Skip to main content
ABCT 2023 Annual Convention Main banner
Final Program


Program Flipbook
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Ticketed Session
Ticketed Session
Recorded Session
Recorded Session
Back
ViewAttendees 4

Symposia

Eating Disorders

Session: Exploring 'Atypical': Understanding the Role of Othering in the Diagnosis of Atypical Anorexia Nervosa

1 - (SYM 132) Youth and Family Identified Precipitants of Weight Loss: Anorexia Nervosa vs Atypical Anorexia Nervosa

Sunday, November 19, 2023
10:30 AM – 12:00 PM PST
Location: Chelan (401), Level 4

Background: Youth with atypical anorexia nervosa (AAN) meet all criteria for anorexia nervosa (AN) except for exhibiting a “normal” body mass index, despite significant weight loss. They exhibit similar rates of medical complications as those with AN yet diagnosis is often delayed. Adult individuals with AAN report maltreatment in clinical settings, weight-based bullying in adolescence, and medical recommendations to lose weight. We hypothesized that youth with AAN are more likely to implicate weight/shape reasons and sociocultural influence as precipitating factors than those with AN.

Method: We conducted a retrospective chart review of adolescents to examine reported precipitants of onset for AN and atypical AN. The sample comprised 1234 youth (NAN=992, NAAN=242) seen in a specialized eating disorder program. Mean age of participants was 15.06 years (SD=2.53 years). The sample was mostly female (N=1003) and White (90%). The sample of AAN youth comprised more males (29% in AAN, 16% in AN). Qualitative analyses used inductive thematic analysis procedures. Two coders piloted a codebook on a sample of patients prior to analyzing the data set. Chi-square analyses examined differences in reasons for onset across diagnosis.

Results: We identified 27 precipitants of onset ranging from acute illness, to desire to improve sporting performance or wanting to get “healthy.” Reasons for onset were similar between youth with AN and AAN, with weight/shape concerns the most cited precipitant (30% in AAN, 29% in AN). Youth with AAN were significantly more likely to cite peer influence (C2(1)=5.973,p=.01), and recommendations from a healthcare provider as triggers for their ED than peers with AN (C2(1)=18.870,p< .001).

Conclusions: Weight/shape concerns were commonly cited as a precipitant for AN in youth regardless of BMI. Sociocultural influences and the role of healthcare providers in perpetuating weight loss/stigma are particularly concerning, highlighting the detrimental impacts of prescribing weight loss to adolescents in larger bodies. The predominantly white and female sample raises questions regarding whether or not minority youth or males with eating disorders are identified.