ObjectiveThere 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.Methods1810 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.ResultsRelative 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.ConclusionIndividuals 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.

中文翻译：

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是否有体重截止点的基础？对居住治疗中心患者非典型厌食症和神经性厌食症亚型的大规模调查

目的围绕如何区分神经性厌食症 (AN) 和非典型 AN (atypAN) 作为诊断实体，以及是否有必要根据 BMI 进行区分，存在争议。更好地了解 atypAN 和 AN 亚型的饮食失调 (ED) 和情绪症状 [AN 限制 (AN-R)、AN-暴饮暴食/清泄 (AN-BP)]，在控制和不控制 BMI 的情况下，可以阐明 atypAN 与AN 亚型以及 BMI 截止值是否有依据。方法 ED 治疗中心的 1810 名女性患者完成了摄入调查。ANCOVA 评估了 AN-R 之间的差异（n= 853），AN-BP（n= 726), 和 atypAN (n= 231) 各组的 ED、抑郁和焦虑症状、焦虑敏感性、体验性回避和正念，无论是否控制 BMI。结果相对于 AN-R、atypAN 和 AN-BP 组，ED 和抑郁症状、焦虑明显更高敏感性、经验性回避和正念显着降低（所有p< 0.001)，但 atypAN 和 AN-BP 组之间没有差异。当控制 BMI 时，atypAN 和 AN-R 之间的所有先前显着差异均不再显着。 结论 BMI 较高的 atypAN 患者会经历更明显的 ED 和情绪症状，这表明仅依靠 BMI 作为疾病严重程度的标志可能并不重要。有问题的。