Do DSM-5 Eating Disorder Criteria Overpathologize Normative Eating Patterns among Individuals with Obesity?. (26th June 2014)

• Record Type: Journal Article
• Authors: Thomas, Jennifer J.; Koh, Katherine A.; Eddy, Kamryn T.; Hartmann, Andrea S.; Murray, Helen B.; Gorman, Mark J.; Sogg, Stephanie; Becker, Anne E.
• Other Names: Kaplan Allan S. Academic Editor.
• Is Part Of: Journal of obesity. Volume 2014(2014)
• Publication Date: 2014-06-26
• Subjects: Obesity -- Periodicals; Obesity; Obesity; Electronic journals; Periodicals; Periodicals; 616.398
• DOI: 10.1155/2014/320803
• Languages: English
• ISSNs: 2090-0708

Abstract

Abstract : Background. DSM-5 revisions have been criticized in the popular press for overpathologizing normative eating patterns—particularly among individuals with obesity. To evaluate the evidence for this and other DSM-5 critiques, we compared the point prevalence and interrater reliability of DSM-IV versus DSM-5 eating disorders (EDs) among adults seeking weight-loss treatment. Method. Clinicians (n = 2 ) assigned DSM-IV and DSM-5 ED diagnoses to 100 participants via routine clinical interview. Research assessors (n = 3 ) independently conferred ED diagnoses via Structured Clinical Interview for DSM-IV and a DSM-5 checklist. Results . Research assessors diagnosed a similar proportion of participants with EDs under DSM-IV (29%) versus DSM-5 (32%). DSM-5 research diagnoses included binge eating disorder (9%), bulimia nervosa (2%), subthreshold binge eating disorder (5%), subthreshold bulimia nervosa (2%), purging disorder (1%), night eating syndrome (6%), and other (7%). Interrater reliability between clinicians and research assessors was "substantial" for both DSM-IV (κ = 0.64, 84% agreement) and DSM-5 (κ = 0.63, 83% agreement). Conclusion . DSM-5 ED criteria can be reliably applied in an obesity treatment setting and appear to yield an overall ED point prevalence comparable to DSM-IV .