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Understanding community provider practices in diagnosing and treating atypical anorexia nervosa: A mixed methods study.

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Title: Understanding community provider practices in diagnosing and treating atypical anorexia nervosa: A mixed methods study.
Authors: Johnson‐Munguia, Sarah, Bottera, Angeline R., Vanzhula, Irina, Forbush, Kelsie T., Gould, Sara R., Negi, Sonakshi, Thomeczek, Marianna L., L'Insalata, Alexa M., Like, Emily E., Sharma, Anjali R., Morgan, R. William, Rasheed, Samiya
Source: International Journal of Eating Disorders. Apr2024, Vol. 57 Issue 4, p892-902. 11p.
Subjects: Anorexia nervosa treatment, Community health services, Medical protocols, Medical specialties & specialists, Research funding, Fisher exact test, Descriptive statistics, Surveys, Thematic analysis, Anorexia nervosa, Convalescence, Physician practice patterns, Research methodology, Weight gain, Social stigma
Abstract: Objective: There is a lack of consensus in defining "significant weight loss" when diagnosing atypical anorexia nervosa (atypical AN) and no guidelines exist for setting target weight (TW). The current study aimed to identify community providers' practices related to the diagnosis of atypical AN and the determination of TW. A secondary aim was to evaluate whether professional discipline impacted "significant weight loss" definitions. Method: A variety of providers (N = 141; 96.4% female) completed an online survey pertaining to diagnostic and treatment practices with atypical AN. Descriptive statistics were computed to characterize provider‐based practices and Fisher's exact tests were used to test for differences in diagnostic practices by professional discipline. Thematic analysis was used to examine open‐ended questions. Results: Most (63.97%) providers diagnosed atypical AN in the absence of any weight loss if other AN criteria were met, but doctoral‐level psychologists and medical professionals were less likely to do so compared to nutritional or other mental health professionals. Most providers found weight gain was only sometimes necessary for atypical AN recovery. Qualitative responses revealed providers found atypical AN to be a stigmatizing label that was not taken seriously. Providers preferred to use an individualized approach focused on behaviors, rather than weight when diagnosing and treating atypical AN. Discussion: Lack of diagnostic clarity and concrete treatment guidelines for atypical AN may result in substantial deviations from the DSM‐5‐TR criteria in real‐world practice. Clinically useful diagnostic definitions for restrictive eating disorders and evidence‐based treatment guidelines for TW and/or other relevant recovery metrics are needed. Public Significance: The current study found variability in how community providers diagnose and determine target recovery weight for atypical anorexia nervosa (atypical AN). Many providers viewed the diagnosis of atypical AN as stigmatizing and preferred to focus on behaviors, rather than weight. This study underscores the importance of creating a clinically useful diagnostic definition and guidelines for recovery for atypical AN backed by empirical evidence that providers may implement in practice. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Eating Disorders is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Understanding community provider practices in diagnosing and treating atypical anorexia nervosa: A mixed methods study.
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  Data: <searchLink fieldCode="AR" term="%22Johnson‐Munguia%2C+Sarah%22">Johnson‐Munguia, Sarah</searchLink><br /><searchLink fieldCode="AR" term="%22Bottera%2C+Angeline+R%2E%22">Bottera, Angeline R.</searchLink><br /><searchLink fieldCode="AR" term="%22Vanzhula%2C+Irina%22">Vanzhula, Irina</searchLink><br /><searchLink fieldCode="AR" term="%22Forbush%2C+Kelsie+T%2E%22">Forbush, Kelsie T.</searchLink><br /><searchLink fieldCode="AR" term="%22Gould%2C+Sara+R%2E%22">Gould, Sara R.</searchLink><br /><searchLink fieldCode="AR" term="%22Negi%2C+Sonakshi%22">Negi, Sonakshi</searchLink><br /><searchLink fieldCode="AR" term="%22Thomeczek%2C+Marianna+L%2E%22">Thomeczek, Marianna L.</searchLink><br /><searchLink fieldCode="AR" term="%22L'Insalata%2C+Alexa+M%2E%22">L'Insalata, Alexa M.</searchLink><br /><searchLink fieldCode="AR" term="%22Like%2C+Emily+E%2E%22">Like, Emily E.</searchLink><br /><searchLink fieldCode="AR" term="%22Sharma%2C+Anjali+R%2E%22">Sharma, Anjali R.</searchLink><br /><searchLink fieldCode="AR" term="%22Morgan%2C+R%2E+William%22">Morgan, R. William</searchLink><br /><searchLink fieldCode="AR" term="%22Rasheed%2C+Samiya%22">Rasheed, Samiya</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Eating+Disorders%22">International Journal of Eating Disorders</searchLink>. Apr2024, Vol. 57 Issue 4, p892-902. 11p.
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  Data: <searchLink fieldCode="DE" term="%22Anorexia+nervosa+treatment%22">Anorexia nervosa treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Community+health+services%22">Community health services</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+protocols%22">Medical protocols</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+specialties+%26+specialists%22">Medical specialties & specialists</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Fisher+exact+test%22">Fisher exact test</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Surveys%22">Surveys</searchLink><br /><searchLink fieldCode="DE" term="%22Thematic+analysis%22">Thematic analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Anorexia+nervosa%22">Anorexia nervosa</searchLink><br /><searchLink fieldCode="DE" term="%22Convalescence%22">Convalescence</searchLink><br /><searchLink fieldCode="DE" term="%22Physician+practice+patterns%22">Physician practice patterns</searchLink><br /><searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Weight+gain%22">Weight gain</searchLink><br /><searchLink fieldCode="DE" term="%22Social+stigma%22">Social stigma</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: There is a lack of consensus in defining "significant weight loss" when diagnosing atypical anorexia nervosa (atypical AN) and no guidelines exist for setting target weight (TW). The current study aimed to identify community providers' practices related to the diagnosis of atypical AN and the determination of TW. A secondary aim was to evaluate whether professional discipline impacted "significant weight loss" definitions. Method: A variety of providers (N = 141; 96.4% female) completed an online survey pertaining to diagnostic and treatment practices with atypical AN. Descriptive statistics were computed to characterize provider‐based practices and Fisher's exact tests were used to test for differences in diagnostic practices by professional discipline. Thematic analysis was used to examine open‐ended questions. Results: Most (63.97%) providers diagnosed atypical AN in the absence of any weight loss if other AN criteria were met, but doctoral‐level psychologists and medical professionals were less likely to do so compared to nutritional or other mental health professionals. Most providers found weight gain was only sometimes necessary for atypical AN recovery. Qualitative responses revealed providers found atypical AN to be a stigmatizing label that was not taken seriously. Providers preferred to use an individualized approach focused on behaviors, rather than weight when diagnosing and treating atypical AN. Discussion: Lack of diagnostic clarity and concrete treatment guidelines for atypical AN may result in substantial deviations from the DSM‐5‐TR criteria in real‐world practice. Clinically useful diagnostic definitions for restrictive eating disorders and evidence‐based treatment guidelines for TW and/or other relevant recovery metrics are needed. Public Significance: The current study found variability in how community providers diagnose and determine target recovery weight for atypical anorexia nervosa (atypical AN). Many providers viewed the diagnosis of atypical AN as stigmatizing and preferred to focus on behaviors, rather than weight. This study underscores the importance of creating a clinically useful diagnostic definition and guidelines for recovery for atypical AN backed by empirical evidence that providers may implement in practice. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of International Journal of Eating Disorders is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=176608693
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      – Type: doi
        Value: 10.1002/eat.24125
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      – Code: eng
        Text: English
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        PageCount: 11
        StartPage: 892
    Subjects:
      – SubjectFull: Anorexia nervosa treatment
        Type: general
      – SubjectFull: Community health services
        Type: general
      – SubjectFull: Medical protocols
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      – SubjectFull: Medical specialties & specialists
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      – SubjectFull: Research funding
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      – SubjectFull: Fisher exact test
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Surveys
        Type: general
      – SubjectFull: Thematic analysis
        Type: general
      – SubjectFull: Anorexia nervosa
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      – SubjectFull: Convalescence
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      – SubjectFull: Physician practice patterns
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      – SubjectFull: Research methodology
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      – SubjectFull: Weight gain
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      – SubjectFull: Social stigma
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      – TitleFull: Understanding community provider practices in diagnosing and treating atypical anorexia nervosa: A mixed methods study.
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              Text: Apr2024
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