FEEDING AND

EATING
DISORDERS
- Characterized by persistent
disturbance of eating or eating
related behavior that results in
altered consumption or
absorption of food and that
significantly impairs physical
health or psychosocial functioning.
 Difference of Disorder from
DSM- IV-TR to DSM 5
 Name of disorder:  Name of disorder:
- Eating Disorders - Feeding and Eating Disorders

 Composed of:  Composed of:

-Anorexia Nervosa -Pica
*restricting type -Rumination Disorder
*binge-eating-purging type -Avoidant/Restrictive Food Intake
-Bulimia Nervosa -Anorexia Nervosa
*purging type *restricting type
*non-purging type *binge-eating/purging type
-Other specified Feeding/Eating -Bulimia Nervosa
Disorder -Binge Eating Disorder
-Other specified Feeding/Eating
Disorder
PICA
-Eating of one or more non-
nutritive, non-food substances on a
persistent basis over a period of at
least 1 month.
Diagnostic Criteria
A. Persistent eating of non-nutritive, non-food
substances over a period of at least 1 month.
B. The eating of non-nutritive, non-food substances is
inappropriate to the developmental level of the
individual.
C. The eating behavior is not part of a culturally
supported or socially normative practice.
D. If the eating behavior occurs in the context of
another mental disorder or medical condition, it is
sufficiently severe to warrant additional clinical
attention.
•May result to BEZOAR
•Abdominal flat plate radiography (x-ray),
ultrasound, and other scanning methods.

•COMORBID WITH:
*Trichotillomania
*Excoriation
*Gastrointestinal Complication
QUESTIONS:
* How long does it have to take to consider
what a person is feeling as disorder?
* Who are more predominant in having Pica?
* What are the possible causes of Pica?
* When can you say that a person is
experiencing Pica?
* Where is Pica more experienced?
People experiencing Pica
PICA
RUMINATION DISORDER
- Repeated regurgitation of
food occurring after feeding
or eating over a period of 1
month.
 Diagnostic Criteria

A. Repeated regurgitation of food over a period of at

least 1 month. Regurgitated food may be re-chewed,
re-swallowed, or spit out.
B. The repeated regurgitation is not attributable to an
associated gastrointestinal or other medical condition.
C. The eating disturbance does not occur exclusively during
the course of anorexia nervosa, bulimia nervosa, binge-
eating disorder, or avoidant/restrictive food intake.
D. If the symptoms occur in the context of another mental
disorder, they are sufficiently severe to warrant
additional clinical attention
Food is then brought up to the mouth
without apparent reason.

INFANTS: straining, arching the back

with head held back, and making
sucking movements.
REGURGITATION- casting up of
incompletely undigested food.
RUMINATION- repeated regurgitation.
-Rechewing or reswallowing
QUESTIONS:
* How long does it have to take to consider
what a person is feeling as disorder?
* Who are more predominant in having
Rumination disorder?
* What are the possible causes of Rumination
disorder?
* When can you say that a person is
experiencing Rumination disorder?
* Where is Rumination disorder more
experienced?
People with Rumination Disorder
RUMINATION DISORDER
Avoidant/Restrictive Food Intake

- Eating or feeding
disturbance that shows
lack of interest in eating
food.
Diagnostic Criteria
A. An eating or feeding disturbance as manifested by
persistent failure to meet appropriate nutritional
and/or energy needs associated with one or more of
the following:
1. Significant weight loss
2. Significant nutritional deficiency
3. Dependence on enteral feeding or oral nutritional
supplements.
4. Marked interference with psychosocial functioning.

B. The disturbance is not better explained by lack of

available food or by an associated culturally
sanctioned practice.
C. The eating disturbance does not occur exclusively
during the course of anorexia nervosa or bulimia
nervosa, and there is no evidence of a disturbance in
the way in which one’s body weight or shape is
experienced.

D. The eating disturbance is not attributable to a

concurrent medical condition or not better explained
by another mental disorder. When the eating
disturbance occurs in the context of another condition
or disorder, the severity of the eating disturbance
exceeds that routinely associated with the condition or
disorder and warrants additional clinical attention.
“dependence” on enteral feeding/oral nutritional
supplements.

*INDIVIDUALS REQUIRING SUPPLEMENTARY FEEDING:

-infants with failure to thrive who requires nasogastric tube
feeding.
-children with neurodevelopmental disorder.
-individuals who rely on gastronomy tube feeding and
complete oral nutritional supplement with absence of
underlying condition.

Might pertain to “restrictive”, “selective”, “choosy”,

“perseverant”, “chronic food refusal”, and “food neophobia”.

“Functional dysphagia”
“Globus hystericus”
QUESTIONS:
* How long does it have to take to consider what a
person is feeling as disorder?
* Who are more predominant in having
Avoidant/Restrictive food intake disorder?
* What are the possible causes of
Avoidant/Restrictive food intake disorder?
* When can you say that a person is experiencing
Avoidant/Restrictive food intake disorder?
* Where is Avoidant/restrictive food intake disorder
more experienced?
People with Avoidant/Restrictive food
intake disorder
AVOIDANT/RESTRICTIVE FOOD
INTAKE DISORDER
ANOREXIA NERVOSA
- A disorder characterized by a
person who has a persistent
energy intake restriction; intense
fear of gaining weight or of
becoming fat; and a disturbance
in self-perceived weight or shape.
 Diagnostic Criteria
A. Restriction of energy intake relative to requirements, leading to a
significantly low body weight in the context of age, sex,
developmental trajectory, and physical health.

B. Intense fear of gaining weight or of becoming fat, or persistent

behavior that interferes with weight gain, even through at a
significantly low weight.

C. Disturbance in the way in which one’s body weight or shape is

experienced, undue influence of body weight or shape on self-
evaluation, or persistent lack of recognition of the seriousness of
the current low body weight.
QUESTIONS:
* How long does it have to take to consider what
a person is feeling as disorder?
* Who are more predominant in having Anorexia
Nervosa?
* What are the possible causes of Anorexia
Nervosa?
* When can you say that a person is experiencing
Anorexia Nervosa?
* Where is Anorexia Nervosa more experienced?
People with Anorexia Nervosa
ANOREXIA NERVOSA
BULIMIA NERVOSA
- A disorder that is characterized by
recurrent episodes of binge eating,
recurrent inappropriate compensatory
behaviors to prevent weight gain, and
self-evaluation that is unduly
influenced by body shape and
weight.
 Diagnostic Criteria
A. Recurrent episodes of binge-eating. An episode of binge-eating is
characterized by both of the following:
1. Eating, in a discrete period of time, an amount of food that is
definitely larger than what most individuals would eat in a similar
period of time under similar circumstances.
2. A sense of lack of control over eating during the episode

B. Recurrent inappropriate compensatory behaviors in order to

prevent weight gain.
C. The binge eating and inappropriate compensatory behaviors both
occur, on average at least once a week for 3 months.
D. Self-evaluation is unduly influenced by body shape and weight.
E. The disturbance does not occur exclusively during episodes of
Anorexia Nervosa.
During binges, they eat food they like to avoid.

PURGE BEHAVIOR
PURGING- to take thing out.

VOMITING: most inappropriate compensatory behavior

-may fast a day, or exercise excessively to prevent

weight gain despite injury or other medical
complications.

SUICIDAL RATE: 20% per decade (because of Bulimia)

STIMULANT- control appetite and weight.

QUESTIONS:
* How long does it have to take to consider
what a person is feeling as disorder?
* Who are more predominant in having
Bulimia Nervosa?
* What are the possible causes of Bulimia
Nervosa?
* When can you say that a person is
experiencing Bulimia Nervosa ?
* Where is Bulimia Nervosa more
experienced?
People with Bulimia Nervosa
BULIMIA NERVOSA
BINGE-EATING DISORDER

- A disorder that is
characterized by
recurrent episodes of
binge eating.
 Diagnostic Criteria
A. Recurrent episodes of binge-eating. An episode of binge-eating is
characterized by both of the following:
1. Eating, in a discrete period of time, an amount of food that is definitely
larger than what most individuals would eat in a similar period of time
under similar circumstances.
2. A sense of lack of control over eating during the episode.

B. The binge-eating episodes are associated with three or more of the

following:
1. Eating much more rapidly than normal.
2. Eating until completely uncomfortably full.
3. Eating large amounts of food when not feeling physically hungry.
4. Eating alone because of feeling embarrassed by how much one is eating.
5. Feeling disgusted with oneself, depressed, or very guilty afterwards.
C. Marked distress regarding binge eating is
present.

D. The binge eating occurs, on average, at

least once a week for three months.

E. The binge eating is not associated with the

recurrent use of inappropriate compensatory
behavior as in bulimia nervosa and does not
occur exclusively during the course of bulimia
nervosa or anorexia nervosa.
“Episode of Binge-Eating”
“Discrete period of time”

Excessive for typical meal can be normal

for holidays.

*May lead to functional impairment,

lower quality of life, more subjective
distress, and greater psychiatric
comorbidity.
QUESTIONS:
* How long does it have to take to consider
what a person is feeling as disorder?
* Who are more predominant in having
Binge-Eating Disorder?
* What are the possible causes of Binge-
Eating Disorder?
* When can you say that a person is
experiencing Binge-Eating Disorder?
* Where is Binge-Eating Disorder more
experienced?
People with binge-eating disorder
 OTHER SPECIFIED EATING
DISORDER
- This category applies to presentations in which
symptoms characteristic of a feeding and eating
disorder that cause clinically significant distress or
impairment in social, occupational, or other
important areas of functioning predominate but do
not meet the full criteria for any of the disorders in
the feeding and eating disorders class.
 Other specified feeding or Eating
Disorder
 Atypical Anorexia Nervosa
 Bulimia Nervosa (of low frequency

and/or limited duration)

 Binge-eating disorder (of low frequency

and/or limited duration)

 Purging disorder

 Night eating syndrome

“What you eat today
will impact how you
live tomorrow.”
-Anonymous