Eating disorder terminology said to hurt treatment

The term “eating disorder” often suggests losing a dangerous amount of weight.

But there are people engaging in harmful eating behaviors who haven’t lost much weight, or who gain some, and they are not getting the treatment they need, doctors say.

Some insurance companies will only cover treatment for eating disorders if the patient meets all of the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, a guidebook for diagnosing mental illnesses, doctors say. Patients who don’t match all the symptoms, which include severe weight loss, are labeled “eating disorder not otherwise specified” (EDNOS) and sometimes don’t qualify for the level of care they need.

A new study, published in the journal Pediatrics, found more than 60 percent of patients with EDNOS met medical criteria for hospitalization and were, on average, sicker than patients diagnosed with full-blown bulimia.

That means more than 60 percent of patients with EDNOS may have trouble getting care covered by an insurance company, said Dr. Rebecka Peebles of the Department of Pediatrics at Stanford University School of Medicine.

“The diagnosis provides no meaningful information regarding the nature of the problem or appropriate treatment approaches,” said Pamela Keel, professor of psychology at Florida State University, who was not involved in the study, in an e-mail.

Researchers looked at 1,310 children and adolescents aged 8 to 19 years.

As many as 10 million women and 1 million men in the United States suffer from eating disorders such as anorexia and bulimia, according to the National Eating Disorders Association. Estimates put binge eating disorder, which currently falls under an EDNOS diagnosis, at an additional 25 million people.


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