Earlier this month, the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) was approved by the American Psychiatric Association, with official release slated for May 2013. This “psychiatric bible” lays out the diagnostic criteria by which mental health professionals classify and diagnose psychiatric illnesses, including eating disorders. Among the many updates to this latest version was a reclassification of binge eating disorder (BED) from the catchall category of “eating disorder not otherwise specified” (EDNOS) to an official diagnostic category of its own.
Chevese Turner, founder and CEO of the Binge Eating Disorder Association (BEDA), stated in a press release that, “We have worked hard with health policy makers and researchers to advocate for the inclusion of BED in the DSM-5. This is long-awaited validation for the more than 10 million people who have long suffered from the misunderstanding and lack of recognition of binge eating disorder, which is the most common eating disorder. Inclusion of binge eating disorder in the DSM-5 is an enormous step forward for prevention, research, education, and treatment of the disorder. Children, adolescents, and adults with binge eating disorder will no longer have to suffer in shame and silence.”
With a lifetime prevalence in the U.S. population of 3.5 percent among women and 2.0 percent among men, BED affects more Americans than anorexia nervosa (AN) and bulimia nervosa (BN) combined and is associated with a range of medical and psychiatric comorbidities. Yet, rather than lauding the inclusion of BED in the DSM-5 as a step forward in the diagnosis and treatment of eating disorders, we have been dismayed by the negative press surrounding this change. In a recent New York Times article, BED was trivialized as no more than “a kind of severe, highly distressing gluttony” that “could tag millions of people considered healthy, if not overindulgent, with a psychiatric label.” Meanwhile, a blog post in the Huffington Post named this “one of the ten worst changes” in the DSM-5, calling BED “a manifestation of gluttony and the easy availability of really great tasting food.”
Equating BED with gluttony is shaming, stigmatizing, and uninformed. Articles such as these contribute to the widespread stigmatization of mental illness and have no place in respectable sources such as the New York Times and Huffington Post. BED is a serious illness, and to say otherwise does a disservice to the millions of lives that have been affected by this disorder, as well as those of us on the front lines of eating disorder research and treatment.
By: Susan Kleiman & Dr. Cynthia Bulik