We reviewed the diagnostic checkpoints associated with the diagnosis of feeding and eating disorders (FED) using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5, focusing on two new categories: avoidant/restrictive food intake disorder (ARFID) and binge-eating disorder (BED). There are some differences between the diagnostic checkpoints for FED employed in Japan and Western countries. In Japan, some patients with anorexia nervosa (AN)-like conditions do not exhibit any evidence of fat phobia or a distorted view of their body weight and shape. Accordingly, we need to differentiate these patients from those with AN or ARFID. Since Japanese BED patients do not have high body mass indices compared with those in Western countries, it is not easy to differentiate BED from non-purging bulimia nervosa in Japan. We observed a 30% reduction in the diagnostic frequency of other specified FED/unspecified FED after the implementation of DSM-5 compared with the diagnostic frequency of eating disorder not otherwise specified based on DSM-IV. These findings suggest that DSM-5 is useful for diagnosing FED, but there are various checkpoints that we need to consider when diagnosing FED using DSM-5.
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