When most people hear the word “anorexia” they think of a starving, wasted, emaciated person. While this is true in some cases of anorexia, it is estimated that atypical anorexia is more common than typical Anorexia Nervosa, which is where a person meets all the criteria for Anorexia Nervosa, except, despite significant weight loss, the individual is not underweight and does not meet the weight criteria for Anorexia Nervosa. Like people with typical anorexia, people with atypical anorexia have an intense fear of gaining weight and becoming “fat” and have a distorted view of themselves and their illness. This eating disorder is classified under OSFED (other specified feeding or eating disorder) in the DSM-5 and is just as serious as anorexia or any other eating disorder.
There are many myths and misconceptions about atypical anorexia, the most prevalent being that atypical anorexia is not as serious as typical anorexia. Many studies show that the medical consequences of atypical anorexia are just as serious as the consequences associated with typical anorexia and that the total amount of weight lost is a greater predictor of health consequences than body weight and BMI are. Just like typical anorexia, atypical anorexia carries the risk of physical consequences such as thinning hair, amenorrhea (loss of menstrual cycle), fainting, organ failure, constant fatigue and coldness, loss of muscle mass, bradycardia (slowed resting heart rate), and osteoporosis (brittle bones). Refeeding syndrome is also a concern for people with atypical anorexia. Additionally, individuals diagnosed with atypical anorexia have shown similar or worse psychological characteristics and disordered eating behaviors than those diagnosed with typical anorexia. These behaviors include calorie restriction, purging, chew/spit, excessive exercise, and bingeing. Just like Anorexia Nervosa, atypical anorexia is associated with higher levels of depression, anxiety, OCD, and substance abuse.
Another misconception about atypical anorexia is that individuals with this diagnosis are always slightly underweight or have a normal BMI and just fall short of meeting the weight criteria for Anorexia Nervosa. The truth is that restrictive eating disorders don’t have a look and many people who suffer with atypical anorexia are still overweight or obese despite significant weight loss. In addition, being overweight or obese puts someone at a higher risk of engaging in disordered eating behaviors and developing an eating disorder. People at higher rates also typically suffer for longer before receiving professional treatment compared with typical anorexics with a low body weight and are also less likely to receive inpatient treatment.
It is also a common myth that an individual with atypical anorexia does not require intense treatment or the same level of care as an individual with typical anorexia. Though people with atypical anorexia are often less visibly sick than those with Anorexia Nervosa, they often have similar or greater medical and psychiatric complications and also often have had the illness for a longer duration of time before receiving treatment. Weight restoration is also often necessary and one study showed that even when a patient presented with a normal body weight, weight restoration was still necessary to eliminate symptoms of bradycardia and an irregular menstrual cycle.
Though atypical anorexia is a less visible illness than typical anorexia, it does not make it less severe and people with atypical anorexia still deserve help and treatment regardless of weight or body size/shape. Anorexia and other eating disorders do not discriminate and can affect anyone regardless of age, gender identity, sexual orientation, race, or social class. If you feel that you or anyone you know may suffer from anorexia or any other eating disorder, don’t hesitate to reach out for help from a friend, parent, doctor, counselor, or anyone else you trust. If you’re interested in learning more or in looking for eating disorder resources, click the links below. RealTalk
Written by Samantha Srichai, Content Contributor
Eating disorder resources:
NEDA eating disorders screening tool
ANAD support groups
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