Greater Body Dissatisfaction at Admission Is Associated With Lower BMI at Discharge in Anorexia Nervosa: Predictive Validity of the Eating Pathology Symptoms Inventory.

Creator(s)

Danielle A N Chapa
Marianna L. Thomeczek
Brianne N. Richson
Alan Duffy
Kara A. Christensen Pacella
Kelsie T. Forbush
Renee D. Rienecke
Dan V. Blalock
Sara R. Gould, Children's Mercy HospitalFollow
Victoria L. Perko
Philip S. Mehler

Document Type

Article

Publication Date

1-2026

Identifier

DOI: 10.1002/eat.24560; PMCID: PMC12614634

Abstract

People with anorexia nervosa (AN) engage in dietary restriction and other weight loss behaviors that result in dangerously low body weight, leading to an increased risk for mortality and medical complications. Weight gain is one of the most important indicators of treatment progress and recovery for AN. There are limited predictors of weight gain for patients with AN, making it difficult for clinicians to anticipate which patients are likely to respond favorably to treatment. Thus, there is a need to identify additional, potentially modifiable predictors of weight gain within a higher level of care for AN. This study tested the predictive validity of the Eating Pathology Symptoms Inventory (EPSI) in adults receiving a higher level of care for AN (N = 340). We hypothesized that EPSI scores at treatment admission would predict body mass index (BMI) at discharge. Linear regression was used to identify predictors of discharge BMI. EPSI Body Dissatisfaction at admission (β = -0.043, p = 0.005) predicted BMI at discharge (controlling for admission BMI, length of stay, and level of care), such that individuals with greater body dissatisfaction at admission had lower BMIs at treatment discharge. Other EPSI scales did not predict BMI. Results supported the predictive validity of EPSI Body Dissatisfaction for discharge weight in adults receiving a higher level of care for AN. Patients who are more dissatisfied with their bodies, despite having a dangerously low BMI at admission, may be at risk for poorer treatment outcomes.

Journal Title

The International journal of eating disorders

Volume

59

Issue

1

First Page

90

Last Page

98

MeSH Keywords

Humans; Anorexia Nervosa; Female; Body Mass Index; Adult; Body Dissatisfaction; Patient Discharge; Young Adult; Male; Adolescent; Body Image; Reproducibility of Results; Weight Gain

PubMed ID

41014241

Keywords

anorexia nervosa; bmi; eating disorders; eating pathology symptoms inventory; predictive validity; psychometrics; treatment outcomes

Comments

Grants and funding

• T32 MH018269/MH/NIMH NIH HHS/United States
• T32 MH082761/MH/NIMH NIH HHS/United States
• NIMH T32 MH082761/MH/NIMH NIH HHS/United States
• NIMH T32 MH018269/MH/NIMH NIH HHS/United States
• NIMH T32 MH018269/MH/NIMH NIH HHS/United States
• NIMH T32 MH082761/MH/NIMH NIH HHS/United States

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Publisher's Link: https://onlinelibrary.wiley.com/doi/10.1002/eat.24560

Recommended Citation

Chapa DAN, Thomeczek ML, Richson BN, et al. Greater Body Dissatisfaction at Admission Is Associated With Lower BMI at Discharge in Anorexia Nervosa: Predictive Validity of the Eating Pathology Symptoms Inventory. Int J Eat Disord. 2026;59(1):90-98. doi:10.1002/eat.24560