A systematic review comparing atypical anorexia nervosa and anorexia nervosa

Walsh, B. Timothy; Hagan, Kelsey E.; Lockwood, Carlin

doi:10.1002/eat.23856

Cited by 96 publications

(177 citation statements)

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“…Female participants aged 10 to 22 years were eligible if they met the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) ( DSM-5 ) criteria for AN with insufficient energy intake relative to requirements due to restrictive eating behaviors characteristic of AN, resulting in a significantly low body weight, or were HCs without a lifetime history of eating disorders with similar Tanner stages. DSM-5 defines low body weight for adults with AN as body mass index (BMI) less than 18.5 (calculated as weight in kilograms divided by height in meters squared) but does not define a cutoff BMI percentile for children and adolescents with AN, and low body weight in this study was defined as no greater than the 10th BMI percentile for age and sex . Screening for AN included evaluation to confirm the lack of any organic conditions that could account for the low body weight.…”

Section: Methodsmentioning

confidence: 99%

“…DSM-5 defines low body weight for adults with AN as body mass index (BMI) less than 18.5 (calculated as weight in kilograms divided by height in meters squared) but does not define a cutoff BMI percentile for children and adolescents with AN, and low body weight in this study was defined as no greater than the 10th BMI percentile for age and sex. 17,18 Screening for AN included evaluation to confirm the lack of any organic conditions that could account for the low body weight.…”

Section: Female Participants Aged 10 To 22 Years Were Eligible If The...mentioning

confidence: 99%

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Association Between Ghrelin and Body Weight Trajectory in Individuals With Anorexia Nervosa

et al. 2023

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ImportanceIndividuals with anorexia nervosa maintain extremely low body weights despite elevations in the circulating orexigenic hormone ghrelin. Whether circulating levels of endogenous ghrelin are associated with weight gain in anorexia nervosa is unknown.ObjectiveTo examine the association between baseline ghrelin and future weight change in individuals with anorexia nervosa.Design, Setting, and ParticipantsThis prospective cohort study was conducted between April 1, 2014, and March 31, 2020, in the US. Girls and women aged 10 to 22 years were recruited from the greater Boston area from community and area treatment centers, enrolled, and followed up for 18 months. Statistical analyses were performed between January and August 2022.ExposuresPresence or absence of anorexia nervosa and elevations in endogenous ghrelin.Main Outcomes and MeasuresChanges in age- and sex-standardized body mass index percentiles from baseline to 9- and 18-month follow-up were the main outcomes of interest.ResultsA total of 68 girls and young women (11 [16%] Asian, 4 [6%] Hispanic or Latina, 51 [75%] White [non–Hispanic or Latina], and 2 [3%] other race or ethnicity), including 35 with anorexia nervosa and 33 healthy controls of similar Tanner stage, were included in this study. Anorexia nervosa and healthy control groups were not statistically different by race and ethnicity, Tanner stage, number completing follow-up visits, and the duration between baseline and follow-up visits. At baseline, individuals with anorexia nervosa were slightly older (median [IQR], 20.1 [18.5-21.0] vs 18.7 [14.7-19.4] years; P = .005), had lower body mass index percentiles (median [IQR], 2.4 [0.3-4.7] vs 52.9 [40.4-68.3]; P &lt; .001), and had elevated circulating ghrelin area under the curve composite index (median [IQR], 1389.4 [1082.5-1646.4] vs 958.5 [743.0-1234.5] pg/mL; P = .003) compared with healthy individuals. In linear mixed-effects regression analyses, baseline ghrelin was associated with prospective weight gain after adjusting for diagnosis, age, race, and duration of follow-up (odds ratio, 2.35; 95% CI, 1.43-3.73; P = .004).Conclusions and RelevanceIn this cohort study, endogenous ghrelin was associated with longitudinal weight gain in individuals with anorexia nervosa. Further studies are warranted to confirm this result and examine its potential clinical utility in treatment development.

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Section: Methodsmentioning

confidence: 99%

Section: Female Participants Aged 10 To 22 Years Were Eligible If The...mentioning

confidence: 99%

Association Between Ghrelin and Body Weight Trajectory in Individuals With Anorexia Nervosa

et al. 2023

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“…Indeed, complications of anorexia nervosa are equally severe for individuals with weight within or above the normal range (i.e. atypical anorexia nervosa compared to anorexia nervosa) (37) . People with binge eating disorder experience a high prevalence of both psychiatric comorbidities (e.g.…”

Section: Eating Disorder Prevalence and Complications In People With ...mentioning

confidence: 99%

Eating Disorders In weight-related Therapy (EDIT) Collaboration: rationale and study design

et al. 2023

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The cornerstone of obesity treatment is behavioural weight management, resulting in significant improvements in cardio-metabolic and psychosocial health. However, there is ongoing concern that dietary interventions used for weight management may precipitate the development of eating disorders. Systematic reviews demonstrate that, while for most participants medically supervised obesity treatment improves risk scores related to eating disorders, a subset of people who undergo obesity treatment may have poor outcomes for eating disorders. This review summarises the background and rationale for the formation of the Eating Disorders In weight-related Therapy (EDIT) Collaboration. The EDIT Collaboration will explore the complex risk factor interactions that precede changes to eating disorder risk following weight management. In this review, we also outline the program of work and design of studies for the EDIT Collaboration, including expected knowledge gains. The EDIT studies explore risk factors and the interactions between them using individual level data from international weight management trials. Combining all available data on eating disorder risk from weight management trials will allow sufficient sample size to interrogate our hypothesis: that individuals undertaking weight management interventions will vary in their eating disorder risk profile, based on personal characteristics and intervention strategies available to them. The collaboration includes the integration of health consumers in project development and translation. An important knowledge gain from this project is a comprehensive understanding of the impact of weight management interventions on eating disorder risk.

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“…The paper proposes the opinion of the pediatrician and child neuropsychiatrist regarding the identification and management of two conditions belonging to the EADs chapter: ARFIDs and atypical anorexia nervosa (AN). Both ARFIDs and atypical forms of anorexia can manifest early and insidiously; they can be underestimated, underdiagnosed and untreated, thus causing severe malnutrition over time, and can be complicated by the presence of psychiatric comorbidities, thus requiring a multidisciplinary management from early childhood [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Pitfalls and Risks of “New Eating Disorders”: Let the Expert Speak!

Salatto¹,

Riccio²,

Garotti³

et al. 2023

Nutrients

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Since the post-pandemic period, there has been an increase in the incidence of eating disorders (EADs) and a lowering of the age of onset. In addition to the ‘classic’ forms, there has also been an increase in new forms of EADs. This article proposes a brief review of the literature concerning mainly two of these new disorders: atypical anorexia and avoidant/restrictive food intake disorder. In addition, a brief overview is proposed of the most frequently raised questions that clinicians may face when dealing with EADs. The answers are provided by doctors from the Federico II University of Naples, who additionally offer the most common red flags on the topic derived from long clinical experience. This article is proposed to be a brief operational guide for all clinicians working in the pediatric area in order to provide diagnostic clues and useful elements to refer patients to specialists for a correct and multidisciplinary treatment.

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A systematic review comparing atypical anorexia nervosa and anorexia nervosa

Cited by 96 publications

References 45 publications

Association Between Ghrelin and Body Weight Trajectory in Individuals With Anorexia Nervosa

Association Between Ghrelin and Body Weight Trajectory in Individuals With Anorexia Nervosa

Eating Disorders In weight-related Therapy (EDIT) Collaboration: rationale and study design

Pitfalls and Risks of “New Eating Disorders”: Let the Expert Speak!

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