In diagnosing anorexia nervosa, which scenario is most indicative for a patient with a low BMI and diet restrictions?

In the context of diagnosing anorexia nervosa, the most indicative scenario involves the patient's perception of their body weight. A hallmark symptom of anorexia nervosa is a distorted body image, where individuals often see themselves as overweight, despite having a significantly low body mass index (BMI). This self-perception encourages them to engage in restrictive eating behaviors and extreme dieting.

When a patient believes she is currently overweight, it highlights a key psychological component of the disorder: body image distortion. This belief is critical in the diagnosis, as it signifies the individual's struggle with their self-esteem and the obsessive thoughts surrounding weight and food.

While other symptoms, such as physical signs like lanugo (fine hair growth due to malnutrition) or participation in intense sports, could be associated with anorexia nervosa, they do not directly indicate the psychological aspect that is crucial for diagnosis. Similarly, abdominal pain and bloating after meals might suggest other gastrointestinal issues rather than reflecting the psychological components necessary for an anorexia nervosa diagnosis. Thus, the belief about being overweight stands out as the most indicative factor in this scenario.