Establishing consensus for labeling and defining the later stage of anorexia nervosa: A Delphi study

Int J Eat Disord. 2021 Oct;54(10):1865-1874. doi: 10.1002/eat.23600. Epub 2021 Aug 30.

Abstract

Objective: Varied perspectives on the later stage of anorexia nervosa (AN) have left the field of eating disorders without a consistent label or definition for this subpopulation. As a result, diverse criteria when recruiting participants have led to incomparable results across research studies and a lack of guidance when assessing and treating patients in the clinical context. The aim of the current study was to develop consensus-based guidelines on the labeling and defining of the later stage of AN.

Method: Utilizing the Delphi methodology, a professional panel of experts (N = 21) participated in three rounds of questionnaires. Five open-ended questions (Round 1) were analyzed using content analysis to form statements relating to a classification system for labeling and defining the later stage of AN. A total of 80 statements were rated in terms of panelists' level of agreement (Rounds 2 and 3).

Results: Consensus was achieved for 28.8% of statements and a further 16.3% of statements reached near consensus in the second and third round of questionnaires. Two labels were identified with five defining features achieving consensus.

Discussion: Findings from the study suggest an alternative approach to labeling be adopted with consensus-based guidelines established for defining the later stage of AN. Implications that may occur from a unified classification system are explored with longitudinal research required to assess the impact on patients experiencing the later stage of AN.

Keywords: anorexia nervosa; defining; enduring; labeling; severe.

MeSH terms

  • Anorexia Nervosa* / therapy
  • Consensus
  • Delphi Technique
  • Humans
  • Surveys and Questionnaires