What is Atypical Anorexia Nervosa? Signs, Symptoms, Support
Eating disorders can manifest in a number of ways.
In last week’s podcast episode, Medical Care and Eating Disorder Recovery, Sarah and anti-diet dietitian, Rachel Shifflet spoke about atypical anorexia. As Rachel put it, “...it’s anorexia with a side of weight stigma!”
Anorexia nervosa isn't a one-size-fits-all experience. Contrary to mainstream beliefs, it's not solely defined by thinness and extreme weight loss.
What has come to be known as atypical anorexia nervosa, challenges the mainstream preconceptions about what anorexia looks like, and who might qualify for the diagnosis without naming body size as a factor.
As eating disorder therapists, all too often we see folks who are misdiagnosed, or feel that they aren’t sick enough because they don’t fit into a diagnostic criteria for an eating disorder.
Many times we see this with folks who have been diagnosed with binge eating disorder, or looking for binge eating disorder therapy, but are actually struggling with anorexia, and have been misdiagnosed due to body-size.
The societal image often associated with eating disorders tends to focus on extreme thinness, leading to a harmful stereotype that can leave many individuals feeling overlooked.
This misconception not only ignores the diverse manifestations of eating disorders, including atypical anorexia, but it also contributes to the damaging notion of not being "sick enough."
The truth is, the impact of an eating disorder goes far beyond physical appearance. It's a complex interplay of emotional, mental, and physical struggles that can affect all people across different body types.
Let’s take a look at atypical anorexia vs anorexia according to the DSM 5 (note that atypical anorexia has been classified under the OSFED eating disorder diagnosis in the DSM 5).
What is anorexia?
Anorexia nervosa is an eating disorder marked by an intense fear of gaining weight and a distorted body image. As outlined by the DSM-5, common symptoms of anorexia include:
Significant Weight Loss: Individuals often maintain a weight well below what is considered healthy for their age and height.
Restrictive Eating Patterns: Anorexia involves strict limitations on the amount and types of food consumed, leading to malnutrition.
Intense Fear of Weight Gain: Those with anorexia experience an overwhelming fear of gaining weight, even if underweight.
Distorted Body Image: A distorted perception of one's body often accompanies anorexia, irrespective of actual weight.
What is Atypical Anorexia?
Atypical anorexia nervosa challenges mainstream and old school beliefs about how anorexia presents. Atypical anorexia shares many features with typical anorexia nervosa, such as restrictive eating patterns, intense fear of gaining weight, and distorted body image. However, what sets it apart is that individuals with atypical anorexia may not exhibit the extreme weight loss often associated with the conventional portrayal.
Imagine it as a spectrum where struggles with food, body image, and self-worth are just as real, but the outward appearance may not align with our outdated, harmful and oppressive preconceived notions.
Symptoms of Atypical Anorexia Nervosa:
Irregular Eating Patterns: Inconsistent or irregular eating habits, including periods of intense restriction.
Intense Fear of Weight Gain: Like in typical anorexia, individuals with atypical anorexia experience an overwhelming fear of gaining weight.
Distorted Body Image: Persistent dissatisfaction with one's body and a distorted perception of body size and shape, leading to efforts to control weight despite not being underweight.
Anxiety Around Meal Times: Heightened anxiety and emotional struggles related to meal times.
Physical Symptoms: Physical symptoms may include fatigue, disruptions in menstrual cycles, and other signs of malnutrition.
Atypical anorexia nervosa often presents itself through a range of symptoms, such as irregular eating patterns, intense fear of gaining weight, and a persistent dissatisfaction with one's body.
| Symptoms | Anorexia Nervosa | Atypical Anorexia Nervosa |
|---|---|---|
| Weight Loss | Significant weight loss | May not exhibit extreme weight loss; weight may remain within or close to a person's typical range. The label of "atypical" stems from weight stigma rather than differing symptoms. |
| Eating Patterns | Highly restrictive eating habits, often leading to malnutrition. | Irregular eating patterns, including restriction, often leading to malnutrition. |
| Body Image | Intense fear of gaining weight, distorted body image. | Persistent dissatisfaction with one's body, fear of weight gain, and distorted body image. |
| Physical Symptoms | Fatigue, weakness, dizziness, and potential organ damage. | Physical symptoms may vary but can include fatigue, weakness, disruptions in menstrual cycles, organ damage and malnutrition. |
| Psychological Impact | Obsessive thoughts about food, preoccupation with body image. | Heightened anxiety around meal times, emotional struggles related to food and body image. |
| Perceived Severity | Often perceived as more severe due to extreme weight loss. | May be perceived as less severe externally due to weight or body size, leading to potential underestimation of the impact. |
Atypical Anorexia is so much more than a diagnosis
Beneath the surface of atypical anorexia, a so many intense emotions exist.
It's not “just” a struggle with appearance; it's a visceral experience marked by the weight of guilt, the isolating grip of shame, the suffocating presence of depression, the near constant hum of anxiety, and the never-ending pursuit of an elusive perfection.
Understanding this intense emotional landscape is so important.
By acknowledging the sheer force of these emotions, our team strives to create a space of raw empathy for individuals navigating the challenges of atypical anorexia, especially the relentless battles they face on the emotional front.
In confronting any type of eating disorder or disordered eating, finding an eating disorder therapist near me is a courageous step towards eating disorder recovery.
A trauma-focused eating disorder therapist can play an important role in recovery. Not only looking at behaviors, but also the influence of trauma in developing an eating disorder. Therapists specializing in both trauma and eating disorders offer a lens to understand and address the emotional challenges associated with anorexia, while also recognizing and renegotiating the impact of past traumas.
Therapy with Reclaim goes beyond surface-level concerns, and invites curiosity into the complex interplay of emotions, nervous system dysregulation and consequent behavioral patterns influenced by trauma.
Beyond eating disorder therapy, a support system is helpful for folks navigating atypical anorexia.
Connecting with resources that understand the complexities of eating disorders and trauma can be a lifeline.
Online Communities: Platforms like The Reclaim You Membership Community provides a space where individuals can share experiences, find understanding, and gather insights from those on similar journeys.
Support Groups: Local or virtual support groups, facilitated by organizations like The Alliance, Center for Discovery and ERC offer a sense of community, breaking the isolation often felt in the midst of atypical anorexia.
Books and Podcasts: Exploring books, podcasts, and educational content from reputable sources like Sick Enough, Reclaiming Body Trust, FoodPsych and Reclaim You with Reclaim Therapy can be powerful tools. These resources can help you build a deeper understanding of your struggles and empower you with knowledge to actively participate in their recovery.
Here at Reclaim Therapy we believe that there is no such thing as being “sick enough” to deserve eating disorder treatment.
An anorexia therapist in Horsham, PA can support you in starting, continuing and progressing through your eating disorder recovery process. Regardless of if you fit into a diagnostic criteria or not, your suffering deserves to be heard, understood, validated and supported.
We would be honored to support you in your recovery process.
🧡,
Reclaim Therapy is a group of specialized eating disorder therapist in Horsham, PA.
Our team specializes in treating disordered eating, trauma therapy, grief counseling and body image concerns. We provide trauma-focused treatment and utilize EMDR Therapy for eating disorders, PTSD and CPTSD treatment.
Want to learn more about our specializations?