Characteristics and clinical trajectories of patients meeting criteria for avoidant/restrictive food intake disorder that are subsequently reclassified as anorexia nervosa

Norris, Mark L.; Santos, Alexandre; Obeid, Nicole; Hammond, Nicole G.; Valois, Darcie D; Isserlin, Leanna; Spettigue, Wendy

doi:10.1002/erv.2710

Cited by 10 publications

(5 citation statements)

References 26 publications

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“…The stated absence of these does not necessarily rule out AN, as some individuals may deny these concerns in order to protect their eating disorder from discovery and treatment. 2 To further complicate the differentiation of AN versus ARFID in general, Norris et al 3 observed that 12% of ARFID patients in one small study were subsequently diagnosed with AN either due to further symptom development or further elicitation of previously unacknowledged body image preoccupations and fear of gaining weight. This was not the case for this patient; in fact, she displayed no increased distress with weight gain during the refeeding process, thus ruling out AN.…”

Section: Discussionmentioning

confidence: 99%

Facing an eating disorder: A case of body dysmorphic disorder and avoidant/restrictive food intake disorder

Milligan

Middleman

2022

SAGE Open Medical Case Reports

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Eating disorders can be notoriously difficult to diagnose and treat. This patient is an 18-year-old female who presents to care severely underweight and notably cachexic. For a number of years, she had experienced depressive symptoms, anxiety, and continued loss of appetite. She denied purposefully restricting foods, recognized that she was thin, and denied a fear of gaining weight. She was admitted to a disordered eating unit for refeeding and during her inpatient stay disclosed that she had a long-standing “hatred of face.” Ultimately, she received the diagnoses of avoidant/restrictive food intake disorder and body dysmorphic disorder. This case highlights the importance of differentiating body dysmorphia, seen in body dysmorphic disorder, and distorted body image, as seen in anorexia nervosa. This differentiation is significant as the treatment approaches to these distinct diagnoses are not the same.

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Section: Discussionmentioning

confidence: 99%

Facing an eating disorder: A case of body dysmorphic disorder and avoidant/restrictive food intake disorder

Milligan

Middleman

2022

SAGE Open Medical Case Reports

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“…The current study matched male and female participants according to key clinical criteria, including symptom presentation, body image concerns, and age. The decision was made to match on symptom presentation, rather than diagnosis, given some of the challenges in differentiating between anorexia nervosa and avoidant restrictive food intake disorder, and the diagnostic shift that is reported in a portion of adolescents with eating disorders [ 37 ]. The sample size of cisgender males who completed both Time 1 and Time 2 data is similar to the number of males who participated in two large randomized clinical trials [ 22 ], and this paper is the first to report symptom measures and treatment outcome in a sample of trans youths in comparison to cisgender youths with eating disorders.…”

Section: Discussionmentioning

confidence: 99%

Gender differences in symptom presentation and treatment outcome in children and youths with eating disorders

et al. 2021

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Background To address the gaps in the literature examining eating disorders among males and gender minority youths, a prospective study was designed to assess gender differences in eating disorder symptom presentation and outcomes. Muscularity concerns may be particularly relevant for male youths with eating disorders, and were included in assessment of eating disorder symptom presentation. Methods All cisgender male youths who presented for specialized eating disorder treatment at one of two sites were invited to participate, along with a group of matched cisgender females, and all youths who did not identify with the sex assigned to them at birth. Youths completed measures of eating disorder symptoms, including muscularity concerns, and other psychiatric symptoms at baseline and end of treatment. Results A total of 27 males, 28 females and 6 trans youths took part in the study. At baseline, Kruskal–Wallis tests demonstrated that trans youths reported higher scores than cisgender male and female youths on measures of eating pathology (Eating disorder examination-questionnaire (EDE-Q) and the body fat subscale of the male body attitudes scale (MBAS)). These analyses demonstrated that there were no differences between cisgender male and female youths on eating disorder symptoms at baseline. However, repeated measures ANOVA demonstrated that males had greater decreases in eating pathology at discharge than did females, based on self-reported scores on the EDE-Q, MBAS, and Body Change Inventory. Conclusions Gender differences in eating pathology appeared at baseline, with trans youths reporting higher levels of eating pathology than cisgender youths, though no differences between cisgender males and females emerged at baseline for eating disorder symptom presentation. Contrary to expectations, there were no gender differences in measures of muscularity concerns. Males demonstrated greater eating disorder symptom improvements than females, suggesting that male adolescents may have better treatment outcomes than females in some domains.

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“…The current study matched male and female participants according to key clinical criteria, including symptom presentation, body image concerns, and age. The decision was made to match on symptom presentation, rather than diagnosis, given some of the challenges in differentiating between anorexia nervosa and avoidant restrictive food intake disorder, and the diagnostic shift that is reported in a portion of adolescents with eating disorders (Norris et al, 2020). The sample size of cisgender males who completed both Time 1 and Time 2 data is similar to the number of males who participated in two large randomized clinical trials (Gorrell et al, 2021), and this paper is the first to report symptom measures and treatment outcome in a sample of trans youths in comparison to cisgender youths with eating disorders.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Gender Differences in Symptom Presentation and Treatment Outcome in Children and Youths With Eating Disorders

Coelho

Suen

Marshall

et al. 2021

Preprint

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Background. To address the gaps in the literature examining eating disorders among males and gender minority youths, a prospective study was designed to assess gender differences in eating disorder symptom presentation and outcomes. Muscularity concerns may be particularly relevant for male youths with eating disorders, and were included in assessment of eating disorder symptom presentation. Methods. All male youths who presented for specialized eating disorder treatment at one of two sites were invited to participate, along with a group of matched females, and all youths who did not identify with the sex assigned to them at birth. Youths completed measures of eating disorder symptoms, including muscularity concerns, and other psychiatric symptoms at baseline and end of treatment.Results. A total of 27 males, 28 females and 6 trans youths took part in the study. At baseline, Kruskal-Wallis tests demonstrated that trans youths reported higher scores than cisgender male and female youths on measures of eating pathology (Eating Disorder Examination – Questionnaire (EDE-Q) and the body fat subscale of the Male Body Attitudes Scale (MBAS)). These analyses demonstrated that there were no differences between cisgender male and female youths on eating disorder symptoms at baseline. However, repeated measures ANOVA demonstrated that males had greater decreases than did females in eating pathology at discharge than did females, based on self-reported scores on the EDE-Q, MBAS, and Body Change Inventory. Conclusions. Gender differences in eating pathology appeared at baseline, with trans youths reporting higher levels of eating pathology than cisgender youths, though no differences between cisgender males and females emerged at baseline for eating disorder symptom presentation. Contrary to expectations, there were no gender differences in measures of muscularity concerns. Males demonstrated greater eating disorder symptom improvements than females, suggesting that male adolescents may have better treatment outcomes than females in some domains.

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Characteristics and clinical trajectories of patients meeting criteria for avoidant/restrictive food intake disorder that are subsequently reclassified as anorexia nervosa

Cited by 10 publications

References 26 publications

Facing an eating disorder: A case of body dysmorphic disorder and avoidant/restrictive food intake disorder

Facing an eating disorder: A case of body dysmorphic disorder and avoidant/restrictive food intake disorder

Gender differences in symptom presentation and treatment outcome in children and youths with eating disorders

Gender Differences in Symptom Presentation and Treatment Outcome in Children and Youths With Eating Disorders

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