Huh. So we're all mentally ill now

[elfs]

I was listening to an NPR article about making binge-eating a DSM-category disorder. The reporter asked one physician what the criteria was for "binge eating." The doctor replied:

The criteria require a clearly unusually large amount of food to be consumed in a relatively short period of time. And typically it is over 1,000 calories.

To meet criteria for the disorder, the episodes are recurrent. They happen at least once a week. They're persistent. The criteria call for at least three months of duration.

The smallest standard adult meal at Burger King is 1,040 calories, so: if you work downtown and you eat at Burger King once a week, you are certifiably mentally ill.

And not because you like Burger King.

Comments

[blaisepascal]

Most DSM-categories have a proviso that it has to have a serious impact on your life or your interaction with others (or similar words which means something similar, but not exactly, what I said). Is that the case here?

More specifically, a different version of the story (linked to from the NPR article) includes a different definition: "Binge eating is defined as eating large amounts of food when you're not hungry and then feeling disgusted and depressed afterward." This is more in line with what I'd consider an eating disorder than eating at Burger King once a week for lunch.

Well, OK. I'm a vegetarian. If I found myself uncontrollably eating a standard adult meal at Burger King, I'd be disgusted and depressed afterward, and if I did it once a week for 3 months, I'd agree to being certifiably mentally ill. But my vegetarianism makes me a special case.

[l33tminion]

Well, I'm not a vegetarian, and I'd feel pretty bad if I was eating fast food every week, too...

[jenk]

Interesting. The Mayo Clinic, OTOH, has this:

A binge is considered eating a larger amount of food than most people would eat under similar situations. For instance, you may eat 10,000 to 20,000 calories worth of food during a binge, while someone following a normal diet may eat 1,500 to 3,000 calories in a day.

Perhaps NPR was proceeding on the idea that anything more than Weight Watchers recommends is a binge.

[woggie.livejournal.com]

Comparing the Mayo Clinic limits to the NPR article, I suspect someone misplaced a decimal, but I could always be mistaken.

[gromm.livejournal.com]

That was my thought exactly. 1,000 calories in one sitting? That's *normal*, especially for men. 10,000 on the other hand, that's binge eating.

The proposed definition

[blaisepascal]

From the dsm5 website:

DSM-5 Proposed Diagnostic Criteria for Binge Eating Disorder



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 (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances

2. a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)

B. The binge-eating episodes are associated with three (or more) of the following:

1. eating much more rapidly than normal

2. eating until feeling uncomfortably full

3. eating large amounts of food when not feeling physically hungry

4. eating alone because of being embarrassed by how much one is eating

5. feeling disgusted with oneself, depressed, or very guilty after overeating

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 (i.e., purging) and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.

I don't think weekly lunch at BK comes anywhere near qualifying for criterion A(1).

[http://users.livejournal.com/_candide_/]

Y'know, one day a few centuries from now, someone's gonna discover that all of these "individual" illnesses being put into the various versions of the DSM are due to:

1. Extremely poor "mental hygiene" turning psychological-sniffles into mind-pneumonia. (And let's face it, kiddies, we live in a very toxic environment, as far as mental heath goes.)
2. BigPharma's marketing departments trying to water down the symptoms of truly nasty mental illnesses (schizophrenia, unipolar, bipolar, ...) to sell as many pills to as many people as possible. (This actually hurts the people who really do need the medication, since those meds then get a "reputation". The resulting popular misinformation then drives those who would benefit from the medication away from it. Very common amongs folks with unipolar mood disorders.)
3. The same thing; the same region of the brain malfunctioning, or the same neurotransmitters being off.
   When the previous 2 are gone, I'm guessing that it will become easy to see this. And if I'm right, then a whole group of illnesses in the DSM versions will collapse down into just one. As will another group. And another. Same cause, but different symptoms.
   Brains are funny that way.
   
   Ferinstance: Unipolar mood disorders. Everyone things they're all about, "feeling really, really bad."
   Not Exactly.
   There's actually guilt-over-nothing, mixed in with the sadness-over-nothing. But when a unipolar episode really kicks into high gear, you get Fear. Panic attacks. Nightmares. Bouts of terror, to add some zest to all of that guilt, worthlessness, hopelessness, anguish, and melancholy. So something like social anxiety disorder may actually be caused by the same thing as unipolar mood disorder, but manifests itself with a different set of symptoms in different people.