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Cited by 9Eating Disorders and BehaviorsNutrition, Health and Food BehaviorChild Nutrition and Feeding Issues

Is there a basis for a weight cut‐off point? A large‐scale investigation of atypical anorexia and anorexia nervosa subtypes among patients at a residential treatment centre.

Open access
Wong, Valerie Z., Lowe, Michael R.·2024·European Eating Disorders Review
DOI 10.1002/erv.3077
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Abstract

Objective: There is debate surrounding how to differentiate between anorexia nervosa (AN) and atypical AN (atypAN) as diagnostic entities, and whether a distinction based on BMI is warranted. Better understanding eating disorder (ED) and emotional symptoms across atypAN and AN subtypes [AN‐restricting (AN‐R), AN‐binge/purge (AN‐BP)], with and without controlling for BMI, can elucidate how atypAN differs from AN subtypes and whether there is a basis for a BMI cut‐off. Methods: 1810 female patients at an ED treatment centre completed intake surveys. ANCOVAs assessed differences across AN‐R (n = 853), AN‐BP (n = 726), and atypAN (n = 231) groups on ED, depressive, and anxiety symptoms, anxiety sensitivity, experiential avoidance, and mindfulness, with and without controlling for BMI. Results: Relative to AN‐R, atypAN and AN‐BP groups endorsed significantly higher ED and depressive symptoms, anxiety sensitivity, experiential avoidance, and significantly lower mindfulness (all p < 0.001), but atypAN and AN‐BP groups did not differ from one another. When controlling for BMI, all previously significant differences between atypAN and AN‐R did not remain significant. Conclusion: Individuals with atypAN who have a higher BMI experience more pronounced ED and emotional symptoms, suggesting that relying solely on BMI as a marker of illness severity may be problematic. Highlights: Atypical anorexia nervosa (atypAN) describes individuals who meet all of the criteria for AN, but who, despite significant weight loss, have a BMI within or above the 'normal' weight range.Individuals with atypAN endorsed more severe eating disorder and emotional symptoms than individuals with AN‐restricting subtype, and the higher BMI of individuals with atypAN accounted for these differences.atypAN symptoms may not only be just as severe as those of AN despite their higher weight, but may be exacerbated by weight stigma and greater body image concerns because of their higher weight.

AI snapshot

Written from the paper’s full text.

TL;DR

This study compared eating-disorder and emotional symptoms among female residential patients with atypical anorexia nervosa (atypAN), anorexia nervosa restricting subtype (AN-R), and anorexia nervosa binge/purge subtype (AN-BP), with and without adjusting for BMI. It found that atypAN and AN-BP patients reported more severe symptoms than AN-R patients, but most atypAN–AN-R differences disappeared after controlling for BMI, raising questions about using BMI alone to define illness severity.

Key findings

  • Among 1,810 female patients, AN-R made up 21.0% of admissions (n = 853), AN-BP 17.9% (n = 726), and atypAN 5.7% (n = 231); mean BMIs were 17.08 for AN-R, 18.15 for AN-BP, and 21.62 for atypAN.
  • With duration of illness controlled, atypAN and AN-BP groups had significantly higher EDE-Q global scores (4.28 and 4.27 vs. 3.61), depressive symptoms (39.43 and 39.24 vs. 35.64), anxiety sensitivity (34.46 and 32.22 vs. 30.25), and experiential avoidance (60.03 and 59.85 vs. 56.08), and significantly lower mindfulness (29.88 and 30.43 vs. 33.53) than AN-R, all p < 0.001; atypAN and AN-BP did not differ from each other.
  • After BMI was added as a covariate, atypAN–AN-R differences were no longer significant, while AN-BP–AN-R differences largely remained; AN-BP then showed significantly greater EDE-Q global scores than atypAN (4.26 vs. 3.91). Effect sizes were small.
  • Exploratory analyses splitting atypAN into binge/purge (n = 145) and restricting (n = 80) groups found the same pattern as AN subtypes: atypAN-BP reported higher eating-disorder psychopathology, depression, and experiential avoidance, and lower mindfulness, than atypAN-R.

Methods

  • Female patients at a residential eating-disorder treatment centre completed intake self-report questionnaires; data came from two sites between 2014 and 2020, representing about 85% of admissions, with a final sample of 1,810 patients diagnosed with AN or atypAN.
  • Diagnoses were established through pre-admission structured phone assessments and post-admission semi-structured psychiatric interviews using DSM-5 criteria; BMI was measured at intake with an electronic scale and stadiometer.
  • ANCOVAs compared AN-R, AN-BP, and atypAN groups on EDE-Q, CES-D, OASIS, ASI, BEAQ, and SMQ scores, first controlling for duration of illness and then adding BMI; Sidak post-hoc tests were used, and exploratory t-tests compared atypAN subtypes.

Limitations

  • The paper states that diagnostic procedures were unclear, including how “significant weight loss” was operationalised, how lack of recognition of seriousness was handled when weight was not low, and whether strict BMI cut-offs were used.
  • The paper states that the sample was mostly white females, that residential treatment may be less accessible to people without financial resources or insurance, and that a referral bias may have made the atypAN patients more symptomatic than atypAN patients not seeking treatment or AN-R patients admitted because of low BMI.
  • Evident from the text: the design is cross-sectional and self-report, so causal claims cannot be made; the paper also notes that all effect sizes were small, limiting clinical relevance, and the residential sample is not an epidemiological sample, limiting generalisability.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1002/erv.3077

Cites

58 of 58 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

4 of 16 cited sources checked · 0 supported · 0 flagged · accuracy not yet measured

  • Interpretationcitation

    AtypAN may be more difficult to detect than AN due to a lack of apparent emaciation, particularly in an environment where weight loss behaviours such as dieting and exercise are culturally normative.

    “AtypAN may be more difficult to detect than AN due to a lack of apparent emaciation, particularly in an environment where weight loss behaviours such as dieting and exercise are culturally normative (Reba-Harrelson et al., 2009).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Reba-Harrelson et al., 2009 source

      The Discussion reports that dieting and attempts to lose weight were common among the women surveyed, supporting the background point about prevalent weight-loss behaviours. It does not address atypical anorexia nervosa or say that a lack of apparent emaciation makes it harder to detect than anorexia nervosa. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
  • Premisecitation

    Epidemiological studies have indicated significantly higher prevalence rates of atypAN compared with AN.

    “Epidemiological studies have indicated significantly higher prevalence rates of atypAN compared with AN (Harrop et al., 2021)”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Harrop et al., 2021 source

      The Results section on epidemiological prevalence says atypical anorexia nervosa (AAN) point prevalence met or exceeded anorexia nervosa (AN) prevalence in most studies comparing both disorders. It does not establish that AAN prevalence was significantly higher: some point-prevalence rates were equal or lower, and half the studies comparing lifetime prevalence found AN higher. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
  • Premisecitation

    AN recovery is much more successful when treated early.

    “Given that AN recovery is much more successful when treated early (Ambwani et al., 2020)”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Ambwani et al., 2020 source

      The introduction (p. 8) says research suggests early intervention produces good outcomes and people with enduring illness respond less well. The exploratory results (p. 17) find less improvement on some measures in the severe-and-enduring group, but they do not establish that treating AN early makes recovery much more successful; the reported recovery rate is for the full cohort (p. 16). (LLM, conf=0.87)

      Experimental — accuracy not yet measured
  • Findingown data

    When controlling for BMI, differences between AN-R and AN-BP for anxiety sensitivity did not remain significant.

    “When controlling for BMI, differences between AN-R and atypAN for anxiety sensitivity remained significant, but differences between AN-R and AN-BP did not.”
    Quote in the paperNot a substantial claim
  • Findingown data

    When controlling for BMI, atypAN did not significantly differ from AN-R or AN-BP on anxiety symptoms, depressive symptoms, experiential avoidance, and mindfulness.

    “AtypAN did not significantly differ from AN-R or AN-BP on these measures.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 18
  • May combine two claims. 20
  • The quote only partly states this claim. 3

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Epidemiological research suggests that lifetime prevalence rates of atypAN are double or triple that of AN, and significantly fewer patients with atypAN are admitted to ED treatment centres.

    “Although epidemiological research suggests that lifetime prevalence rates of atypAN are double or triple that of AN, significantly fewer patients with atypAN are admitted to ED treatment centres (for a review, see Harrop et al., 2021).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Harrop et al., 2021 source

      The Results (Aim 2: Prevalence in epidemiological samples; page not provided) say AAN lifetime prevalence was double or triple AN prevalence in half the studies comparing them, not across all studies. The Results on consecutive referrals and admissions say approximately 79% of studies reported more AN than AAN patients, but some found the reverse; the copy does not establish statistical significance for the admission difference. (LLM, conf=0.84)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingown data

    Groups significantly differed on BMI: individuals with atypAN reported the highest BMI, followed by AN-BP and then AN-R.

    “Groups significantly differed from each other with regards to BMI: individuals with atypAN reported the highest BMI, followed by AN-BP and then AN-R (Table 2).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    AN-R represented 21.0% of all admissions to the residential treatment centre, AN-BP represented 17.9%, and atypAN represented 5.7%.

    “AN-R (n = 853) represented 21.0% of all admissions to the residential treatment centre, AN-BP (n = 726) represented 17.9%, and atypAN (n = 231) represented 5.7%.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    When controlling for BMI in addition to ED duration, ED symptom differences between AN-BP and AN-R remained significant.

    “When controlling for BMI, significant differences in ED symptoms between AN-BP and AN-R remained significant”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Duration of illness significantly differed across groups (p < 0.001), whereas age did not (p = 0.092).

    “Duration of illness significantly differed across groups (p < 0.001), whereas age did not (p = 0.092; see Supplemental Table 1).”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    Anxiety severity (OASIS) was significantly greater in the AN-BP group relative to AN-R when controlling for ED duration.

    “Anxiety severity was significantly greater in the AN-BP group relative to AN-R”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    When controlling for BMI, differences between AN-R and AN-BP on experiential avoidance remained significant, with AN-BP endorsing greater experiential avoidance than AN-R.

    “When BMI was controlled, differences between AN-R and AN-BP groups on anxiety symptoms, depression symptoms, experiential avoidance, and mindfulness remained significant, such that those with AN-BP endorsed greater anxiety, depressive, and experiential avoidance symptoms than AN-R (Supplemental Table 3).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Individuals with AN-BP reported greater purging than individuals with AN-R, but not atypAN.

    “Individuals with AN-BP also reported greater purging than individuals with AN-R, but not atypAN (Supplemental Table 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    When controlling for BMI, differences between AN-R and AN-BP on depressive symptoms remained significant, with AN-BP endorsing greater depressive symptoms than AN-R.

    “When BMI was controlled, differences between AN-R and AN-BP groups on anxiety symptoms, depression symptoms, experiential avoidance, and mindfulness remained significant, such that those with AN-BP endorsed greater anxiety, depressive, and experiential avoidance symptoms than AN-R (Supplemental Table 3).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    When controlling for BMI, differences between AN-R and AN-BP on anxiety symptoms remained significant, with AN-BP endorsing greater anxiety than AN-R.

    “When BMI was controlled, differences between AN-R and AN-BP groups on anxiety symptoms, depression symptoms, experiential avoidance, and mindfulness remained significant, such that those with AN-BP endorsed greater anxiety, depressive, and experiential avoidance symptoms than AN-R (Supplemental Table 3).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    When controlling for BMI in addition to ED duration, ED symptom differences between AN-BP and atypAN became significant, with AN-BP endorsing greater ED psychopathology than atypAN.

    “differences between AN-BP and atypAN became significant such that individuals with AN-BP endorsed significantly greater ED psychopathology than those with atypAN and AN-R.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingreasoning

    Individuals with atypAN showed higher levels of depressive symptoms relative to individuals with AN-R but not AN-BP.

    “Individuals with atypAN showed higher levels of depressive symptoms relative to individuals with AN-R but not AN-BP”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The findings provide a potential explanation for mixed findings in the literature: individuals with atypAN have more severe ED psychopathology than those with AN-R, but similar levels of ED psychopathology as individuals with AN-BP.

    “The majority of these studies do not distinguish between AN-R and AN-BP, and our findings provide a potential explanation for mixed findings by suggesting that individuals with atypAN have more severe ED psychopathology than those with AN-R, but similar levels of ED psychopathology as individuals with AN-BP.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    BMI may account for the greater ED-related concerns found in individuals with atypAN, as the significant differences between atypAN and AN-R became non-significant when controlling for BMI.

    “When controlling for BMI, the significant differences between atypAN and AN-R became non-significant, suggesting that BMI may account for the greater ED-related concerns found in individuals with atypAN.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    AtypAN was similar in behavioural profile to AN-R but not to AN-BP, which might explain why BMI accounted for differences in ED psychopathology between atypAN and AN-R.

    “AtypAN was similar in behavioural profile to AN-R but not to AN-BP, which might explain why BMI accounted for differences in ED psychopathology between atypAN and AN-R.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Diagnostic procedures in the current study lacked clarity regarding how DSM-5 criteria for atypAN were operationalised.

    “One major limitation was a lack of clarity surrounding diagnostic procedures in the current study.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Individuals with atypAN exhibit more severe ED concerns, comorbidity, and emotional difficulties than those with AN, yet are less likely to receive treatment.

    “However, multiple studies have now shown that individuals with atypAN exhibit more severe ED concerns, comorbidity, and emotional difficulties than those with AN (Walsh et al., 2023), yet are less likely to receive treatment (Harrop et al., 2023).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Walsh et al., 2023 source
    • cites Harrop et al., 2023 source

  • May combine two claims.

    Interpretationown data

    AtypAN symptoms may develop and be just as severe as those of AN despite their higher weight.

    “AtypAN symptoms may not only develop and be just as severe as those of AN despite their higher weight”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All variables were checked for normality and outliers.

    “All variables were checked for normality and outliers.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Atypical AN was introduced in DSM-5 to describe individuals who met all psychological and behavioural criteria for AN, but who, despite significant weight loss, had a BMI within or above the normal weight range.

    “'Atypical' AN (atypAN) was introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to describe individuals who met all of the psychological and behavioural criteria for AN, but who, despite significant weight loss, had a BMI within or above the 'normal' weight range (American Psychiatric Association, 2013).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites American Psychiatric Association, 2013

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Patients with atypAN experienced greater minimisation and denial of their EDs, as well as overt forms of weight discrimination, in medical care and during inpatient treatment.

    “Harrop et al. (2023) found that patients with atypAN experienced greater minimisation and denial of their EDs, as well as overt forms of weight discrimination, in medical care and during inpatient treatment.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Harrop et al., 2023 source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning

    The reality of living in a culture that heavily scrutinises physical appearance and reveres thinness may contribute to heightened depressive symptoms in individuals with atypAN relative to those with AN-R.

    “Finally, the reality of living in a culture that heavily scrutinises physical appearance and reveres thinness may contribute to heightened depressive symptoms in individuals with atypAN relative to those with AN-R.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

    Study design and conductown data

    The self-report measures used in the current study demonstrated good internal consistency (Cronbach's α = 0.86-0.93).

    “Cronbach's α for the EDE-Q in the current study was = 0.93.”
    • Also stated in: § 2.2.2 | Centre for Epidemiologic Studies Depression Scale (CES-D) · plain
      “Cronbach's α for the CES-D in the current study was = 0.91.”
    • Also stated in: § 2.2.3 | Overall Anxiety Severity and Impairment Scale · plain
      “Cronbach's α for the OASIS in the current study was = 0.86.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The ASI has shown good reliability and validity in clinical samples.

    “The ASI has shown good reliability and validity in clinical samples (Rifkin et al., 2015).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rifkin et al., 2015 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    When environmental responses ignore or block these needs from being met, situationally-accurate emotions may become paired with helplessness and loss of control.

    “When environmental responses ignore or block these needs from being met, situationally-accurate emotions may become paired with helplessness and loss of control (Cardona et al., 2022).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cardona et al., 2022 source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning

    AtypAN symptoms may be exacerbated by weight stigma and invalidation around ED struggles because of their higher weight.

    “but may be exacerbated by weight stigma and invalidation around ED struggles because of their higher weight.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Duration of illness was included as a covariate to adjust for its potential effects on outcome variables.

    “In our first set of analyses, we included duration of illness as a covariate to adjust for its potential effects on outcome variables.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The BEAQ has shown good reliability and construct and discriminant validity with other measures of emotional functioning.

    “The BEAQ has shown good reliability and construct and discriminant validity with other measures of emotional functioning (Gámez et al., 2014).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Gámez et al., 2014 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    BMI (and duration of illness) was included as a covariate in ANCOVAs to help clarify the reason for differences observed when BMI was not controlled.

    “We then conducted ANCOVAs with BMI (and duration of illness) as covariates, to help clarify the reason for differences observed in the initial analyses when BMI was not controlled.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Our sample only comprised of women.

    “Additionally, our sample only comprised of women”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning

    The sample being mostly white females may be because residential treatment programs are costly and less feasible for individuals without access to financial resources or health insurance.

    “which may be because residential treatment programs are costly and less feasible for individuals without access to financial resources or health insurance.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Residential treatment programs are costly and less feasible for individuals without access to financial resources or health insurance.

  • Classified as probably not a substantial claim.

    Premisecitation

    Emaciation, or current BMI, is used as the indicator for ED severity in the DSM-5.

    “Emaciation, or current BMI, is used as the indicator for ED severity in the DSM-5 (APA, 2013).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites APA, 2013

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Individuals with AN-BP often have higher BMIs and greater levels of ED psychopathology than those with AN-R.

    “Because individuals with AN-BP often have higher BMIs and greater levels of ED psychopathology (Reas & Rø, 2018) than those with AN-R”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Reas & Rø, 2018 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The finding of elevated psychopathology in individuals with atypAN relative to AN may be due to a potential referral bias, because individuals admitted to the treatment centre with atypAN may have had more severe ED symptoms than both individuals with atypAN not seeking treatment and many with AN-R whose admission was influenced by their low BMI.

    “we may have found elevated psychopathology in individuals with atypAN relative to those with AN because of a potential referral bias: individuals admitted to the treatment centre with atypAN, who were not emaciated, may have had more severe ED symptoms than both individuals with atypAN not seeking treatment and many with AN-R whose admission was influenced by their low BMI.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Emotions serve an adaptive function by signalling important information about one's needs.

    “According to Cardona et al. (2022)'s model of chronic invalidation as a pathway to emotion dysregulation, emotions serve an adaptive function by signalling important information about one's needs.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cardona et al., 2022 source

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    The DSM-5 does not provide a specific BMI cut-off for AN, but states that a BMI of 18.5 kg/m2 is the lower limit of normal body weight for adults, suggesting that a BMI equal to or greater than 18.5 kg/m2 would not be considered significantly low.

    “While the DSM-5 does not provide a specific BMI cut-off, it states that the Centres for Disease Control and Prevention and the World Health Organisation use a BMI of 18.5 kg/m 2 as the lower limit of normal body weight for adults, suggesting that a BMI equal to or greater than 18.5 kg/m 2 would not be considered significantly low.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites American Psychiatric Association, 2013

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

36 of 36

  • The paper relies on this without support.

    Residential treatment programs are costly and less feasible for individuals without access to financial resources or health insurance.

    “which may be because residential treatment programs are costly and less feasible for individuals without access to financial resources or health insurance.”

  • The paper relies on this without support.

    Insurance companies often do not cover treatment for individuals with AN who do not meet the 'underweight' cutoff.

    “Insurance companies often do not cover treatment for individuals with AN who do not meet the 'underweight' cutoff”

  • The paper relies on this without support.

    The lack of streamlining and clarity of diagnostic procedures is one of the factors hampering research on atypAN.

    “the lack of streamlining and clarity of diagnostic procedures is one of the factors hampering research on atypAN.”
3 of 3

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • BMI-adjusted anxiety-sensitivity difference is reported as both absent and significant

    Major

    The abstract says no previously significant difference between atypAN and AN-R remained after controlling for BMI. The results instead say their anxiety-sensitivity difference remained significant, consistent with Table 3.

  • Not every AN-BP versus AN-R difference persisted after BMI adjustment

    Minor

    The discussion says the emotional-characteristic differences between AN-BP and AN-R remained significant. The results specifically say their anxiety-sensitivity difference did not remain significant.

2 of 2

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Fairburn C. G., 2008, Cognitive behavior therapy and eating disorders (pp. xii, 324)

Cited by

Sorted by citations

Related

Authors
Wong, V. Z., & Lowe, M. R.
Affiliations
  • Rutgers, The State University of New Jersey (US)
  • Drexel University (US)
Corresponding author
Lowe, Michael R.
ORCID
Venue
European Eating Disorders Review
Publisher
Wiley
Published
2024-02-21
Volume
32
Issue
4
Pages
641-651
ISSN
  • 1072-4133 (ISSN-L)
  • 1099-0968
DOI
10.1002/erv.3077
OpenAlex
W4392057526
Cited by
9
References
58
Citations by year
2026: 3 · 2025: 3 · 2024: 3
FWCI
4.49
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • European Eating Disorders Review (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords
atypical anorexia nervosa, anorexia nervosa subtypes, body mass index, diagnostic classification, eating disorder symptoms, depressive symptoms, anxiety symptoms, anxiety sensitivity, experiential avoidance, mindfulness, female patients, residential treatment
MeSH terms
Adolescent, Adult, Anorexia Nervosa, Anxiety, Body Weight, Depression, Female, Humans, Residential Treatment, Body Mass Index, Young Adult

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Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-11.

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