Atypical Anorexia Nervosa: Signs and Symptoms

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When it comes to the eating disorder anorexia, there are many stigmas associated with this psychiatric illness that create misunderstandings about this disease and those who are suffering. For example, many people assume that anorexia is automatically related to a very low body weight or drastic weight loss. However, what about individuals who struggle with restrictive eating and abnormal eating behaviors associated with anorexia nervosa who are of normal body weight? Enter atypical anorexia nervosa.

Understanding Atypical Anorexia Nervosa

Contrary to many of the stigmas assumed about anorexia nervosa, a person can present with the restrictive behaviors and features of anorexia without meeting the low weight criteria for a diagnosis of anorexia.

According to the diagnostic criteria for anorexia nervosa from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), individuals struggling with this disorder will have a restriction of energy intake relative to their caloric requirement, which leads to a significantly low body weight in the context of several factors, including gender, physical health, age, developmental trajectory, and more. Other criterion includes an intense fear of gaining weight and/or becoming fat as well as a disturbance in body perception.

Woman near the lake thinking about Atypical Anorexia

A person dealing with atypical anorexia nervosa will exhibit these same criteria without weight loss. In fact, individuals with atypical anorexia nervosa may be within or above a normal weight range for their age, sex, etc., which makes the presentation “atypical”.

Atypical anorexia nervosa falls under the category of Other Specified Feeding or Eating Disorders (OFSED), which is one of the most prevalent eating disorders among adults today [1].

Presentation of Atypical Anorexia Nervosa

Rather than listing specific criteria for atypical anorexia nervosa, the DSM-5 has outlined this specific OFSED subtype as defined by anorexic features without low weight.

For example, a person struggling with atypical anorexia nervosa may exhibit an extreme fear of being fat or of any weight changes and resort to abnormal eating and feeding behaviors, such as calorie counting, cutting out certain foods/food groups, avoiding social events and functions that involve food, and more.

Dangers of Those Struggling With Atypical Anorexia Nervosa

Many individuals who have atypical anorexia nervosa may not even realize that they are struggling with a severe and deadly eating disorder, simply due to the weight stigma that surrounds this disease. A person may think, “I am not sick enough to have an eating disorder”, because they may be within a normal/above weight range.

This is a deadly trap that can prevent many individuals who are struggling from seeking out the professional and appropriate help needed for recovery. It is important to remember and understand that weight is not a defining criterion for an eating disorder, and the more this message is promoted, the more Young man with eating disorder therapisteffectively this stigma can be challenged.

A person can suffer from eating disorder tendencies, particularly related to anorexia, regardless of their size, shape, or weight. If you have found yourself struggling with abnormal eating patterns or unusual thoughts when it comes to your body and food, be sure to talk with someone you trust.

Having a professional assessment can be the first step in understanding what you might be struggling with and in connecting with the necessary treatment to help you address your concerns. Eating disorders, regardless of their formal diagnoses, are deadly psychiatric illnesses that can result in severe consequences if left untreated.

Atypical anorexia nervosa, even if it does not present like the classic anorexia diagnosis, can be debilitating for an individual who is struggling. If you or a loved one may be dealing with an eating disorder, be sure to reach out to someone and talk about your struggles. Speaking out for help is often the first step in overcoming these diseases.


Crystal Headshot 2About the Author: Crystal is a Masters-level Registered Dietitian Nutritionist (RDN) with a specialty focus on eating disorders, maternal/child health and wellness, and intuitive eating. Combining clinical experience with a love of social media and writing, Crystal serves where her passion to help others find recovery and healing are integrated into each part of her work.

As a Certified Intuitive Eating Counselor, Crystal has dedicated her career to helping others establish a healthy relationship with food and body through her work and nutrition private practice.


[1]: Thomas JJ, Vartanian LR, Brownell KD (May 2009). “The relationship between eating disorder not otherwise specified (EDNOS) and officially recognized eating disorders: meta-analysis and implications for DSM”. Psychol Bull 135 (3): 407–33. doi:10.1037/a0015326. PMC 2847852. PMID 19379023.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on February 8, 2018
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