ObjectivesRestrictive eating disorders (EDs) occur across the weight spectrum, but historically more focus has been given to anorexia nervosa (AN) than atypical anorexia nervosa (atypAN). AtypAN's relegation to a diagnosis in the “other specified feeding and eating disorder” (OSFED) category and paucity of research surrounding atypAN invariably implies a less clinically severe ED. However, a growing body of research has begun to question the assumption that atypAN is less severe than AN. The current review and meta‐analysis aimed to provide a comprehensive review to compare atypAN and AN on measures of eating disorder psychopathology, impairment, and symptom frequency to test whether atypAN is truly less clinically severe than AN.MethodsTwenty articles that reported on atypAN and AN for at least one of the variables of interest were retrieved from PsycInfo, PubMed, and ProQuest.ResultsFor eating‐disorder psychopathology, results indicated that differences were nonsignificant for most indicators; however, atypAN was associated with significantly higher shape concern, weight concern, drive for thinness, body dissatisfaction, and overall eating‐disorder psychopathology than AN. Results indicated that atypAN and AN did not significantly differ on clinical impairment or the frequency of inappropriate compensatory behaviors, whereas there was a significantly higher frequency of objective binge episodes in AN (vs. atypAN).DiscussionOverall, findings indicated that, in contrast to the current classification system, atypAN and AN were not clinically distinct. Results underscore the need for equal access to treatment and equal insurance coverage for restrictive EDs across the weight spectrum.Public SignificanceThe current meta‐analysis found that atypAN was associated with higher drive for thinness, body dissatisfaction, shape concern, weight concern, and overall eating‐disorder psychopathology than AN; whereas AN was associated with higher frequency of objective binge eating. Individuals with AN and atypAN did not differ on psychiatric impairment, quality‐of‐life, or frequency of compensatory behaviors, highlighting the need for equal access to care for restrictive EDs across the weight spectrum.

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BACKGROUND University students are an at-risk group for the development of eating disorders (EDs), yet many college campuses lack sufficient resources to provide ED specialty care. Students report unique reasons for not seeking ED treatment, including the desire to solve the problem on their own (e.g., seeking help from friends, self-medicating, or waiting to see if their problems improve), inability to afford treatment, lack of time to participate in treatment, fear of seeing their primary care physician, and lack of recognition of their issues as an ED. Mobile health (mHealth) apps may be a cost-effective helpful adjunctive tool to overcome personal and systemic barriers and encourage help-seeking. Objective: The current paper describes the development, usability, and acceptability of the Building Healthy Eating and Self-Esteem Together for University Students (BEST-U) mHealth smartphone application that is designed to fill critical gaps in access to ED treatment on college campuses. OBJECTIVE The current paper describes the development, usability, and acceptability of the Building Healthy Eating and Self-Esteem Together for University Students (BEST-U) mHealth smartphone application that is designed to fill critical gaps in access to ED treatment on college campuses. METHODS We used a four-phase iterative development process that focused on user-centered design. The four-phases included: 1) needs assessment, on the basis of literature reviews; 2) prototype development and initial evaluation in a pilot trial; 3) redesign; and 4) further pilot testing to assess usability and acceptability of the final version of the mHealth app. RESULTS The BEST-U prototype was an 11-week program that provided interactive, weekly “modules'' that focused on second and third-wave cognitive-behavioral skills. Modules focused on topics such as psychoeducation, reducing thought distortions and body checking, improving body image, interpersonal effectiveness, and behavior chain analysis. Content included interactive quizzes, short answer questions, and daily and weekly logs and surveys completed in the app. BEST-U was paired with brief 25-30 minute weekly telehealth “coaching” sessions provided by a licensed provider or supervised trainee. Pilot testing revealed issues with one module of the app content, which some participants viewed as having low relevance to their experience, and therapist concerns with the organization of the app content. These issues were addressed through removal, addition, and reorganization of BEST-U modules with the help of therapists-in-training across two workshops. Results indicated that the revised version of BEST-U was highly acceptable and user-friendly. CONCLUSIONS BEST-U is a promising new mHealth app to help therapists deliver brief, evidence-based cognitive-behavioral interventions Although larger-scale efficacy tests are needed, our pilot results indicate that BEST-U is an acceptable and user-friendly app that holds promise for future implementation and dissemination in university mental-health settings.

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