Examining the weight status criterion as a perpetuator of harm and racial/ethnic disparities in anorexia nervosa

Eat Behav. 2025 Apr:57:101984. doi: 10.1016/j.eatbeh.2025.101984. Epub 2025 Apr 23.

Abstract

Anorexia Nervosa is distinguished from a similar - if not identical - disorder, atypical Anorexia Nervosa, based on weight status. Atypical Anorexia Nervosa is diagnosed when, "despite significant weight loss, [an] individual's weight is within or above the normal range." The current scholarly commentary grapples with the historical, biological, and psychosocial flaws inherently entangled in utilizing weight status (and its standardized metrics - i.e., Body Mass Index) as proxies for dietary restriction and health status. We briefly synthesize evidence suggesting that utilization of weight status to differentiate Anorexia Nervosa and Atypical Anorexia Nervosa perpetuates systemic and structural health inequities for individuals with marginalized racial and ethnic identities. This commentary aims to spark discussion on the lack of utility in maintaining two seemingly identical disorders at the cost of perpetuating harm toward historically marginalized groups.

Keywords: Anorexia nervosa; Atypical anorexia nervosa; Body mass index; Health inequities; Race; Weight status.

MeSH terms

  • Anorexia Nervosa* / diagnosis
  • Anorexia Nervosa* / ethnology
  • Anorexia Nervosa* / psychology
  • Body Mass Index
  • Body Weight*
  • Ethnicity* / psychology
  • Health Status Disparities*
  • Humans
  • Racial Groups* / psychology