["Journal of Clinical Psychology, EarlyView. ", "\nABSTRACT\n\nObjective\nGastrointestinal (GI) disturbances and eating disorder symptoms commonly co‐occur. Hypervigilance and anxiety about GI symptoms may motivate eating disorder behaviors to manage and/or avoid GI symptoms. We hypothesized that GI‐specific anxiety would be more strongly associated with dietary restriction and purging than GI‐specific hypervigilance. Further, we hypothesized that distinguishing between GI‐specific anxiety and hypervigilance would have incremental validity over using an existing measure of GI‐anxiety and related constructs initially developed for patients with irritable bowel syndrome, the Visceral Sensitivity Index.\n\n\nMethods\nThree hundred and eighty‐two undergraduate students with elevated eating pathology (83.5% female, 87.4% White) completed questionnaires assessing GI‐specific hypervigilance and anxiety, the Visceral Sensitivity Index, and eating disorder symptoms. Participants were recruited with elevated shape/weight‐oriented eating pathology (N = 309) and elevated avoidant/restrictive food intake disorder‐related eating pathology (N = 73). Analyses were pre‐registered.\n\n\nResults\nRegarding dietary restriction, the relative weight of GI‐specific anxiety did not differ from that of GI‐specific hypervigilance. Further, neither variable provided incremental validity over the Visceral Sensitivity Index in understanding restriction. Regarding purging, GI‐specific anxiety was not more strongly associated with purging than GI‐specific hypervigilance. However, GI‐specific anxiety, but not GI‐specific hypervigilance, demonstrated incremental validity over the Visceral Sensitivity Index in explaining purging.\n\n\nConclusion\nDistinguishing between GI‐specific hypervigilance and anxiety adds incremental validity in understanding purging but not restriction. Future research should examine whether addressing anxious cognitions about GI symptoms improves purging outcomes.\n"]