{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T16:54:02Z","timestamp":1788454442274,"version":"build-2803163510"},"reference-count":49,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:00:00Z","timestamp":1711324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2024,4]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n For adolescents, DSM\u20105 differentiates anorexia nervosa (AN) and atypical AN with the 5th BMI\u2010centile\u2010for\u2010age. We hypothesized that the diagnostic weight cut\u2010off yields (i) lower weight loss in atypical AN and (ii) discrepant premorbid BMI distributions between the two disorders. Prior studies demonstrate that premorbid BMI predicts admission BMI and weight loss in patients with AN. We explore these relationships in atypical AN.<\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n \n Based on admission BMI\u2010centile < or \u22655th, participants included 411 female adolescent inpatients with AN and 49 with atypical AN from our registry study. Regression analysis and\n t<\/jats:italic>\n \u2010tests statistically addressed our hypotheses and exploratory correlation analyses compared interrelationships between weight loss, admission BMI, and premorbid BMI in both disorders.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Weight loss in atypical AN was 5.6\u2009kg lower than in AN upon adjustment for admission age, admission height, premorbid weight and duration of illness. Premorbid BMI\u2010standard deviation scores differed by almost one between both disorders. Premorbid BMI and weight loss were strongly correlated in both AN and atypical AN.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Whereas the weight cut\u2010off induces discrepancies in premorbid weight and adjusted weight loss, AN and atypical AN overall share strong weight\u2010specific interrelationships that merit etiological consideration. Epidemiological and genetic associations between AN and low body weight may reflect a skewed premorbid BMI distribution. In combination with prior findings for similar psychological and medical characteristics in AN and atypical AN, our findings support a homogenous illness conceptualization. We propose that diagnostic subcategorization based on premorbid BMI, rather than admission BMI, may improve clinical validity.<\/jats:p>\n <\/jats:sec>\n \n Public significance<\/jats:title>\n Because body weights of patients with AN must drop below the 5th BMI\u2010centile per DSM\u20105, they will inherently require greater weight loss than their counterparts with atypical AN of the same sex, age, height and premorbid weight. Indeed, patients with atypical AN had a 5.6\u2009kg lower weight loss after controlling for these variables. In comparison to the reference population, we found a lower and higher mean premorbid weight in patients with AN and atypical AN, respectively. Considering previous psychological and medical comparisons showing little differences between AN and atypical AN, we view a single disorder as the most parsimonious explanation. Etiological models need to particularly account for the strong relationship between weight loss and premorbid body weight.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/eat.24189","type":"journal-article","created":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T01:33:44Z","timestamp":1711416824000},"page":"967-982","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Premorbid body weight predicts weight loss in both anorexia nervosa and atypical anorexia nervosa: Further support for a single underlying disorder"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5364-6073","authenticated-orcid":false,"given":"Johannes","family":"Hebebrand","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy University Hospital Essen (A\u00f6R), University of Duisburg\u2010Essen Essen Germany"},{"name":"Center for Translational Neuro\u2010 and Behavioral Sciences, University Hospital Essen, University of Duisburg\u2010Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0110-7980","authenticated-orcid":false,"given":"Jochen","family":"Seitz","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy University Hospital Essen (A\u00f6R), University of Duisburg\u2010Essen Essen Germany"},{"name":"Center for Translational Neuro\u2010 and Behavioral Sciences, University Hospital Essen, University of Duisburg\u2010Essen Essen Germany"},{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy University Hospital, RWTH Aachen Aachen 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