Which finding most clearly suggests anorexia nervosa rather than bulimia nervosa?

Question

BlackTom AI · Accepted Answer

Restrictive food intake with an intense fear of weight gain is the hallmark of anorexia nervosa and therefore most clearly suggests anorexia rather than bulimia.

1) Relevant knowledge points and concepts
- DSM-5 criteria for anorexia nervosa include: (a) restriction of energy intake leading to significantly low body weight, (b) intense fear of gaining weight or becoming fat, and (c) disturbance in the way one’s body weight or shape is experienced. Subtypes include a restrictive type (no recurrent binge eating or purging) and a binge-eating/purging type.
- Bulimia nervosa is defined by recurrent binge eating episodes followed by inappropriate compensatory behaviors (e.g., self-induced vomiting, laxatives), occurring at least once a week for several months; individuals with bulimia often are at normal body weight.
- Physical findings: parotid gland swelling and dental enamel erosion are classic signs of repeated self-induced vomiting; normal body weight favors bulimia over anorexia.

2) Reasoning process step by step
- Evaluate each option against diagnostic features.
- “Restrictive food intake with intense fear of weight gain” directly matches the core DSM-5 features of anorexia (restriction + intense fear).
- “Swollen parotid glands” and “dental enamel erosion” point to recurrent vomiting—a compensatory behavior classically seen in bulimia nervosa (and in the binge/purge subtype of anorexia, but less specific for pure restrictive anorexia).
- “Normal body weight” argues against anorexia because anorexia requires significantly low body weight.

3) Calculations
- None required.

4) Why the correct answer is correct
- The phrase explicitly describes the restrictive subtype of anorexia: persistent restriction of caloric intake together with intense fear of weight gain, which is diagnostic for anorexia nervosa and differentiates it from bulimia where restriction is not the defining feature.

5) Why the other options are incorrect
- Swollen parotid glands: suggest repetitive vomiting — more indicative of bulimia (or anorexia binge/purge subtype), not the restrictive anorexia picture.
- Normal body weight: inconsistent with anorexia’s low-weight criterion; more typical of bulimia.
- Dental enamel erosion: caused by exposure to gastric acid from vomiting — again points toward bulimia or purging behaviors, not restrictive anorexia.

6) Conclusion
The correct answer is “Restrictive food intake with intense fear of weight gain,” which matches the provided answer.

Which finding most clearly suggests anorexia nervosa rather than bulimia nervosa?Single choice

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