The Effect of the Inclusion of Binge Eating Disorder in the DSM-V

Spotlight Article by John Dolores, J.D., Ph.D.

The Effect of the Inclusion of Binge Eating Disorder in the DSM-V

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John DoloresDr. John Dolores is a clinical psychologist with an extensive background treating patients with a variety of disorders, including eating disorders. Dr. Dolores most recently was the Director of Behavioral Health at a General Medical Center in Wyoming, where he improved quality care by implementing empirically supported treatment throughout the department and created statewide programs to bring mental health care to under-served populations. His goal is to improve the quality of care and enhance the programming at Center for Hope so that the maximum amount of patients can be successfully treated with state-of-the-art care. He believes that recovery from an eating disorder requires knowledgeable, compassionate staff in a comfortable, healing environment with a person-centered, recovery-based focus. 

Dr. Dolores received his Ph.D. in clinical psychology from Drexel University and his J.D. from Villanova University School of Law. He trained as a fellow in Health Psychology at the Medical University in South Carolina, where he specialized in medical-psychological co-morbid conditions which included treatment of eating disorders. He also practiced forensic psychology at Florida State Hospital, where he conducted competency to stand trial assessments and risk assessments. Dr. Dolores is trained in DBT, CBT, ACT, and various other psychotherapeutic techniques. 

In addition to his professional life, Dr. Dolores is a devoted husband and father of four children.  He enjoys spending time with his family, watching sports, and enjoying the Reno/Tahoe area.

 

The Effect of the Inclusion of Binge Eating Disorder in the DSM-V

The original Diagnostic and Statistical Manual of Mental Disorders (DSM) was published back in 1952 and has undergone a variety of changes in the ensuing years with four updates having been published.  With the release of the latest edition, DSM-V, a variety of changes are taking place within the Eating Disorder diagnostic classification and criteria.  Changes are anticipated in the diagnostic criteria for Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Eating Disorder, Not Otherwise Specified (EDNOS).  However, the biggest, most impactful change may be the decision to create a separate diagnostic category for Binge Eating Disorder (BED).  In the past, BED has not been considered a separate disorder, but was lumped into the catch-all category of EDNOS.  With this separation from EDNOS, a major distinction has been made and a significant leap forward has occurred for all who support continued treatment and research of BED.

First and foremost, the inclusion of BED as one of the three primary Eating Disorders serves to validate the condition as specific, like AN and BN, and thus requiring its own treatment protocol.  Perception is often dictated by diagnosis.  Previously, someone with BED would have been listed as EDNOS, which has a variety of possibilities and treatment methods.  Now, with the DSM-V, someone with BED will receive a diagnosis of BED, which will improve accessibility to appropriate treatment and cut down on confusion.  The new diagnostic classification further serves to legitimize the diagnosis of BED.  This legitimization goes beyond the mental health field as Eating Disorders are frequently a topic of public policy.  Funding for research on BED should increase with this enhanced recognition.  With increased research comes further insight regarding the most effective treatment methods.  With treatment improvement, people generally become more willing to enter treatment as the positive results can be scientifically demonstrated.  From a marketing standpoint, research with clinically significant results can really boost the desirability of a treatment program.

Second, along with more research creating improved treatment, funding also may flow to the treatment programs themselves.  For many years now, the U.S. has focused on the obesity epidemic with millions of dollars going into weight loss programs.  Since BED and obesity commonly co-occur, enhanced knowledge of BED can only help with obesity as well and, hopefully, some of the money that is going into weight loss programs can be reallocated to treating BED and aligning weight loss programs with that philosophy.  Additionally, with its new diagnostic classification, BED should command more respect (and ultimately coverage) from insurance companies.  Because of mental health parity, insurance companies are required to cover mental health issues in the same way medical issues would be covered based upon the individual policy.  Since the government has mandated this increased coverage, insurance companies are becoming very restrictive by creating their own “medical necessity” criteria to determine need for treatment.  With the new BED diagnosis and increased research that should come with it, providers will have better ammunition with which to combat the insurance companies and gain increased coverage for their clients.

Finally, with recognition comes awareness and with awareness comes prevention.  By no longer “hiding” in EDNOS, BED has a much better platform on which to stand.  BED can be seen for what it is and people can be better educated regarding BED.  Prevention, of course, is the key to societal change.  With any disorder or condition, preventative measures are always preferable to treatment after the disorder or condition has developed.  By identifying the warning signs of BED and conducting early interventions, we may be able to reverse the trend of the disorder and the first step is increased awareness, which the new BED diagnostic classification will achieve.

 

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