Do Feeding and Eating Disorders Fit the General Definition of Mental Disorder?
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Do Feeding and Eating Disorders Fit the General Definition of Mental Disorder? M. Cristina Amoretti1
© The Author(s) 2020
Abstract This paper aims at considering the conceptual status of feeding and eating disorders (FEDs). Now that the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has changed the classification and some relevant criteria of FEDs, it is particularly relevant to evaluate their psychiatric framework and their status as mental disorders. I focus my efforts on addressing only one specific question: Do FEDs fit the DSM-5 general definition of mental disorder? In DSM-5 a mental disorder is defined as a syndrome that reflects a dysfunction and is usually associated with significant distress or disability. More importantly, there is an explicit statement saying that all mental disorders listed in the manual must meet the requirements highlighted by the general definition. Thus, I evaluate whether or not FEDs are really meant to reflect a dysfunction and are usually associated with significant distress or disability. Keywords Disability · Distress · Dysfunction · DSM-5 · Feeding and eating disorders (FEDs) · Mental disorder
1 Introduction This paper aims at considering the conceptual status of feeding and eating disorders (FEDs). Now that the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has changed the overall classification and some specific criteria of FEDs, it is important to evaluate their psychiatric frameworks and their status as mental disorders. I focus my efforts in this analysis on clarifying one conceptual dimension of the overall FEDs debate by addressing only one specific question: Do FEDs fit the DSM-5 general definition of mental disorder? Or, to put it differently, are FEDs mental disorders in line with the DSM-5’s criteria? In DSM-5, a mental disorder is defined as a syndrome that reflects a dysfunction and is usually associated with significant distress or disability (American Psychiatric Association 2013a); thus, a mental disorder seems to be identified with a harmful dysfunction (Wakefield 1992). In DSM-5 there is also an explicit statement saying that all mental disorders listed in the manual must meet the requirements highlighted
by their general definition (American Psychiatric Association 2013a, 20). Thus, I evaluate whether or not FEDs can reasonably be said to reflect a dysfunction and whether they are usually associated with distress or disability. The question of whether or not FEDs can be regarded as mental disorders is conceptually interesting and important in its own right and it has practical and ethical consequences, too. However, in the present context, I will not focus on these consequences. The paper is structured as follows. First, I briefly discuss the nosological history and the most relevant features of FEDs as well as the main requirements of the DSM-5 general definition of mental disorder. Then, I stress the importance of identifying the specific dysfunctions that underlie FEDs, as the definition of mental
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