The intersection between factitious disorder and eating disorders: a narrative review

J Acad Consult Liaison Psychiatry. 2025 Aug 8:S2667-2960(25)00535-X. doi: 10.1016/j.jaclp.2025.08.004. Online ahead of print.

ABSTRACT

BACKGROUND: Factitious disorder is a rare condition that is important to recognise and treat appropriately. Patients with eating disorders can present seeking care for self-induced illnesses such as complications of purging and deliberate self-harm, the origins of which may not be disclosed by the patient. Rarely, patients will also present self-reporting a history of an eating disorder where there is evidence that this has been fabricated or exaggerated.

OBJECTIVE: Critically evaluate the literature to better understand the presentation of factitious disorder co-occurring with eating disorders.

METHODS: A literature search was conducted to identify published clinical cases of factitious disorder co-occurring with eating disorders. Demographics, clinical presentations, factors leading to a diagnosis of factitious disorder, aetiological factors, psychiatric comorbidity, healthcare utilisation, management and outcomes were examined.

RESULTS: 34 cases were identified in 29 publications across the years 1984-2022 from 10 countries. Mean age was 27.8 (range 14-48) and 94% of cases were female. A healthcare background was identified in 29% of cases. The most common method of producing factitious illness was via self-induction (74%). Most cases represented factitious disorder comorbid with eating disorders, only 4 cases (12%) described patients presenting with a factitious eating disorder.

CONCLUSIONS: Factitious disorder can intersect with eating disorders in a variety of presentations but this has been rarely described in the literature. Further research is warranted to better characterise this phenomenon.

PMID:40784549 | DOI:10.1016/j.jaclp.2025.08.004