Objective

DSM-5 Atypical Anorexia Nervosa (AAN), a new eating disorder diagnosis, presents similarly to Anorexia Nervosa (AN) in the absence of severe underweight. The prevalence of AAN and other DSM-5 eating disorders was estimated in a sample of Veterans. Sociodemographic, mental health, and eating behavior correlates were examined.

Method

Iraq and Afghanistan war era Veterans (N = 1137, 51.6% female) completed the Eating Disorder Diagnostic Scale-5 for probable AAN diagnosis, and validated measures of eating pathology and mental health, between February 2016 and October 2019. Multivariate analyses compared Veterans with AAN to those with and without any DSM-5 eating disorder.

Results

Among completers, 13.6% of women and 4.9% of men in the sample met criteria for probable AAN and 19.2% of women and 13.9% of men for another eating disorder. Mean age was 41 years, and on average BMIs were classified as overweight (BMI = 28.8, SD = 5.6) despite being at least 10% lower than their lifetime highest weight. Two-thirds reported dietary restraint on more than half the days in the past month. On measures of mental health, the AAN group had worse functioning than the no eating disorder group, similar functioning to Veterans with Binge Eating Disorder (BED), and better functioning than Veterans with Bulimia Nervosa (BN).

Discussion

Results support AAN as a highly prevalent and clinically significant diagnosis. Findings highlight the need to identify and address eating disorders, particularly other specified eating disorders not meeting criteria for AN, BN, or BED, in active military and Veteran, and other high-risk and underserved, populations.

中文翻译：

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非典型神经性厌食症，毕竟不是那么典型：美国退伍军人中的患病率，相关性和临床严重性

客观的

DSM-5非典型神经性厌食症（AAN）是一种新的饮食失调诊断，在没有严重体重过轻的情况下，其表现与神经性厌食症（AN）类似。在退伍军人样本中估计了AAN和其他DSM-5饮食失调的患病率。研究了社会人口统计学，心理健康和饮食行为的相关性。

方法

伊拉克和阿富汗战争时代的退伍军人（N = 1137，女性51.6％）完成了《进食障碍诊断量表》 -5，以进行可能的AAN诊断，并在2016年2月至2019年10月间验证了饮食病理和心理健康的测量方法。多因素分析比较了退伍军人与有和没有任何DSM-5进食障碍者的AAN。

结果

在完成者中，样本中13.6％的女性和4.9％的男性符合可能的AAN的标准，另有19.2％的女性和13.9％的男性符合另一种饮食失调的标准。平均年龄为41岁，尽管平均体重指数比其一生最高体重低至少10％，但平均被归类为超重（体重指数= 28.8，标准差= 5.6）。三分之二的人表示在过去一个月中有一半以上的时间节食。在心理健康方面，AAN组的功能比无饮食障碍组的功能差，与患有暴食症的退伍军人（BED）的功能相似，并且比患有贪食症的退伍军人（BN）的功能更好。

讨论

结果支持AAN作为高度流行和具有临床意义的诊断。研究结果强调了在活跃的军人和退伍军人以及其他高风险和服务水平低下的人群中，需要识别和解决饮食失调症，尤其是其他特定的饮食失调症，这些疾病不符合AN，BN或BED的标准。