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regarding eating disorders. Its failures in capturing the multifaceted
nature of EDs can potentially lead to delayed diagnosis, inadequate treatment and incomplete recovery monitoring. A multidimensional approach incorporating body composition analysis, behavioral and psychological assessments and metabolic evaluation is crucial for improving clinical outcomes and supporting sustained recovery in individuals with eating disorders.
Ultimately, insurance and healthcare protocols must move beyond arbitrary weight thresholds and instead adopt evidence-based criteria to ensure fair, compassionate and effective care for all individuals affected by eating disorders, regardless of BMI.
References
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Garner, D. M.( 2022). Clinical handbook of eating disorders: An integrated approach. Guilford Press. IFEDD( International Federation of Eating Disorder Dietitians).( 2024). MHPAEA clarification comment letter: Weight / BMI misuse in eating disorder treatment coverage. https:// ifedd. org / wp-content / uploads / 2024 / 08 / MHPAEA-Clarification- Comment-Letter-from-IFEDD. pdf ifedd. org
Lebow, J., Sim, L. A., & Kransdorf, L. N.( 2015). Prevalence of a history of overweight and obesity in adolescents with restrictive eating disorders. Journal of Adolescent Health, 56( 1), 19 – 24. https:// doi. org / 10.1016 / j. jadohealth. 2014.06.005
National Eating Disorders Association.( 2025). Body Mass Index( BMI) and Eating Disorders. https:// www. nationaleatingdisorders. org / bmi /
American Psychiatric Association.( 2022). Diagnostic and statistical manual of mental disorders( 5th ed., text rev.). https:// doi. org / 10.1176 / appi. books. 9780890425787
Bulik, C. M., et al.( 2023). Beyond BMI: A multi-dimensional approach to assessing recovery in eating disorders. Journal of Eating Disorders, 11, 542. https:// doi. org / 10.1186 / s40337-023-01416-6
Hafner, V., et al.( 2023). Weight stigma and barriers to treatment in eating disorders: A clinical perspective. European Eating Disorders Review, 31( 1), 45 – 58. https:// doi. org / 10.1002 / erv. 2943
Keys, A., Fidanza, F., Karvonen, M. J., Kimura, N., & Taylor, H. L.( 1972). Indices of relative weight and obesity. Journal of Chronic Diseases, 25( 6), 329 – 343.
Mehler, P. S., & Brown, C.( 2015). Anorexia nervosa— medical complications. Journal of Eating Disorders, 3( 1), 11. https:// doi. org / 10.1186 / s40337-015-0040-8
Treasure, J., Duarte, T. A., & Schmidt, U.( 2020). Eating disorders. The Lancet, 395( 10227), 899 – 911. https:// doi. org / 10.1016 / S0140-6736( 19) 32656-0
Vogel, K., et al.( 2014). The use of bioelectrical impedance analysis in eating disorders: A review. European Eating Disorders Review, 22( 3), 182 – 190
Dr. Suleman is a board certified and Distinguished Fellow of the American Psychiatric Association, practicing as an adult psychiatrist at the Robley Rex VA Medical Center.
Junaid Shahzad is a second-year medical student at the University of Louisville School of Medicine.
Sona Shahzad is a first-year medical student at the University of Louisville School of Medicine.
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