Did you know that less than 6% of people with eating disorders are medically diagnosed as “underweight”?

When most people think of anorexia, an image of a highly underweight, young girl often comes to mind. But, the reality is that many people experience the harmful symptoms and consequences of anorexia without meeting the significantly low body weight criteria, which is where the term atypical anorexia comes into play. Atypical anorexia is when an individual meets all the criteria for anorexia without being classified as underweight.

Although the diagnostic differentiation may seem useful, the term atypical anorexia can actually be quite harmful for those struggling. Keep reading to learn more about atypical anorexia, how it is diagnosed, and what to do if you or a loved one is struggling.

What is Atypical Anorexia?

Atypical anorexia nervosa is an eating disorder characterized by an intense fear of gaining weight and a distorted body image that results in self-imposed starvation and often significant weight loss. The term “atypical” is used to describe cases where individuals exhibit the same symptoms of anorexia nervosa but do not meet the low body weight criteria traditionally associated with the disorder.

In other words, individuals with atypical anorexia may display restrictive eating patterns, a preoccupation with food, an intense fear of gaining weight, and an obsession with body image, but they may not necessarily exhibit the severe underweight criteria. 

Despite not meeting the weight criteria, individuals with atypical anorexia still experience the same psychological symptoms and often the same medical complications as those with smaller bodies. Furthermore, individuals with atypical anorexia often experience co-occurring conditions such as, but not limited to, anxiety, depression, and obsessive-compulsive disorder.

How Atypical Anorexia is Diagnosed

Atypical anorexia is a new diagnosis added to the DSM-5 and currently listed under the category of “Other Specified Feeding or Eating Disorders (OSFED).” To be diagnosed with atypical anorexia nervosa, an individual must meet all the criteria for anorexia nervosa without the low body weight requirement. According to the DSM-5, the key diagnostic criteria for atypical anorexia include:

• Restriction of energy intake: The individual engages in behaviors that restrict the intake of calories, which may include strict dieting, fasting, excessive exercise, or other means of avoiding food.
• Intense fear of weight gain: There is an irrational fear of gaining weight or becoming fat despite being at a normal or above-average weight.
• Disturbance in self-perceived body size and shape: The individual has a distorted perception of their body weight or shape, seeing themselves as overweight even when they are not.
• Significant interference with daily life: The behaviors associated with atypical anorexia significantly interfere with the individual’s ability to function in various areas of life, including relationships, work, and social activities.

It’s important to remember that an accurate diagnosis and proper treatment plan should always be conducted by qualified professionals who specialize in treating eating disorders.

Not sure if it’s an eating disorder? Take our eating disorder screener to gain a better understanding of whether you or a loved one may be struggling.

Common Warning Signs and Symptoms of Atypical Anorexia

Because atypical anorexia is associated with being in the “normal” weight range, its diagnosis is often unfortunately missed under the false pretense that people of normal weight or considered overweight cannot have an eating disorder. For this reason, it’s essential to be aware of the common warning signs and symptoms aside from diagnostic criteria that may indicate an individual is struggling. Some of these warning signs include:

• Preoccupation with food, dieting, and body weight: Constant thoughts about food, counting calories, and persistent concerns about body weight and shape.
• Restrictive eating patterns: Limiting food intake, avoiding certain food groups, or following rigid dietary rules.
• Body dissatisfaction: Repeated talk about a distorted perception of one’s body size or shape, even when at a healthy weight.
• Social withdrawal: Avoidance of social activities, gatherings, or events that may involve food, as well as isolation from friends and family.
• Excessive exercise: Engaging in intense or compulsive exercise routines, often as a way to burn calories and control potential weight gain.
• Physical symptoms: Fatigue, dizziness, weakness, hair loss, brittle nails, cold intolerance, and other physical symptoms associated with malnutrition.
• Changes in eating habits: Suddenly eating alone, playing with food, cutting food into tiny pieces, or adopting unusual eating rituals.
• Emotional changes: Mood swings, irritability, anxiety, or depression related to concerns about body weight and food.

Importantly, not every person with atypical anorexia will necessarily display each one of these symptoms together or in the same way. However, recognizing these warning signs early on and seeking professional help is essential for effective intervention and treatment. If you suspect that you or a loved one may be struggling, we highly encourage reaching out for help as soon as possible.

Why The Term “Atypical Anorexia” Can Be Harmful

While it may seem beneficial to differentiate between traditional anorexia nervosa and atypical anorexia diagnoses, it may actually do more harm than good. The term “atypical anorexia” is often considered unhelpful, as it contributes to the weight stigma that falsely perceives all individuals with eating disorders as being underweight. With fewer than 6% of people with eating disorders medically classified in the underweight range, this harmful misconception has resulted in many people not receiving the help they need.

Individuals with atypical anorexia still face serious health risks associated with restrictive eating, a distorted body image, malnutrition, and other disordered behaviors. In fact, those who have lost 10% of their body weight in a rapid period of time are at the same risk of experiencing medical complications compared to those with smaller bodies.

Alongside this, using the term “atypical” often downplays the severity of the condition, leading to further delayed diagnosis and intervention. To ensure appropriate care and support, it is crucial to recognize that individuals with atypical anorexia experience the same physical and psychological challenges and are equally as deserving of timely and comprehensive treatment.

Getting Help For Atypical Anorexia

Treatment for all types of eating disorders, including atypical anorexia, often consists of a multidisciplinary treatment team who assess and treat all physical and psychological aspects of the disorder. Members of this team may include a therapist, dietitian, primary care provider, psychiatrist, and various other healthcare professionals.

Moreover, a crucial part of recovery is having the right support system, which is why we’ve created our RecoVERY community. With continuous community support, beneficial resources, and valuable psychoeducation, our community is designed to help individuals feel confident in their recovery journey and regain a healthy relationship with food and body image. Join the community for free to see how it can help change the course of your recovery journey!

VERY’s virtual eating recovery treatment helps individuals with all types of eating disorders achieve and maintain a lasting, successful recovery. Supported by a team of compassionate, specialized professionals, our goal is for all individuals struggling to live a life filled with purpose and meaning, free from the eating disorder.

Have questions? Schedule a free consultation to learn more.