Diagnostic Criteria for Atypical Anorexia Nervosa: A Proposal

Area of Science:

• Psychiatry
• Clinical Psychology
• Eating Disorders Research

Background:

• The term 'atypical anorexia nervosa' has a complex history, originating with Hilde Bruch.
• Current diagnostic criteria, particularly in the DSM-5, lack clarity on key features like weight status.
• The ICD-11 has also faced challenges in defining this eating disorder.

Purpose of the Study:

• To review the historical usage and challenges associated with the term 'atypical anorexia nervosa'.
• To propose a new name and refined diagnostic criteria for this condition.

Main Methods:

• Literature review of 'atypical' terminology in eating disorders.
• Analysis of diagnostic manuals, including the DSM-IV, DSM-5, and ICD-11.
• Examination of specific wording and criteria in existing descriptions.

Main Results:

• Hilde Bruch first used 'atypical anorexia nervosa' for individuals with weight loss but without typical psychological features.
• DSM-IV and DSM-5 descriptions are similar but lack precise definitions for 'significant weight loss' and 'normal or above normal weight'.
• The current nomenclature is considered problematic.

Conclusions:

• The existing description and name for atypical anorexia nervosa require revision.
• A new name, 'anorexia nervosa-like eating disorder (weight in normal or above normal range)' (ANLED), is proposed.
• Suggested diagnostic criteria could be included in the DSM-5-TR for further study.