Transdiagnostic fears and avoidance behaviors across eating disorders

Abstract Background: Anxiety and avoidance behaviors are common maintenance symptoms of anorexia nervosa. It was investigated whether those behaviors are transdiagnostic eating disorder characteristics. Methods: Eating disorder patients (n=250) and healthy controls (n=111) completed online questionnaires assessing general anxieties, eating disorder specific anxieties and avoidance behaviors. Results: All eating disorders showed more specific eating anxieties and intolerance of uncertainty than healthy controls. Binge eating disorder patients scored between the other eating disorders and healthy controls on general anxiety and food avoidance behaviors. Their food avoidance behaviors and eating restraint did not differ from healthy controls, whereas all other eating disorders scored significantly higher on both. Conclusions: Eating disorder specific anxieties, general anxieties, and food avoidance behaviors were found to be transdiagnostic symptoms in anorexia nervosa, bulimia nervosa and other specified feeding and eating disorders. While binge eating disorder patients exhibit as many specific eating fears as other eating disorders, general fears and avoidance behaviors are less evident in this group. Specialized interventions targeting anxieties may be promising add-on interventions, not only for anorexia nervosa, but for the treatment of all eating disorders.