Diagnosis Meets Practice

This chapter offers a comprehensive and practical guide to eating disorder (ED) assessment, blending diagnostic criteria with real-world clinical insights. It positions ED assessment as both an art and a science, requiring therapists to blend diagnostic rigor with empathy, curiosity, and a deep understanding of the function of disordered eating in their clients’ lives. The goal is not simply accurate diagnosis, but effective, personalized treatment planning that honors the complexity of the individual. It explores the major DSM-5-TR diagnoses (i.e., Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, ARFID, OSFED, and UFED) while highlighting how symptoms often evolve, overlap, or co-occur with conditions like depression, trauma, or OCD. The authors emphasize that disordered eating behaviors often serve meaningful psychological functions, such as managing distress or regaining a sense of control. Therefore, understanding the motivations behind behaviors is essential to effective case formulation and treatment planning. Case vignettes throughout the chapter bring nuance to the diagnostic process, illustrating the complex and shifting nature of ED presentations in practice and the importance of individualized, context-informed care.