Chapter 14: Feeding and Eating Disorders

The material emphasizes that disordered eating emerges from complex interactions among biological vulnerability, psychological factors, and sociocultural influences rather than representing simple food preferences or vanity. Early childhood feeding disorders include Avoidant/Restrictive Food Intake Disorder, characterized by severe food avoidance resulting in nutritional deficiency and growth impairment; Pica, involving persistent consumption of non-food substances often linked to intellectual disabilities or micronutrient deficiencies; and Failure to Thrive, marked by inadequate weight gain and developmental delays stemming from neglect, medical conditions, or insufficient nutrition. Adolescent presentations include Anorexia Nervosa, involving severe dietary restriction coupled with intense fear of weight gain and fundamental disturbance in body perception; Bulimia Nervosa, featuring recurrent episodes of uncontrolled eating followed by compensatory behaviors such as self-induced vomiting or excessive exercise; and Binge Eating Disorder, characterized by loss of control during eating episodes without subsequent purging or restrictive compensation. The chapter explores neurobiological mechanisms including genetic predisposition and serotonin dysregulation alongside sociocultural factors such as internalization of thinness ideals, family dynamics, and media influence. Comorbidity patterns demonstrate significant overlap with anxiety, depression, and obsessive-compulsive features. Evidence-based treatment approaches emphasize Family-Based Therapy as particularly effective for younger adolescents, Cognitive-Behavioral Therapy for modifying maladaptive eating patterns and body image distortions, nutritional rehabilitation for restoring physiological health, and integrated community support for preventing relapse and sustaining recovery.