{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:19:45Z","timestamp":1790349585512,"version":"4.1.0"},"reference-count":31,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T00:00:00Z","timestamp":1642723200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The validity of body mass index (BMI) specifiers for anorexia nervosa (AN) has been questioned, but their applicability to inpatients with extremely low BMIs and their prognostic validity are currently unknown. Therefore, we designed this study: (a) to test current BMI specifiers in severe inpatients; (b) to explore a \u201cvery extreme\u201d specifier (VE-AN; BMI \u2264 13.5); and (c) to verify inpatients\u2019 hospitalization outcome according to BMI severity. We enrolled 168 inpatients with AN completing the following: Eating disorder Examination-Questionnaire, Eating Disorder Inventory-2, State-Trait Anxiety Inventory, Beck Depression Inventory, Body Shape Questionnaire, and EQ-5D-VAS. According to the current BMI classification, those with a BMI &lt; 15 versus those with non-extreme AN (NE-AN, BMI \u2265 15) differed on all measures but the quality of life with those with NE-AN reporting more impaired scores on all measures. Adopting an exploratory classification comparing VE-AN, extreme AN (E-AN, BMI = 13.6\u201314.99), and NE-AN, no differences emerged between VE-AN and E-AN, while those with NE-AN reported significantly more impaired scores on all variables while the quality of life again did not differ across groups. Hospitalization outcome improved for all groups, independently of BMI. Groups differed concerning the length of stay that mirrored BMI severity and impacted also hospitalization outcomes. Taken together, our data support the lack of validity of current BMI specifiers in AN, even in the acute setting. Moreover, the exploratory subgroup of patients with BMI \u2264 13.5 did not delineate a clinically different group.<\/jats:p>","DOI":"10.3390\/jcm11030542","type":"journal-article","created":{"date-parts":[[2022,1,23]],"date-time":"2022-01-23T20:34:40Z","timestamp":1642970080000},"page":"542","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Body Mass Index Specifiers in Anorexia Nervosa: Anything below the \u201cExtreme\u201d?"],"prefix":"10.3390","volume":"11","author":[{"given":"Federica","family":"Toppino","sequence":"first","affiliation":[{"name":"Eating Disorders Center, Department of Neuroscience \u201cRita Levi Montalcini\u201d, \u201cCitt\u00e0 della Salute e della Scienza\u201d Hospital of Turin, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1347-7054","authenticated-orcid":false,"given":"Paola","family":"Longo","sequence":"additional","affiliation":[{"name":"Eating Disorders Center, Department of Neuroscience \u201cRita Levi Montalcini\u201d, \u201cCitt\u00e0 della Salute e della Scienza\u201d Hospital of Turin, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8877-0138","authenticated-orcid":false,"given":"Matteo","family":"Martini","sequence":"additional","affiliation":[{"name":"Eating Disorders Center, Department of Neuroscience \u201cRita Levi Montalcini\u201d, \u201cCitt\u00e0 della Salute e della Scienza\u201d Hospital of Turin, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5826-5664","authenticated-orcid":false,"given":"Giovanni","family":"Abbate-Daga","sequence":"additional","affiliation":[{"name":"Eating Disorders Center, Department of Neuroscience \u201cRita Levi Montalcini\u201d, \u201cCitt\u00e0 della Salute e della Scienza\u201d Hospital of Turin, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1328-9678","authenticated-orcid":false,"given":"Enrica","family":"Marzola","sequence":"additional","affiliation":[{"name":"Eating Disorders Center, Department of Neuroscience \u201cRita Levi Montalcini\u201d, \u201cCitt\u00e0 della Salute e della Scienza\u201d Hospital of Turin, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). 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