Nose-Ogura S, Kawai K, Terauchi M. Attitude and experience of obstetricians and gynecologists toward eating disorders assessment and management in Japan: A nationwide survey. The journal of obstetrics and gynaecology research 2024. link 7 Sader M, Waiter GD, Williams JHG. The cerebellum plays more than one role in the dysregulation of appetite: Review of structural evidence from typical and eating disorder populations. Brain and behavior 2023. link 8 Stice E, Rohde P, Yokum S, Gau JM, Bohon C, Shaw H. A randomized trial of two group-delivered transdiagnostic eating disorder treatments: Dissonance-based treatment versus interpersonal psychotherapy. Journal of consulting and clinical psychology 2023. link 9 Staller K, Abber SR, Burton Murray H. The intersection between eating disorders and gastrointestinal disorders: a narrative review and practical guide. The lancet. Gastroenterology & hepatology 2023. link00351-X) 10 Turner P. Implementation of the medical emergencies in eating disorders in adults guidance on non-specialist units. British journal of nursing (Mark Allen Publishing) 2023. link 11 Magee MK, Jones MT, Fields JB, Kresta J, Khurelbaatar C, Dodge C et al.. Body Composition, Energy Availability, Risk of Eating Disorder, and Sport Nutrition Knowledge in Young Athletes. Nutrients 2023. link 12 . Medical Management of Restrictive Eating Disorders in Adolescents and Young Adults. The Journal of adolescent health : official publication of the Society for Adolescent Medicine 2022. link 13 Filipponi C, Visentini C, Filippini T, Cutino A, Ferri P, Rovesti S et al.. The Follow-Up of Eating Disorders from Adolescence to Early Adulthood: A Systematic Review. International journal of environmental research and public health 2022. link 14 Juli L, Juli R, Juli MR, Juli G. Eating and Nutrition Disorders: Intra and Post-Lockdown Pandemic Emergencies. Psychiatria Danubina 2022. link 15 Burton Murray H, Calabrese S. Identification and Management of Eating Disorders (including ARFID) in GI Patients. Gastroenterology clinics of North America 2022. link 16 Werlang ME, Sim LA, Lebow JR, Lacy BE. Assessing for Eating Disorders: A Primer for Gastroenterologists. The American journal of gastroenterology 2021. link 17 Colón-Ramos U, Monge-Rojas R, Smith-Castro V, Wang J, Cheng YI, Perreira KM et al.. Family function and eating behaviours among Hispanic/Latino youth: results from the Hispanic Community Children's Health Study/Study of Latino Youth (SOL Youth). Public health nutrition 2021. link 18 Daniels E, Hanson J. Energy-Adjusted Dietary Intakes Are Associated with Perceived Barriers to Healthy Eating but Not Food Insecurity or Sports Nutrition Knowledge in a Pilot Study of ROTC Cadets. Nutrients 2021. link 19 Ferreira-Pêgo C, Rodrigues J, Costa A, Sousa B. Eating behavior: The influence of age, nutrition knowledge, and Mediterranean diet. Nutrition and health 2020. link 20 Berner LA, Brown TA, Lavender JM, Lopez E, Wierenga CE, Kaye WH. Neuroendocrinology of reward in anorexia nervosa and bulimia nervosa: Beyond leptin and ghrelin. Molecular and cellular endocrinology 2019. link 21 Bert F, Gualano MR, Voglino G, Rossello P, Perret JP, Siliquini R. Orthorexia Nervosa: A cross-sectional study among athletes competing in endurance sports in Northern Italy. PloS one 2019. link 22 Monteleone AM, Castellini G, Volpe U, Ricca V, Lelli L, Monteleone P et al.. Neuroendocrinology and brain imaging of reward in eating disorders: A possible key to the treatment of anorexia nervosa and bulimia nervosa. Progress in neuro-psychopharmacology & biological psychiatry 2018. link 23 Quatromoni PA. A Tale of Two Runners: A Case Report of Athletes' Experiences with Eating Disorders in College. Journal of the Academy of Nutrition and Dietetics 2017. link 24 . Expressing anger positively could reduce eating disorders. Nursing children and young people 2016. link 25 . Delivering a message of hope. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2016. link 26 Long J. Sarah's support has helped me to tackle my eating disorder. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2016. link 27 Joy E, Kussman A, Nattiv A. 2016 update on eating disorders in athletes: A comprehensive narrative review with a focus on clinical assessment and management. British journal of sports medicine 2016. link 28 Tan JO, Calitri R, Bloodworth A, McNamee MJ. Understanding Eating Disorders in Elite Gymnastics: Ethical and Conceptual Challenges. Clinics in sports medicine 2016. link 29 . Beat (Beat Eating Disorders). Nursing management (Harrow, London, England : 1994) 2015. link 30 Eddy KT, Thomas JJ, Hastings E, Edkins K, Lamont E, Nevins CM et al.. Prevalence of DSM-5 avoidant/restrictive food intake disorder in a pediatric gastroenterology healthcare network. The International journal of eating disorders 2015. link 31 Girz L, Robinson AL, Tessier C. Is the next generation of physicians adequately prepared to diagnose and treat eating disorders in children and adolescents?. Eating disorders 2014. link 32 Begg DP, Woods SC. The endocrinology of food intake. Nature reviews. Endocrinology 2013. link 33 Sundgot-Borgen J, Meyer NL, Lohman TG, Ackland TR, Maughan RJ, Stewart AD et al.. How to minimise the health risks to athletes who compete in weight-sensitive sports review and position statement on behalf of the Ad Hoc Research Working Group on Body Composition, Health and Performance, under the auspices of the IOC Medical Commission. British journal of sports medicine 2013. link 34 Lynch E. Learning curve. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2011. link 35 Monteleone P. New frontiers in endocrinology of eating disorders. Current topics in behavioral neurosciences 2011. link 36 Andersen AE, Ryan GL. Eating disorders in the obstetric and gynecologic patient population. Obstetrics and gynecology 2009. link 37 Leddy MA, Jones C, Morgan MA, Schulkin J. Eating disorders and obstetric-gynecologic care. Journal of women's health (2002) 2009. link 38 Ward VB. Eating disorders in pregnancy. BMJ (Clinical research ed.) 2008. link 39 Bonci CM, Bonci LJ, Granger LR, Johnson CL, Malina RM, Milne LW et al.. National athletic trainers' association position statement: preventing, detecting, and managing disordered eating in athletes. Journal of athletic training 2008. link 40 Quatromoni PA. Clinical observations from nutrition services in college athletics. Journal of the American Dietetic Association 2008. link 41 Manore MM, Kam LC, Loucks AB. The female athlete triad: components, nutrition issues, and health consequences. Journal of sports sciences 2007. link 42 Zerbe KJ. Eating disorders in the 21st century: identification, management, and prevention in obstetrics and gynecology. Best practice & research. Clinical obstetrics & gynaecology 2007. link 43 Nattiv A, Loucks AB, Manore MM, Sanborn CF, Sundgot-Borgen J, Warren MP. American College of Sports Medicine position stand. The female athlete triad. Medicine and science in sports and exercise 2007. link 44 Whitson E, Cordova ML, Demchak T, Stemmans CL, King KA. Certified athletic trainers' knowledge and perception of professional preparation involving eating disorders among athletes. Journal of allied health 2006. link 45 Currie A, Morse ED. Eating disorders in athletes: managing the risks. Clinics in sports medicine 2005. link 46 Brunet M. Female athlete triad. Clinics in sports medicine 2005. link 47 Beals KA. Eating behaviors, nutritional status, and menstrual function in elite female adolescent volleyball players. Journal of the American Dietetic Association 2002. link90285-3) 48 Friedl L. Eating disorders. Journal - Oklahoma Dental Association 2001. link 49 Johnson JG, Spitzer RL, Williams JB. Health problems, impairment and illnesses associated with bulimia nervosa and binge eating disorder among primary care and obstetric gynaecology patients. Psychological medicine 2001. link 50 Abraham S. Obstetricians and maternal body weight and eating disorders during pregnancy. Journal of psychosomatic obstetrics and gynaecology 2001. link 51 Woodmansey KF. Recognition of bulimia nervosa in dental patients: implications for dental care providers. General dentistry 2000. link 52 Morgan JF. Eating disorders and gynecology: knowledge and attitudes among clinicians. Acta obstetricia et gynecologica Scandinavica 1999. link 53 Sossin K, Gizis F, Marquart LF, Sobal J. Nutrition beliefs, attitudes, and resource use of high school wrestling coaches. International journal of sport nutrition 1997. link 54 Franco K, Campbell N, Tamburrino M, Evans C. Rumination: the eating disorder of infancy. Child psychiatry and human development 1993. link 55 Myer SA, O'Brien A. Multisystem complications of bulimia: a critical care case. Dimensions of critical care nursing : DCCN 1993. link 56 Gupta MA, Gupta AK, Ellis CN, Voorhees JJ. Bulimia nervosa and acne may be related: a case report. Canadian journal of psychiatry. Revue canadienne de psychiatrie 1992. link 57 Frank ES. Shame and guilt in eating disorders. The American journal of orthopsychiatry 1991. link 58 Fontaine KL. The conspiracy of culture. Women's issues in body size. The Nursing clinics of North America 1991. link 59 Yates WR, Sieleni B. Anorexia and bulimia. Primary care 1987. link 60 Freedman RJ. Reflections on beauty as it relates to health in adolescent females. Women & health 1984. link

    Original source

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