Atypical Anorexia Nervosa

girls in support group

By Mandy Parsons

The National Eating Disorder Association (NEDA) reports that approximately 20 million women and 10 million men in America will have an eating disorder during their lifetime. Among the different types of eating disorders is anorexia nervosa, characterized by weight loss, difficulty maintaining a healthy body weight, and distorted body image.

Those suffering from anorexia often have an intense fear of gaining weight along with an unrealistic view of weight. Consequently, they may restrict their food intake or resort to diet aids, purging, as well as exercising in excess to avoid gaining weight.

And while someone with anorexia typically exhibits abnormally low body weight, NEDA asserts that a person does not need to be emaciated or underweight to be struggling. Studies have found that larger-bodied individuals can have anorexia as well, suffering from what is commonly referred to as atypical anorexia nervosa.

What is Atypical Anorexia Nervosa?

Women’s Health (UK) describes atypical anorexia as a disorder in which someone has “all of the symptoms of anorexia that a doctor would look for to make a diagnosis, but whose weight is in the ‘normal’ range.”

It is a challenge for health care providers to recognize and treat atypical anorexia because most of them have been trained to use low weight as the primary indicator for diagnosing malnourishment and the disorder.

The Meadows Ranch’s Clinical Director Anna Contor elaborates: “Atypical anorexia definitely refers to that intense fear of weight gain. And it’s going into that extreme restriction of energy food without having that extreme weight loss or low body weight.” Simply put, the behaviors of anorexia are present minus the stereotypical anorexic appearance.

This can be problematic for patients like journalist-author Carrie Arnold who recounts her battle with atypical anorexia in Women’s Health. She says that because she did not fit the anorexia stereotype, she was often misdiagnosed or dismissed by medical professionals from whom she sought help.

The National Institutes of Health (NIH) confirms her predicament and many others’ who suffer from atypical anorexia. A study published by the National Library of Medicine (NLM) notes that it is a challenge for health care providers to recognize and treat atypical anorexia because most of them have been trained to use low weight as the primary indicator for diagnosing malnourishment and the disorder.

Atypical Anorexia Nervosa Symptoms

Accordingly, many atypical anorexia symptoms mimic those of typical anorexia and can include:

  • A Distorted View of Body Weight and Shape

Atypical anorexia patients may struggle with body dysmorphia, a distorted view of their body weight and shape. Because of this altered perception, they have trouble discerning what a healthy weight looks like for them.

  • Anxiety About Gaining Weight

Atypical anorexia is fueled by an intense fear of gaining weight. As a result, men and women with atypical anorexia fixate on behaviors affecting their weight. This might drive them to weigh obsessively, significantly limit their calories, vomit food they have eaten, take laxatives and diuretics, or overexercise.

  • Social Withdrawal

People with atypical anorexia will often avoid situations that revolve around food, as places like restaurants and parties trigger unwanted behaviors. Depression is a factor for many who suffer from atypical anorexia, resulting in a decreased desire to socialize or participate in group activities.

  • Physical Ailments

The physical toll on those with atypical anorexia is especially disturbing, with patients reporting hair loss, brittle bones and nails, muscle weakness, extreme fatigue, absence of a menstrual period in women, and heart issues, among other complaints.

Atypical Anorexia Nervosa Treatment

Fortunately, there is help for individuals seeking treatment. The New York Times Magazine reports that people seeking atypical anorexia treatment has risen considerably since the mid-2000s, with those suffering comprising up to half of all patients hospitalized in eating disorder programs.

People seeking atypical anorexia treatment has risen considerably since the mid-2000s, with those suffering comprising up to half of all patients hospitalized in eating disorder programs.

Atypical anorexia treatment may involve one or more of the following approaches, many of which are suggested by the NLM:

  • Medical treatment – focusing on increasing caloric intake and reversing the effects of malnutrition while determining an appropriate weight goal
  • Pharmacologic management – introducing medications like selective serotonin uptake inhibitors (SSRIs) to help with mental symptoms such as anxiety and depression
  • Family-based therapy – empowering caregivers to restore their child to full health
  • Cognitive behavioral therapy (CBT) – training the brain to process negative thoughts associated with food-related behaviors more productively
  • Dialectical behavioral therapy (DBT) – incorporating CBT and mindfulness-based skills to increase interpersonal effectiveness, develop emotion regulation, and build distress tolerance skills

Treatment will vary depending on your specific needs. If you have been diagnosed with atypical anorexia and are exploring treatment options, or perhaps you think you may have atypical anorexia, we at The Meadows Ranch would love to talk with you. We provide inpatient treatment for women and girls who struggle with eating disorders, equipping them with the necessary tools for a successful recovery. Contact us today to learn more.