When you hear the word “anorexia,” what image comes to mind? Most people hear the word “anorexia” and immediately think of an extremely thin person. The reality is, however, eating disorders come in all shapes and sizes, and they do not always lead to extreme weight loss. One very serious eating disorder, called atypical anorexia, shares all the features of traditional anorexia (including severe and life-threatening health complications), yet those suffering from it are still within a normal or above normal weight range.
What is Atypical Anorexia?
The DSM-V defines atypical anorexia as an eating disorder that meets all the criteria for typical anorexia nervosa (AN), with the exception that the individual is still within or above a normal weight range. In other words, individuals with atypical anorexia restrict their caloric intake, engage in binge-purge episodes, have an intense fear of gaining weight, and/or experience serious physical and psychological problems as a result of these disordered behaviors (just like with regular anorexia). The only difference is that individuals with atypical anorexia happen to be in a larger body than “traditional anorexics.”
While many people think typical anorexia (i.e., the individual is below the normal weight range and appears extremely thin) is a more serious form of the disorder, research shows atypical anorexia is just as severe and life-threatening. For example, in a 2016 study of adolescents with atypical AN and adolescents with typical AN, researchers found that adolescents with atypical AN experienced the same mental and physical health complications as those with full-threshold AN . In fact, the study found that in some cases, adolescents with atypical AN suffered more severely (especially when it came to eating and body image-related distress) than those with typical AN .
Some of the physical and psychological complications associated with atypical anorexia include the following:
- Bradycardia (slow heart rate)
- Amenorrhea (loss of menstrual cycle or delayed puberty)
- Low blood pressure
- Low bone density
- Electrolyte imbalance
- Psychiatric comorbidity (e.g., depression, anxiety, obsessive-compulsive disorder)
- Suicidal ideation
Treatment for Atypical Anorexia
Despite the fact that individuals with atypical anorexia experience the same (if not more severe) physical and psychological complications as those with full-threshold AN, many people with atypical AN fail to get the treatment they deserve. One reason for this is that individuals with atypical AN don’t believe they’re “sick enough” to seek treatment for an eating disorder. In fact, since they’re still within a “normal” or “above normal” weight range, they may even receive praise and compliments from friends and family for the weight they’ve lost or the “healthy habits” they’ve adopted.
Another common barrier to treatment for atypical anorexia is fatphobia and weight stigma among health providers. Despite the patient displaying warning signs of an eating disorder (e.g., rapid weight loss, excessive exercise, obsession with food, loss of menstrual cycle, etc.), many health providers fail to talk about eating disorders and may even encourage weight loss strategies simply because the patient’s weight is in the “normal” or “above normal” range.
Unfortunately, these barriers to treatment mean many people suffer from atypical anorexia for years without ever receiving a diagnosis or getting the help they need. This is why it is critical for family members and loved ones to know the signs and symptoms of atypical anorexia and advocate for their loved ones if they suspect an eating disorder is present.
Warning Signs & Symptoms
The following signs and symptoms are commonly associated with atypical anorexia:
- Fearing weight gain
- Obsessing about your appearance, weight, or body shape
- Restricting your caloric intake
- Adopting rigid rules and routines around food and eating
- Avoiding situations that involve food and eating
- Making excuses, so you don’t have to eat certain foods
- Skipping meals
- Having a distorted view of your body (e.g., believing you are a bigger size than you really are)
- Engaging in compensatory behaviors to make up for the food you’ve eaten (purge vomiting, use of laxatives, excessive exercise, etc.)
If you or a loved one are displaying any of the symptoms of atypical anorexia, seek medical help right away. Remember that weight is not a qualifier for an eating disorder diagnosis.
Anyone can have an eating disorder, no matter their size. And as countless research shows, people with atypical anorexia suffer severe (even life-threatening) physical and psychological complications.
So don’t believe the lie that you aren’t “sick enough” to get help. If you or a loved one are experiencing any of the signs of an eating disorder, then you are sick enough, and you do deserve to get treatment today.
References: Sawyer, S. M., Whitelaw, M., Le Grange, D., Yeo, M., & Hughes, E. K. (2016, April). Physical and Psychological Morbidity in Adolescents With Atypical Anorexia Nervosa. PubMed.gov. https://pubmed.ncbi.nlm.nih.gov/27025958/.  ibid.
About the Author:
Sarah Musick is a freelance writer who specializes in eating disorder awareness and education. After battling with a 4-years long eating disorder, she made it her mission to help others find hope and healing in recovery.
Her work has been featured on numerous eating disorder blogs and websites. When she’s not writing, Sarah is off traveling the world with her husband.
The opinions and views of our guest contributors are shared to provide a broad perspective on 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.
Published February 5, 2021, on EatingDisorderHope.com
Reviewed & Approved on February 5, 2021, by Jacquelyn Ekern MS, LPC