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This review evaluates whether data support modification of the requirement for intense fear of weight gain to meet AN criterion B in DSM\u2010V.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We performed a systematic search of the Medline and PsychInfo literature and evaluated the relevant publications by Robins and Guze's (Am J Psychiatry 126, 983\u2013987, 1970) criteria as a standard for diagnostic validity. We also performed a meta\u2010analysis comparing the severity of eating pathology in AN to (a) NFP\u2010AN and (b) AN with low drive for thinness (low\u2010DT\u2010AN).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A modest literature indicates that NFP\u2010AN has wide geographic distribution and occurs in both Western and non\u2010Western populations alongside cases of typical AN. Aggregating across eligible studies, patients with NFP\u2010AN or low\u2010DT\u2010AN score at least 2\/3 of a standard deviation lower on measures of eating pathology than patients with conventional AN. Transcultural comparison of drive for thinness suggests significantly lower norms in non\u2010Western cultures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>NFP\u2010AN occurs with wide distribution. Further research is necessary on the course and outcomes of NFP\u2010AN to characterize its congruence with, or distinction from, conventional AN. We discuss several options for including a description of NFP\u2010AN in DSM\u2010V. \u00a9 2009 American Psychiatric Association. 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