{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:16:34Z","timestamp":1791303394177,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,8,16]],"date-time":"2016-08-16T00:00:00Z","timestamp":1471305600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32 DK007028, K24 HL092902, R01 MH083657, R01 DK052625, M01 RR01066, UL1 RR025758, 8UL1 TR000170, 1UL 1TR001102"],"award-info":[{"award-number":["T32 DK007028, K24 HL092902, R01 MH083657, R01 DK052625, M01 RR01066, UL1 RR025758, 8UL1 TR000170, 1UL 1TR001102"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p><jats:italic>DSM\u20105<\/jats:italic> revised the diagnostic criteria for anorexia nervosa (AN) by eliminating the amenorrhea requirement, liberalizing weight and psychological criteria, and adding the formal diagnosis of \u201catypical AN\u201d for individuals with AN psychological symptoms without low weight. We sought to determine whether bone density (BMD) is impaired in women diagnosed with AN using the new, more liberal, <jats:italic>DSM\u20105<\/jats:italic> criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Cross\u2010sectional study of 168 women, 18\u2009\u2212\u200945y: <jats:bold>(<\/jats:bold>1) AN by <jats:italic>DSM\u2010IV (<\/jats:italic><jats:bold><jats:italic>DSM\u2010IV AN<\/jats:italic><\/jats:bold><jats:italic>)<\/jats:italic> (<jats:italic>n<\/jats:italic>\u2009=\u200937), (2) AN by <jats:italic>DSM\u20105<\/jats:italic> but not <jats:italic>DSM\u2010IV<\/jats:italic> criteria (<jats:bold><jats:italic>DSM\u20105 AN<\/jats:italic><\/jats:bold>) (<jats:italic>n<\/jats:italic>\u2009=\u200933), (3) atypical AN (<jats:bold>ATYPICAL AN<\/jats:bold>) (<jats:italic>n<\/jats:italic>\u2009=\u200977), (4) healthy comparison group (<jats:bold>HC<\/jats:bold>) (<jats:italic>n<\/jats:italic>\u2009=\u200921). Measurements included dual energy X\u2010ray absorptiometry, Eating Disorder Examination\u2010Questionnaire, Eating Disorder Inventory\u20102, Hamilton Depression and Anxiety Rating Scales.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>BMD <jats:italic>Z<\/jats:italic>\u2010score &lt;\u22121.0 was present in 78% of <jats:italic>DSM\u2010IV<\/jats:italic>, 82% of <jats:italic>DSM\u20105<\/jats:italic>, and 69% of ATYPICAL. Mean <jats:italic>Z<\/jats:italic>\u2010scores were comparably low in <jats:italic>DSM\u2010IV<\/jats:italic> and <jats:italic>DSM\u20105<\/jats:italic>, intermediate in ATYPICAL, and highest in HC. Lack of prior low weight or amenorrhea was, but history of overweight\/obesity was not, protective against bone loss. Mean lean mass and percent fat mass were significantly lower in all AN groups than HC. <jats:italic>DSM\u2010IV, DSM\u20105,<\/jats:italic> and ATYPICAL had comparable psychopathology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Despite liberalizing diagnostic criteria, many women diagnosed with AN and atypical AN using <jats:italic>DSM\u20105<\/jats:italic> criteria have low BMD. Presence or history of low weight and\/or amenorrhea remain important indications for DXA. Loss of lean mass, in addition to fat mass, is present in all AN groups, and may contribute to low BMD. The deleterious effect of eating disorders on BMD extends beyond those with current low weight and amenorrhea. \u00a9 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:343\u2013351)<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.22603","type":"journal-article","created":{"date-parts":[[2016,8,16]],"date-time":"2016-08-16T06:56:56Z","timestamp":1471330616000},"page":"343-351","source":"Crossref","is-referenced-by-count":55,"title":["Bone density, body composition, and psychopathology of anorexia nervosa spectrum disorders in <i>DSM\u2010IV<\/i> vs <i>DSM\u20105<\/i>"],"prefix":"10.1002","volume":"50","author":[{"given":"Melanie","family":"Schorr","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital Neuroendocrine Unit Boston Massachusetts"},{"name":"Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston Massachusetts"},{"name":"Massachusetts General Hospital Eating Disorders Clinical and Research Program Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamryn T.","family":"Eddy","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston Massachusetts"},{"name":"Massachusetts General Hospital Eating Disorders Clinical and Research Program Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura E.","family":"Dichtel","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Neuroendocrine Unit Boston Massachusetts"},{"name":"Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Lawson","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Neuroendocrine Unit Boston Massachusetts"},{"name":"Harvard Medical School Boston 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