Gender, cultural, and geographical differences in feeding and eating disorders

Feeding and eating disorders have had a complex and multifaceted history, leading to the current classification in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, which recognizes eight distinct disorders. Although simple obesity is not classified as a feeding and eating disorder, it shares important clinical and biological features with several of these conditions. This study examines the influence of gender, sociocultural, and geographical factors on the epidemiology, severity, and prognosis of feeding and eating disorders based on previous investigations. The first study compared anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified across male patient cohorts from two geographically and culturally distinct countries. The second study evaluated the psycho–neuro– endocrine–immuno–biological aspects of obesity by assessing relative risk and odds ratios among male and female patients receiving specialist treatment. The third study explored the conceptualization of feeding and eating disorders as addictive phenomena within an experimental program for pathological addictions. Statistical, neurobiological, psychodynamic, social, and clinical aspects are integrated to provide a comprehensive understanding of how gender and sociocultural context shape the presentation and progression of feeding and eating disorders. Treatment of feeding and eating disorders cannot be based solely on classification criteria and reference standards, but must be carefully personalized, case by case, based on gender, geographic characteristics, and the individual peculiarities of the affected subjects, to the point of considering treatment, in unsuccessful or resistant cases, as a form of addiction.