Reference
Guide | Reference

45  Eating and Feeding Regulation

45.1 Summary

  • A dimensional construct describing regulation of eating, appetite, and body-related behaviors.

45.2 Core Construct

  • Balance of intake, appetite, and body image concerns that shape eating behavior.

45.3 Subdimensions

  • Restriction or avoidance.
  • Binge or loss of control.
  • Compensatory behaviors or excessive exercise.
  • Body image or weight/shape concern.

45.4 Severity Anchors (0-4)

  • 0: No clinically meaningful eating dysregulation.
  • 1: Mild, intermittent, manageable.
  • 2: Moderate, recurring, impacts function.
  • 3: Severe, persistent, with medical or functional risk.
  • 4: Extreme, disabling or unsafe.

45.5 Time-Course Patterns

  • Episodic with stress-linked spikes.
  • Chronic patterns with fluctuating severity.

45.6 Functional Impact

  • Work/school: concentration loss, health impacts.
  • Relationships: secrecy, conflict around meals.
  • Self-care: nutritional compromise or medical risk.

45.7 Developmental Expression

  • Childhood: avoidant or sensory-based restrictions.
  • Adolescence: body image concerns, restriction or bingeing.
  • Adulthood: chronic patterns or relapse.

45.8 Cultural / Context Notes

  • Food norms and body ideals shape expression.
  • Food insecurity can mimic restriction.

45.9 Differential and Rule-Outs

  • Medical causes of weight loss or appetite change.
  • Mood or anxiety-driven appetite shifts.
  • Substance or medication effects.

45.10 Measurement Prompts

  • Brief eating behavior screen.
  • Weight or behavior tracking as appropriate.

45.11 Treatment-Relevant Correlates (non-prescriptive)

  • High restriction with low insight suggests medical risk monitoring.

45.13 Documentation Snippet (1-2 lines)

  • “Eating dysregulation with restriction and body image concern; Eating/Feeding 3; chronic course.”