Are Anorexia nervosa and bulimia nervosa separate disorders? Challenging the ‘transdiagnostic’ theory of eating disorders

Abstract

The hypothesis that AN and BN are a single disorder with a common cause is not supported by Hill's Criteria of Causation. This argues against the notion of a transdiagnostic theory of eating disorders.

The Concept of Body Image Disturbance in Anorexia Nervosa: An Empirical Inquiry Utilizing Patients' Subjective Experiences

“…On the other hand, several authors argue that there is solid empirical evidence supporting the notion that AN should be considered a distinct and separate phenotype (Birmingham, Touyz, & Harbottle, 2009;Bulik et al, 2007;Clinton, Button, Norring, & Palmer, 2004;Collier & Treasure, 2004;van Son et al, 2010). The differentiation between AN and other eating disorders is based upon recent evidence including genetics, epidemiology, response to psychotropic drugs and neuroimaging (for a review, see for example Birmingham et al, 2009.…”

“…The differentiation between AN and other eating disorders is based upon recent evidence including genetics, epidemiology, response to psychotropic drugs and neuroimaging (for a review, see for example Birmingham et al, 2009. Also Clinton and colleagues (2004), using cluster analyses of large samples of eating disorder patients, found support for the current differentiation between AN patients and other eating disorder patients.…”

Eating disorder diagnoses in general practice settings: Comparison with structured clinical interview and self-report questionnaires

“…Despite recent advances in transdiagnostic theories and treatments (e.g. Fairburn et al, 2003), there are differences in how different forms of eating pathology may be optimally managed (Beumont & Touyz, 2003;Birmingham et al,2009). This is especially important when evidence-based treatment options exist for one disorder and not another (e.g.…”

Influence of Attitudes towards Change and Self‐directness on Dropout in Eating Disorders: A 2‐Year Follow‐up Study

“…Patients suffering from EDs move in and out of illness state throughout, display many relapses, show a relevant lifetime psychiatric comorbidity and migrate between different diagnoses. For instance, it is common over a course of illness for patients to cross over from anorexia nervosa restricting type (AN-R) to anorexia nervosa binge/purging type (AN-BP) and from AN-BP to bulimia nervosa (BN) (Birmingham, Touyz, & Harbottle, 2009). Thus, an integration of categorical and dimensional approaches has been proposed in order to improve psychopathological research and treatment choices (Castellini et al, 2011).…”