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Feeding & Eating Disorders

Feeding & Eating Disorders. B. Timothy Walsh, MD Professor of Psychiatry, Columbia University New York State Psychiatric Institute. Feeding & Eating Disorders. Defining characteristic: persistent disturbance in eating behavior. Eating Disorders in DSM-IV. Anorexia Nervosa Bulimia Nervosa.

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Feeding & Eating Disorders

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  1. Feeding & Eating Disorders B. Timothy Walsh, MD Professor of Psychiatry, Columbia University New York State Psychiatric Institute

  2. Feeding & Eating Disorders • Defining characteristic: • persistent disturbance in eating behavior

  3. Eating Disordersin DSM-IV • Anorexia Nervosa • Bulimia Nervosa

  4. Feeding & Eating Disordersin DSM-5 • Anorexia Nervosa • Bulimia Nervosa • Binge Eating Disorder (BED) • Avoidant/Restrictive Food Intake Disorder (ARFID) • Pica • Rumination Disorder • NotObesity

  5. Core Features - 1 • Anorexia Nervosa (AN) • Persistent caloric restriction -> low weight; fear of weight gain • Bulimia Nervosa (BN) • Binge eating & purging • Binge Eating Disorder (BED) • Binge eating & no purging

  6. Core Features - 2 • Avoidant/Restrictive Food Intake Disorder (ARFID) • Restrictive food intake, but not AN • Pica • Ingestion of non-nutritive, non-food substances • Rumination Disorder • Regurgitation of ingested food

  7. (AN) Anorexia Nervosa Bulimia Nervosa (BN) Binge Eating Disorder (BED) Disordered Eating

  8. (AN) Anorexia Nervosa Prevalence Bulimia Nervosa (BN) Binge Eating Disorder (BED) Disordered Eating

  9. (AN) Anorexia Nervosa Cost Severity Prevalence Bulimia Nervosa (BN) Binge Eating Disorder (BED) Disordered Eating

  10. (AN) Anorexia Nervosa Cost Severity Prevalence Intensity of Care Bulimia Nervosa (BN) Intensity of Care Binge Eating Disorder (BED) Disordered Eating

  11. Intensity / Levels of Care • Outpatient (primary care vs specialist care) • Intensive Outpatient Program (IOP) • Generally 3X weekly multi-modal treatment • Partial Hospital Program (PHP) • Daily comprehensive treatment, including meals • Residential • 24 x 7 • All voluntary participation • Lower staffing than inpatient • Structured differently in different parts of US (e.g., supportive housing + PHP) • Inpatient (psychiatry vs medicine or pediatrics)

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