Eating disorders: neurologic manifestations

Neeraj Kumar MD (

Dr. Kumar of the Mayo Clinic and the Mayo College of Medicine has no relevant financial relationships to disclose.

Amy A Pruitt MD, editor. (

Dr. Pruitt of the University of Pennsylvania School of Medicine has no relevant financial relationships to disclose.

Originally released August 28, 2000; last updated October 18, 2020; expires October 18, 2023


The hallmark of eating disorders is abnormal eating patterns or weight control behaviors. Excessive focus on and altered perception of body shape and weight is integral to these disorders. Eating disorders are associated with disrupted psychosocial functioning and impaired physical health, including neurologic complications (American Psychiatry Association 2013; Treasure et al 2020).

Historical note and terminology

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) recognizes 6 feeding and eating disorders: those that were included in DSM-IV include anorexia nervosa, bulimia nervosa, and binge eating disorder; the 3 disorders added in DSM-5 were avoidant-restrictive food intake disorder, pica, and rumination disorder (Tables 1 to 6) (American Psychiatric Association 2013). With the exception of pica, at a specific point in time only one of these diagnosis can be assigned, emphasizing the mutually exclusive nature of this classification scheme.

Historical accounts have revealed that forms of voluntary self-starvation have existed for thousands of years. It was not until 1873, however, that Gull and Lasegue presented complete medical descriptions of anorexia nervosa, leading to the disorder being accepted as a true disorder in the late 1800s (Gull 1873; Lasegue 1873; Bemporad 1997). Binge eating disorder was first recognized in 1959 in a paper written by Albert Stunkard (Stunkard 1959). He had associated eating episodes with night-time eating, but the term is now used irrespective of the timing of excessive eating.

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