Feeding and Eating Disorders (DSM-5)

name: Feeding and Eating Disorders
display_name: Feeding and Eating Disorders (DSM-5)
creation_date: "2026-07-29T00:00:00Z"
description: >-
  The feeding and eating disorders are a clinically defined class of mental
  disorders characterized by a persistent disturbance of eating or
  eating-related behavior that results in altered consumption or absorption of
  food and significantly impairs physical health or psychosocial functioning.
  The class corresponds to the DSM-5 "Feeding and Eating Disorders" chapter and
  spans two conceptual poles: the weight/shape-driven eating disorders (anorexia
  nervosa, bulimia nervosa, binge eating disorder) and the feeding disorders,
  in which disturbed intake is not motivated by body-image concern
  (avoidant/restrictive food intake disorder, pica, rumination disorder). The
  members are mutually exclusive by convention for a given episode: a single
  diagnosis is assigned according to the predominant presentation.
grouping_basis:
- CLINICAL_CONVENTION
- SHARED_PHENOTYPE
grouping_rationale: >-
  Grouped as an explicit, curated union over the distinct DSM-5 feeding and
  eating disorder entities, assembled below the level of the MONDO taxonomy.
  The shared, defining feature is a persistent disturbance of eating or
  eating-related behavior causing altered food intake/absorption with functional
  impairment (SHARED_PHENOTYPE), and the boundary of the class is a diagnostic
  convention (the DSM-5 chapter; CLINICAL_CONVENTION). The members are
  deliberately kept as separate Disease entries rather than merged, because they
  differ fundamentally in motivation (drive for thinness / fear of weight gain
  in anorexia and bulimia nervosa; loss-of-control overeating without regular
  compensation in binge eating disorder; sensory/appetitive/aversive restriction
  without body-image disturbance in ARFID; ingestion of non-nutritive substances
  in pica; effortless regurgitation in rumination disorder), in their core
  pathophysiology, and in their treatment. This is therefore a grouping over
  distinct entities, not a lumping of them into one disease.
mappings:
  mondo_mappings:
  - term:
      id: MONDO:0005451
      label: eating disorder
    mapping_predicate: skos:exactMatch
    mapping_source: MONDO
    mapping_justification: >-
      The grouping concept corresponds to the MONDO eating disorder class. All
      six listed members are is-a descendants of MONDO:0005451. exactMatch
      records the intended conceptual alignment; MONDO descendants of
      MONDO:0005451 without DisMech entries (e.g., other specified feeding or
      eating disorder) are curation gaps rather than evidence that the grouping
      concept is only a close match.
    consistency:
    - reference: MONDO
      consistent: CONSISTENT
      notes: >-
        All 6 listed members (anorexia nervosa MONDO:0005351, bulimia nervosa
        MONDO:0005452, binge eating disorder MONDO:0005582, ARFID MONDO:7770002,
        pica disease MONDO:0001441, rumination disorder MONDO:0001301) are is-a
        descendants of MONDO:0005451.
membership_criteria:
- description: >-
    A disorder belongs to the feeding and eating disorders if it is a persistent
    disturbance of eating or eating-related behavior that alters food
    consumption or absorption and impairs physical health or psychosocial
    functioning, and is classified within the MONDO eating disorder
    (MONDO:0005451) subtree / DSM-5 Feeding and Eating Disorders chapter.
  criteria_semantics: NECESSARY
  logic:
    criterion_predicate: HAS_MAPPING
    description: >-
      Disease term is an is-a descendant of MONDO:0005451 (eating disorder) —
      i.e., classified within the MONDO eating disorder subtree / the DSM-5
      Feeding and Eating Disorders chapter. Every member additionally presents,
      by definition, with a persistent disturbance of eating or eating-related
      behavior that impairs physical health or psychosocial functioning.
members:
- member: Anorexia Nervosa
  member_type: DISEASE
  differentiating_mechanisms:
  - description: >-
      Restriction of energy intake driven by an intense fear of gaining weight
      and a disturbance in body-image/self-evaluation, leading to significantly
      low body weight. Distinguished within the class by the weight-phobic
      cognition plus the physiologic sequelae of starvation (neuroendocrine
      suppression, bradycardia, osteopenia).
    phenotype_term:
      preferred_term: Weight loss
      term:
        id: HP:0001824
        label: Weight loss
- member: Bulimia Nervosa
  member_type: DISEASE
  differentiating_mechanisms:
  - description: >-
      Recurrent binge eating followed by recurrent inappropriate compensatory
      behavior (self-induced vomiting, laxative misuse, fasting, or excessive
      exercise) to prevent weight gain, with self-evaluation unduly influenced
      by body shape and weight, in the absence of the low body weight that
      defines anorexia nervosa. Distinguished by the binge–purge cycle and its
      complications (hypokalemia, dental erosion, parotid enlargement).
    phenotype_term:
      preferred_term: Vomiting
      term:
        id: HP:0002013
        label: Vomiting
- member: Binge Eating Disorder
  member_type: DISEASE
  differentiating_mechanisms:
  - description: >-
      Recurrent loss-of-control binge eating with marked distress, but WITHOUT
      the regular inappropriate compensatory behavior of bulimia nervosa and
      without the weight/shape overvaluation being required. Distinguished by
      the absence of compensation and its frequent association with obesity and
      metabolic comorbidity.
    phenotype_term:
      preferred_term: Binge eating (loss-of-control overeating)
      term:
        id: HP:0002591
        label: Polyphagia
- member: Avoidant Restrictive Food Intake Disorder
  member_type: DISEASE
  differentiating_mechanisms:
  - description: >-
      Persistent failure to meet nutritional/energy needs from avoidance or
      restriction of intake driven by sensory sensitivity, low appetite/interest
      in food, or fear of aversive consequences (choking, vomiting) — crucially
      WITHOUT body-image disturbance or drive for thinness, the feature that
      separates it from anorexia nervosa. Distinguished by the non-weight-phobic
      motivation for restriction.
    phenotype_term:
      preferred_term: Poor appetite
      term:
        id: HP:0004396
        label: Poor appetite
- member: Pica
  member_type: DISEASE
  differentiating_mechanisms:
  - description: >-
      Persistent eating of non-nutritive, non-food substances (e.g., earth,
      clay, ice, paint, hair) inappropriate to developmental level and not a
      culturally sanctioned practice. Distinguished within the class by the
      ingestion of non-food items rather than a disturbance of the amount or
      restriction of normal food.
    phenotype_term:
      preferred_term: Pica
      term:
        id: HP:0011856
        label: Pica
- member: Rumination Disorder
  member_type: DISEASE
  differentiating_mechanisms:
  - description: >-
      Repeated, effortless regurgitation of recently ingested food that is then
      re-chewed, re-swallowed, or spat out, not attributable to a
      gastrointestinal or other medical condition. Distinguished by the
      characteristic post-prandial regurgitation behavior rather than altered
      food intake or non-food ingestion.
    phenotype_term:
      preferred_term: Abnormal eating behavior (effortless regurgitation)
      term:
        id: HP:0100738
        label: Abnormal eating behavior
notes: >-
  Explicit union over the DSM-5 feeding and eating disorder entities. Members
  reference existing Disease entries by name; differentiating mechanisms cite
  the feature that separates each member from its siblings. "Other specified
  feeding or eating disorder" (OSFED) is a recognized residual DSM-5 category
  and a curation gap; it is intentionally not yet listed as a member.