DSM, heal thyself

I think it is time for the DSM on eating disorders to change. So does The Joy Project.

Help Improve Patient Care
By Helping to Change the Diagnostic Criteria for Eating Disorders!One of our most important missions at the Joy Project is to assist those who suffer from eating disorders in getting their voices heard. As some of you may know, the American Psychiatric Association (APA) is currently in the process of reconsidering the diagnostic criteria for eating disorders, which will be published in the Diagnostic and Statistical Manual for Mental Disorders- V in 2012. We believe that a crucial part of this process is consideration of the negative impact that the current criteria may have from the perspective of the patients themselves. If you would like to help bring these issues to the attention of the Eating Disorders Working Group of the APA, you can help us out in two ways. First, we have composed a petition to the APA, outlining the general problems the current diagnostic criteria can pose for patients. You can add your signature and add comments. We've also created a personal experience form letter , in which you have the chance to share any personal experiences you may have had regarding the ways in which a focus on weight or "severity" of your eating disorder may have affected your own personal journey. Then, send your letter directly to the Joy Project, where we will compile them and deliver them to the revision work group at the APA!


  1. A thousand times yes. I personally believe that all this separation between the "types" of eating disorders is not only pointless but detrimental. All EDs stem from the same roots, and simply manifest themselves differently in individuals. The fact that most people with EDs have a myriad of symptoms that change over the years, along with a weight fluxuating between obesity and emaciation, should prove that the focus on weight and neat catagorical boxes is energy better spent elsewhere.

  2. Absolutely...
    We need an ED Spectrum like that used in Autism. We acknowledge disordered eating and ED's but there is no room for the symptoms to flow and cluster as seen in real patients. There is also no severity rating that denotes patients with life threatening forms of these illnesses (Anorexia/Bulimia Gravis???)

  3. MB,

    I like the idea of a "spectrum" since research has shown that many sufferers shift from one set of symptoms to another as the illness progresses.

    What I don't like is the indication of illness severity in the spectrum. ALL eating disorders are life threatening; that's part of the current problem with EDNOS. Insurance companies are going to use any excuse they possibly can to avoid paying for treatment- what better excuse than "it's not that bad," usually expressed as "not medically necessary." I realize that this is less of a problem with the DSM than with our effed up insurance system, but insurers also use the DSM as a basis to determine what/how much to pay.

    The other thing is determining which criteria would make an eating disorder more "severe" than another. People can deteriorate very rapidly. The other problem is the nature of eating disorders themselves, and the competition therein. Even when I did fit the diagnostic criteria for AN, I didn't think I was thin enough. And several of the times I've been the sickest, I've had EDNOS.

    I do think we need to be much clearer about the differences between disordered eating and eating disorders, but eating disorder symptoms do exist on a spectrum of different types of behaviors. They're all serious.

  4. But anorexia and bulimia are two distinct disorders, with different etiology, symptoms, and response to treatment. There is research to support this.


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