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I've been reading about anorexia and as I understand it, it's an eating disorder where someone severely restricts their intake of food because of an intense fear of gaining weight, a distorted perception of weight, equating weight with self-worth, and things like that.

I was wondering, is it possible for someone to have anorexia without weight and body esteem issues? In other words, they severely restrict their food intake but not because of a fear of gaining weight or body esteem issues. I came across this Quora question, but the only answer there is an anecdotal one.

Or perhaps is there some eating disorder other than anorexia that matches this description? I came across this article, Does Everyone With an ED Have Body Dysmorphia?, but it didn't really help.

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It is possible for someone to have an eating disorder without weight and body esteem issues (Sarkar, et al. 2013), but not Anorexia.

Fear of becoming fat or gaining weight and having a distorted view of themselves and of their condition are criteria required in the Diagnostics and Statistical Manual which is used for diagnosing mental health problems. Therefore, Anorexia would not be diagnosed without these criteria being present.

An eating disorder without body image issues would be diagnosed as EDNOS (Eating Disorder Not Otherwise Specified) under the 4th Edition, but as the 5th edition merged the former categories of Eating Disorders and Feeding Disorder in Infancy or Early Childhood and formed the new category, Feeding and Eating Disorders, the diagnosis under the 5th edition would be OSFED (Other Specified Feeding or Eating Disorder).

OSFED is every bit as serious as anorexia, bulimia, or binge eating disorder, and people suffering from OSFED are every bit as deserving and in need of treatment – their eating disorder is just presenting in a different way. It is common for symptoms to not fit with the exact diagnostic criteria for anorexia, bulimia, or binge eating disorder – OSFED accounts for a large percentage of eating disorders (Beat Eating Disorders, 2017).

References

Beat Eating Disorders (2017). Other Specified Feeding or Eating Disorder (OSFED). Retrieved from: https://www.beateatingdisorders.org.uk/types/osfed

Sarkar, S., Padhy, S. K., Rao, P., & Gupta, S. (2013). Transient eating problems in an adolescent without body image disturbances: a diagnostic quandary. Indian journal of psychological medicine, 35(4), 410. doi: 10.4103/0253-7176.122244 PubMed Central: PMC3868099

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This could be ARFID or OFSED.

ARFID

Avoidant Restrictive Food Intake Disorder (ARFID) is a new diagnosis in the DSM-5, and was previously referred to as “Selective Eating Disorder.” ARFID is similar to anorexia in that both disorders involve limitations in the amount and/or types of food consumed, but unlike anorexia, ARFID does not involve any distress about body shape or size, or fears of fatness.....a person with ARFID does not consume enough calories to grow and develop properly and, in adults, to maintain basic body function. In children, this results in stalled weight gain and vertical growth; in adults, this results in weight loss. ARFID can also result in problems at school or work, due to difficulties eating with others and extended times needed to eat.

OFSED (formerly EDNOS) refers to an eating or feeding disorder that does not meet the full diagnostic criteria of another eating disorder.

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  • $\begingroup$ To be clearer, the OP criteria is "they severely restrict their food intake but not because of a fear of gaining weight or body esteem issues". You are not severely restricting food intake as such with ARFID but you certainly are with OSFED. Nevertheless, a good lead to a slightly different diagnosis. $\endgroup$ – Chris Rogers Jan 4 at 11:53
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That's a question of definition. Anorexia can be either a mental health issue or a symptom.

If by anorexia you mean anorexia nervosa, then per definition it's an eating disorder, that among other things, implies body image issues.

Notice however, that anorexia can also simply mean the symptom, which is a pathological lack of appetite. In this case, it's a symptom of another illness, and not an illness per se. The underlying cause can well be cancer, AIDS, for example. For example, as it is used by Ezeoke and Morley (2015).

Wikipedia even has two separate pages for the illness: https://en.wikipedia.org/wiki/Anorexia_nervosa

and for the symptom: https://en.wikipedia.org/wiki/Anorexia_(symptom)

Ezeoke, C. C., & Morley, J. E. (2015). Pathophysiology of anorexia in the cancer cachexia syndrome. Journal of cachexia, sarcopenia and muscle, 6(4), 287-302.

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