Atypical anorexia nervosa after bariatric surgery and the DSM-5 diagnostic criteria: Commentary on Walsh et al. (2023).
DSM-5 criteria
anorexia nervosa
atypical anorexia nervosa
bariatric surgery
persistent energy intake restriction
significant low weight
significant weight loss
Journal
The International journal of eating disorders
ISSN: 1098-108X
Titre abrégé: Int J Eat Disord
Pays: United States
ID NLM: 8111226
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
revised:
19
01
2023
received:
12
12
2022
accepted:
19
01
2023
medline:
12
4
2023
pubmed:
3
2
2023
entrez:
2
2
2023
Statut:
ppublish
Résumé
The applicability of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for anorexia nervosa (AN) and atypical AN to individuals having undergone bariatric surgery poses several challenges due to the atypical presentation of AN-like symptoms in this population. We describe these challenges, propose modifications to the corresponding diagnostic criteria, and delineate areas of research to inform possible adaptations of atypical AN criteria with applicability to postbariatric surgery populations. We discuss the utility of a strict definition of "significantly low weight" and "significant weight loss" as part of DSM-5 Criterion A for AN and atypical AN, highlighting the importance of clinical judgment. We also question the clinical distinction between AN and atypical AN based solely on weight and argue that the hallmark feature of both diagnoses in postbariatric surgery populations should be persistent energy intake restriction coupled with persistent weight-control behaviors. Finally, criteria B and C need to allow the distinction between common concerns of bariatric surgery patients regarding weight and eating, and clinically relevant symptoms of atypical AN and AN. Knowing the rates, the specificities, and the impact of atypical AN on postsurgical weight loss has important implications for the clinical attention of these often-overlooked patients.
Types de publication
Case Reports
Journal Article
Research Support, Non-U.S. Gov't
Comment
Langues
eng
Sous-ensembles de citation
IM
Pagination
831-834Commentaires et corrections
Type : CommentOn
Informations de copyright
© 2023 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC.
Références
American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). APA.
Conceição, E. M., Orcutt, M., Mitchell, J., Engel, S., Lahaise, K., Jorgensen, M., Woodbury, K., Hass, N., Garcia, L., & Wonderlich, S. (2013). Eating disorders after bariatric surgery: A case series. The International Journal of Eating Disorders, 46(3), 274-279. https://doi.org/10.1002/eat.22074
Harrop, E. N., Mensinger, J. L., Moore, M., & Lindhorst, T. (2021). Restrictive eating disorders in higher weight persons: A systematic review of atypical anorexia nervosa prevalence and consecutive admission literature. International Journal of Eating Disorders, 54(8), 1328-1357. https://doi.org/10.1002/eat.23519
Hilbert, A., Staerk, C., Strömer, A., Mansfeld, T., Sander, J., Seyfried, F., & Kaiser, S. (2022). Nonnormative eating behaviors and eating disorders and their associations with weight loss and quality of life during 6 years following obesity surgery. JAMA Network Open, 5(8), e2226244. https://doi.org/10.1001/jamanetworkopen.2022.26244
Walsh, B. T., Hagan, K., & Lockwood, C. (2022). A systematic review comparing atypical anorexia nervosa and anorexia nervosa. International Journal of Eating Disorders. https://doi.org/10.1002/eat.23856