The current review assessed the clinical utility of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) and alternative severity ratings for eating disorders (EDs) in their ability to distinguish ED psychopathology between the severity groups and frequency distribution of these severity ratings. EMBASE, MEDLINE, PsycARTICLES, PsycINFO, and ProQuest were used to identify relevant academic and grey literature published between 2013 and June 2021. Twenty-two studies were retrieved for the systematic review, and 19 studies qualified for the meta-analyses. We found that individuals with anorexia nervosa (AN) and bulimia nervosa (BN) were close to evenly represented across the DSM–5 severity groups. Conversely, approximately 82% of those with binge eating disorder (BED) were categorized into the mild and the moderate severity groups. In terms of differences across the DSM–5 severity groups for ED symptomatology, we found various significant differences for BN (g = .23–1.23), but only a few significant differences for AN (g = .002–.30) and BED (g = .13–1.55). Finally, using the alternative ED severity rating overvaluation of weight and shape, significant differences were observed in ED psychopathology between the low and high weight/shape overvaluation BED severity groups (g = .13–1.23). The findings of this review provide support for the clinical utility of the DSM–5 severity ratings in BN, but not in AN or BED, and suggest an alternative severity classification for BED based on overvaluation of weight and shape that may have utility as a severity indicator.

Objectives To assess the clinical significance and distinctiveness of purging disorder (PD) from other eating disorder (ED) diagnoses. Method Participants included 3127 women consecutively admitted to an ED treatment centre (246 PD, 465 anorexia nervosa restrictive [AN‐R], 327 AN‐binge purging [AN‐BP], 1436 bulimia nervosa [BN], 360 binge eating disorder [BED], 177 atypical AN and 116 unspecified feeding or eating disorder [UFED]) who were diagnosed according to DSM‐5 criteria. Additionally, 822 control participants were recruited from the community. All participants completed measures assessing ED symptoms (EDI‐2), general psychopathology (SCL‐90‐R) and personality (TCI‐R). Results Patients with PD, when compared to controls, scored significantly higher on the EDI‐2 and SCL‐90‐R, and most TCI‐R dimensions. Most of the significant differences between PD and the other ED diagnoses emerged between PD and AN‐R, followed by Atypical‐AN, UFED, AN‐BP and BED, with patients with PD typically reporting higher scores on the EDI‐2 and SCL‐90‐R subscales. Significant differences between PD and BN were also present, but to a lesser extent. The findings for personality varied amongst the different ED diagnoses. Conclusions PD is a clinically significant disorder, which seems to be more similar to BN than it is to AN and the other ED subtypes.

Emerging evidence suggests that disordered eating, particularly binge-eating symptomatology, is overrepresented within Polycystic Ovary Syndrome (PCOS) populations. This comorbidity presents a clinical dilemma as current treatment approaches for PCOS emphasize the importance of weight management, diet, exercise, and the potential for harm of such treatment approaches in PCOS patients with comorbid disordered eating. However, limited research has assessed the occurrence of binge eating and disordered eating in PCOS patients. Consequently, little is known about the prevalence of binge eating in PCOS, and the possible etiological processes to explain this comorbidity remain poorly understood. Given the paucity of research on this topic, the aims of this narrative review are fourfold: 1) to outline the main symptoms of PCOS and binge eating; 2) to provide an overview of the prevalence of binge eating in PCOS; 3) to outline possible etiological factors for the comorbidity between PCOS and binge eating; and 4) to provide an overview of management strategies of binge eating in PCOS.

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Objective:The cognitive-interpersonal model proposes that high levels of attention to detail and cognitive rigidity confer risk for the development of eating disorders (EDs) and that socioemotional deficits, such as alexithymia, contribute to their maintenance. However, no studies have examined the direct and indirect relationships of these constructs. We investigated the mediating role of specific alexithymia traits (difficulties describing feelings, difficulties identifying feelings, and externally oriented thinking) on the relationship between attention to detail, cognitive rigidity, and ED symptoms while controlling for anxiety and depression symptoms. Method: Four hundred and one nonclinical female participants (M = 20.57, SD = 4.99 years old) completed self-report measures assessing the variables of interest.Results: Path analyses revealed that difficulties identifying feelings was the only significant mediator between attention to detail and cognitive rigidity to ED symptoms. However, these mediation effects became nonsignificant after controlling for anxiety and depression.Conclusions: Difficulties identifying feelings may in part underlie the relationship between attention to detail and cognitive rigidity and ED symptoms, providing support for the cognitive-interpersonal model. However, these relationships are heavily influenced by anxiety and depression symptoms. Enhancing individual's ability to identify emotional states may help to decrease ED symptoms for individuals who report high levels of attention to detail and cognitive rigidity. K E Y W O R D Salexithymia, attention to detail, cognitive rigidity, eating disorders