Is weight phobia always necessary for a diagnosis of anorexia nervosa?

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Abstract
Several reviews of the history of anorexia nervosa have concluded that weight phobia, a basic diagnostic criterion for the disorder, did not emerge as a predominant motive for food refusal until around 1930. In addition, investigators have reported cases of self-starvation without apparent weight phobia in non-Western cultures. Three explanations have been proposed for these findings: 1) patients who do not demonstrate a definite weight phobia are in fact suffering from an eating disorder not otherwise specified, 2) weight phobia has been overlooked or concealed, and 3) there has been a transformation in the content of anorexia nervosa in the West and an analogous situation may be occurring in the developing countries. The authors conclude that a change in the core features of anorexia nervosa in Western cultures since 1930 can be demonstrated. They explore the question of whether anorexia nervosa would be the same illness if the criterion of weight phobia were not required and conclude that anorexia nerv...