What is Atypical Anorexia?

Anorexia nervosa is one of the most well-known and most discussed eating disorders. What many people might not realize is that there is a similar type of eating disorder called atypical anorexia nervosa, a diagnosis that falls under Other Specified Feeding or Eating Disorders (OSFED). The two anorexia diagnoses differ in that those experiencing atypical anorexia meet many but not all of the diagnostic criteria for anorexia. For example, atypical anorexia may apply to someone who is restricting their food intake but is not “underweight.” 

Because OSFED is less well-known, the diagnoses within are sometimes misunderstood as less common illnesses. In reality, OSFED is actually the most prevalent eating disorder category in the DSM. 

In this blog, we will dive into the signs and symptoms, potential effects, and stigma surrounding atypical anorexia. 

Signs and Symptoms of Atypical Anorexia

Atypical anorexia is the same as anorexia, except without the criterion of an extremely low body weight. This means that just like anorexia, atypical anorexia includes an intense fear of gaining weight, an emphasis on body shape and appearance, and restriction of food intake. Atypical anorexia also includes weight loss, but despite that rapid decline in weight, the person is still “normal” weight or “overweight.” In addition to restriction, some people with this illness also exercise obsessively, binge eat, or purge.

Although someone with atypical anorexia may not appear “underweight,” many other signs can indicate that someone is suffering with this illness. Some of those signs and symptoms include:

  • Social withdrawal
  • Excessive exercise
  • A negative or distorted view of their body weight or shape
  • Fatigue
  • Constipation
  • Brittle hair and nails
  • Absence of menstruation (amenorrhea)
  • Fragile bones
  • Muscle weakness

Dangers of Atypical Anorexia

Although atypical anorexia and anorexia are both serious illnesses, some people assume that anorexia is more serious because of the extremely low body weight that occurs. A 2016 study of adolescents with atypical anorexia showed that the adverse psychological and physical effects of the illness were just as intense as those experienced by people with anorexia. Atypical anorexia and anorexia both come with health consequences and psychological distress, and both are worthy of professional treatment. 

Some examples of the serious physical effects of atypical anorexia include:

  • Low blood pressure and lightheadedness
  • Exceedingly low heart rate
  • Bone and muscle loss or damage
  • Damage to vital organs
  • Fertility issues due to the loss of menstruation

Stigma Surrounding Atypical Anorexia

In 2021, plus-size model Tess Holliday went public with her struggles with atypical anorexia. Because Holliday lives in a larger body, she was bombarded with invalidating comments about her eating disorder. Some people couldn’t believe that a person in a larger body could experience anorexia. 

Dismissing the experiences of people living in larger bodies is, unfortunately, nothing new. Weight bias and weight stigma are a long-ingrained part of our society. Many people in larger bodies may not be diagnosed with an eating disorder—even when they show clear signs of one—simply because of their weight. Even if people believe that a person in a larger body does indeed have an eating disorder, they may think that it is not as dangerous as an eating disorder that causes someone to be “underweight.” These are both examples of the real-life impact that weight stigma and bias can have on people in larger bodies.

We live in a culture that idealizes thin bodies and encourages weight loss no matter the cost. Weight-loss diets are especially praised in those that are considered “overweight.” But comments about weight can be so damaging, especially if the reason for the drop in weight is related to disordered eating or an eating disorder. Instead of people noticing that someone is struggling, they may be unknowingly encouraging unhealthy behavior. To someone with an eating disorder, this may sound like they are not “sick enough” to get help. This is the furthest thing from the truth. 

Recovery is Possible

Weight bias and weight stigma—along with impossible beauty standards—make it so much more difficult for someone with atypical anorexia to reach out for help. Again and again, diet culture sends the message that people in larger bodies must lose weight. But health cannot be measured by size, and for many, dieting is incredibly damaging. 

It’s important to remember that diagnoses like atypical anorexia are imperfect classification schemes used to label symptoms, not people. If you have atypical anorexia, know that you deserve treatment for your eating disorder just as much as anyone else. Your pain matters. Though your illness may be less well-known, it’s not any less important.

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