Editing Eating disorder (section)

=== Differential diagnoses ===
There are multiple medical conditions which may be misdiagnosed as a primary psychiatric disorder, complicating or delaying treatment. These may have a [[synergistic]] effect on conditions which mimic an eating disorder or on a properly diagnosed eating disorder.
* [[Lyme disease]] is known as the "great imitator", as it may present as a variety of psychiatric or neurological disorders including anorexia nervosa.<ref>{{cite journal |vauthors=Fallon BA, Nields JA |s2cid=22568915 |title=Lyme disease: a neuropsychiatric illness |journal=The American Journal of Psychiatry |volume=151 |issue=11 |pages=1571–83 |date=November 1994 |pmid=7943444 |doi=10.1176/ajp.151.11.1571}}</ref><ref>{{cite journal |vauthors=Pachner AR |title=Borrelia burgdorferi in the nervous system: the new "great imitator" |journal=Annals of the New York Academy of Sciences |volume=539 |issue=1 |pages=56–64 |year=1988 |pmid=3190104 |doi=10.1111/j.1749-6632.1988.tb31838.x |bibcode=1988NYASA.539...56P |s2cid=7629978}}</ref>
* [[Gastrointestinal disease]]s,<ref name=SatherleyHoward2015 /> such as [[celiac disease]], [[Crohn's disease]], [[peptic ulcer]], [[eosinophilic esophagitis]]<ref name=BernOBrien2013 /> or [[non-celiac gluten sensitivity]],<ref name="VoltaCaio2015">{{cite journal |vauthors=Volta U, Caio G, De Giorgio R, Henriksen C, Skodje G, Lundin KE |title=Non-celiac gluten sensitivity: a work-in-progress entity in the spectrum of wheat-related disorders |journal=Best Practice & Research. Clinical Gastroenterology |volume=29 |issue=3 |pages=477–91 |date=June 2015 |pmid=26060112 |doi=10.1016/j.bpg.2015.04.006 | type = Review | quote = Among psychiatric disorders, a minority (6%) of patients with NCGS showed a previous clinical history of eating behavior abnormalities ''('NCGS = non-eliac gluten sensitivity)''}}</ref> among others. Celiac disease is also known as the "great imitator", because it may involve several organs and cause an extensive variety of non-gastrointestinal symptoms, such as psychiatric and neurological disorders,<ref name="Duggan2004">{{cite journal |vauthors=Duggan JM |title=Coeliac disease: the great imitator |journal=The Medical Journal of Australia |volume=180 |issue=10 |pages=524–6 |date=May 2004 |pmid=15139831 |type=Review |url=https://www.mja.com.au/system/files/issues/180_10_170504/dug10818_fm.pdf |url-status=live |archive-url=https://web.archive.org/web/20160305091756/https://www.mja.com.au/system/files/issues/180_10_170504/dug10818_fm.pdf |archive-date=March 5, 2016 |doi=10.5694/j.1326-5377.2004.tb06058.x |s2cid=44954098}}</ref><ref name="ZingoneSwift2015">{{cite journal |vauthors=Zingone F, Swift GL, Card TR, Sanders DS, Ludvigsson JF, Bai JC |title=Psychological morbidity of celiac disease: A review of the literature |journal=United European Gastroenterology Journal |volume=3 |issue=2 |pages=136–45 |date=April 2015 |pmid=25922673 |pmc=4406898 |doi=10.1177/2050640614560786 | type = Review}}</ref><ref name="JacksonEaton2012">{{cite journal |vauthors=Jackson JR, Eaton WW, Cascella NG, Fasano A, Kelly DL |title=Neurologic and psychiatric manifestations of celiac disease and gluten sensitivity |journal=The Psychiatric Quarterly |volume=83 |issue=1 |pages=91–102 |date=March 2012 |pmid=21877216 |pmc=3641836 |doi=10.1007/s11126-011-9186-y}}</ref> including anorexia nervosa.<ref name=BernOBrien2013 />
* [[Addison's disease]] is a disorder of the [[adrenal cortex]] which results in decreased hormonal production. Addison's disease, even in subclinical form may mimic many of the symptoms of anorexia nervosa.<ref>{{cite journal |vauthors=Adams R, Hinkebein MK, McQuillen M, Sutherland S, El Asyouty S, Lippmann S |title=Prompt differentiation of Addison's disease from anorexia nervosa during weight loss and vomiting |journal=Southern Medical Journal |volume=91 |issue=2 |pages=208–11 |date=February 1998 |pmid=9496878 |doi=10.1097/00007611-199802000-00017 |s2cid=33433769 |url=https://oce.ovid.com/article/00007611-199802000-00017/HTML}}</ref>
* [[Gastric adenocarcinoma]] is one of the most common forms of cancer in the world. Complications due to this condition have been misdiagnosed as an eating disorder.<ref>{{cite journal |vauthors=Siew LC, Huang C, Fleming J |title=Gastric adenocarcinoma mistakenly diagnosed as an eating disorder: case report |journal=The International Journal of Eating Disorders |volume=43 |issue=3 |pages=286–8 |date=April 2010 |pmid=19365820 |doi=10.1002/eat.20678}}</ref>
* [[Hypothyroidism]], [[hyperthyroidism]], [[hypoparathyroidism]] and [[hyperparathyroidism]] may mimic some of the symptoms of, can occur concurrently with, be masked by or exacerbate an eating disorder.<ref>{{cite journal |vauthors=Mannucci E, Ricca V, Filetti S, Boldrini M, Rotella CM |title=Eating behavior and thyroid disease in female obese patients |journal=Eating Behaviors |volume=4 |issue=2 |pages=173–9 |date=August 2003 |pmid=15000980 |doi=10.1016/S1471-0153(03)00012-6}}</ref><ref>{{cite journal |vauthors=Byerley B, Black DW, Grosser BI |title=Anorexia nervosa with hyperthyroidism: case report |journal=The Journal of Clinical Psychiatry |volume=44 |issue=8 |pages=308–9 |date=August 1983 |pmid=6874653}}</ref><ref>{{cite journal |vauthors=Krahn D |title=Thyrotoxicosis and bulimia nervosa |journal=Psychosomatics |volume=31 |issue=2 |pages=222–4 |year=1990 |pmid=2330406 |doi=10.1016/S0033-3182(90)72201-3}}</ref><ref>{{cite journal |vauthors=Tiller J, Macrae A, Schmidt U, Bloom S, Treasure J |title=The prevalence of eating disorders in thyroid disease: a pilot study |journal=Journal of Psychosomatic Research |volume=38 |issue=6 |pages=609–16 |date=August 1994 |pmid=7990069 |doi=10.1016/0022-3999(94)90058-2}}</ref><ref>{{cite journal |vauthors=Fonseca V, Wakeling A, Havard CW |title=Hyperthyroidism and eating disorders |journal=BMJ |volume=301 |issue=6747 |pages=322–3 |date=August 1990 |pmid=2393739 |pmc=1663651 |doi=10.1136/bmj.301.6747.322}}</ref><ref>{{cite journal |vauthors=Birmingham CL, Gritzner S, Gutierrez E |title=Hyperthyroidism in anorexia nervosa: case report and review of the literature |journal=The International Journal of Eating Disorders |volume=39 |issue=7 |pages=619–20 |date=November 2006 |pmid=16958126 |doi=10.1002/eat.20308}}</ref><ref>{{cite journal |vauthors=Mattingly D, Bhanji S |title=Hypoglycaemia and anorexia nervosa |journal=Journal of the Royal Society of Medicine |volume=88 |issue=4 |pages=191–5 |date=April 1995 |pmid=7745563 |pmc=1295161}}</ref><ref>{{cite journal |vauthors=Ozawa Y, Koyano H, Akama T |title=Complete recovery from intractable bulimia nervosa by the surgical cure of primary hyperparathyroidism |journal=The International Journal of Eating Disorders |volume=26 |issue=1 |pages=107–10 |date=July 1999 |pmid=10349592 |doi=10.1002/(SICI)1098-108X(199907)26:1<107::AID-EAT15>3.0.CO;2-U}}</ref>
* [[Toxoplasma gondii|Toxoplasma]] [[seropositivity]]: even in the absence of symptomatic [[toxoplasmosis]], toxoplasma gondii exposure has been linked to changes in human [[behavior]] and psychiatric disorders including those comorbid with eating disorders such as depression. In reported case studies the response to antidepressant treatment improved only after adequate treatment for toxoplasma.<ref>{{cite journal |vauthors=Kar N, Misra B |title=Toxoplasma seropositivity and depression: a case report |journal=BMC Psychiatry |volume=4 |page=1 |date=February 2004 |pmid=15018628 |pmc=356918 |doi=10.1186/1471-244X-4-1 |doi-access=free}}</ref>
* [[Neurosyphilis]]: It is estimated that there may be up to one million cases of untreated syphilis in the US alone. "The disease can present with psychiatric symptoms alone, psychiatric symptoms that can mimic any other psychiatric illness". Many of the manifestations may appear atypical. Up to 1.3% of short term psychiatric admissions may be attributable to neurosyphilis, with a much higher rate in the general psychiatric population. (Ritchie, M Perdigao J,)<ref>Ritchie MA, Perdigao JA. Neurosyphilis: Considerations for a Psychiatrist. Louisiana State University School of Medicine Department of Psychiatry [http://www.priory.com/psych/neurosyphilis.htm Neurosyphilis] {{webarchive |url=https://web.archive.org/web/20100105214941/http://priory.com/psych/neurosyphilis.htm |date=2010-01-05}}</ref>
* [[Dysautonomia]]: a wide variety of autonomic nervous system (ANS) disorders may cause a wide variety of psychiatric symptoms including anxiety, [[panic attack]]s and depression. Dysautonomia usually involves failure of [[sympathetic nervous system|sympathetic]] or [[parasympathetic nervous system|parasympathetic]] components of the ANS system but may also include excessive ANS activity. Dysautonomia can occur in conditions such as diabetes and alcoholism.

Psychological disorders which may be confused with an eating disorder, or be co-morbid with one:
* [[Emetophobia]] is an anxiety disorder characterized by an intense fear of vomiting. A person so impacted may develop rigorous standards of [[food hygiene]], such as not touching food with their hands. They may become socially withdrawn to avoid situations which in their perception may make them vomit. Many who have emetophobia are diagnosed with anorexia or self-starvation. In severe cases of emetophobia they may drastically reduce their food intake.<ref>{{cite journal |vauthors=Lipsitz JD, Fyer AJ, Paterniti A, Klein DF |s2cid=11784677 |title=Emetophobia: preliminary results of an internet survey |journal=Depression and Anxiety |volume=14 |issue=2 |pages=149–52 |year=2001 |pmid=11668669 |doi=10.1002/da.1058 |doi-access=free}}</ref><ref>{{cite journal |vauthors=Boschen MJ |title=Reconceptualizing emetophobia: a cognitive-behavioral formulation and research agenda |journal=Journal of Anxiety Disorders |volume=21 |issue=3 |pages=407–19 |year=2007 |pmid=16890398 |doi=10.1016/j.janxdis.2006.06.007}}</ref>
* [[Phagophobia]] is an anxiety disorder characterized by a fear of eating, it is usually initiated by an adverse experience while eating such as [[choking]] or vomiting. Persons with this disorder may present with complaints of pain while swallowing.<ref>{{cite journal |vauthors=Shapiro J, Franko DL, Gagne A |title=Phagophobia: a form of psychogenic dysphagia. A new entity |journal=The Annals of Otology, Rhinology, and Laryngology |volume=106 |issue=4 |pages=286–90 |date=April 1997 |pmid=9109717 |doi=10.1177/000348949710600404 |s2cid=22215557}}</ref>
* [[Body dysmorphic disorder]] (BDD) is listed as an [[Obsessive–compulsive disorder|obsessive-compulsive disorder]] that affects up to 2% of the population. BDD is characterized by excessive rumination over an actual or perceived physical flaw. BDD has been diagnosed equally among men and women. While BDD has been misdiagnosed as anorexia nervosa, it also occurs comorbidly in 39% of eating disorder cases. BDD is a chronic and debilitating condition which may lead to social isolation, major depression and suicidal ideation and attempts. Neuroimaging studies to measure response to facial recognition have shown activity predominately in the left hemisphere in the left [[lateral prefrontal cortex]], lateral [[temporal lobe]] and left [[parietal lobe]] showing hemispheric imbalance in information processing. There is a reported case of the development of BDD in a 21-year-old male following an inflammatory brain process. Neuroimaging showed the presence of a new atrophy in the frontotemporal region.<ref>{{cite journal |vauthors=Gabbay V, Asnis GM, Bello JA, Alonso CM, Serras SJ, O'Dowd MA |title=New onset of body dysmorphic disorder following frontotemporal lesion |journal=Neurology |volume=61 |issue=1 |pages=123–5 |date=July 2003 |pmid=12847173 |doi=10.1212/01.WNL.0000069607.30528.D5 |s2cid=6059843}}</ref><ref>{{cite journal |vauthors=Phillips KA, McElroy SL, Keck PE, Hudson JI, Pope HG |title=A comparison of delusional and nondelusional body dysmorphic disorder in 100 cases |journal=Psychopharmacology Bulletin |volume=30 |issue=2 |pages=179–86 |year=1994 |pmid=7831453}}</ref><ref>{{cite journal |vauthors=Feusner JD, Townsend J, Bystritsky A, Bookheimer S |title=Visual information processing of faces in body dysmorphic disorder |journal=Archives of General Psychiatry |volume=64 |issue=12 |pages=1417–25 |date=December 2007 |pmid=18056550 |doi=10.1001/archpsyc.64.12.1417 |doi-access=free}}</ref><ref>{{cite journal |vauthors=Feusner JD, Yaryura-Tobias J, Saxena S |title=The pathophysiology of body dysmorphic disorder |journal=Body Image |volume=5 |issue=1 |pages=3–12 |date=March 2008 |pmid=18314401 |pmc=3836287 |doi=10.1016/j.bodyim.2007.11.002}}</ref>