Beyond the Stereotypes: The Reality of Atypical Anorexia


Atypical anorexia is characterised by a fear of gaining weight and severe calorie and food restrictions. However, individuals with this condition typically do not display significant weight loss or extremely low body weight.

Some individuals think an eating disorder is less severe if a person has a ‘healthy’ body weight. The facts of atypical anorexia nervosa, however, suggest differently. People with atypical anorexia continue to have negative attitudes about their body, weight, and connection to eating. Atypical anorexia, regardless of how it affects a person’s size, is a serious mental health disorder that can negatively influence your life, career, and relationships.

The Challenges of Atypical Anorexia

Atypical anorexia is considered a mental health disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and presents a number of difficulties and challenges. One challenge is that it is less recognised or understood than the more common eating disorders. Many people with atypical anorexia do not fulfil the diagnostic criteria for anorexia nervosa, making it more difficult to receive the right care. They might also endure their eating disorder’s physical and psychological effects for a long time.

Another issue with atypical anorexia is that it can be more challenging to identify in the early stages. Individuals with atypical anorexia may not always have considerably low body weight, unlike those with anorexia nervosa, where low body weight is one of the key diagnostic criteria. Their eating habits may also be less controlled and erratic, making diagnosing the disease more difficult. Additionally, individuals might not exhibit the same degree of obsession with food, weight, or shape as those who have anorexia nervosa, which can make diagnosis more challenging. For this reason, it’s critical to be aware of additional atypical anorexia symptoms like anxiety about weight gain, a mistaken perception of one’s physique, and excessive activity.

Furthermore, the obsessive fear of gaining weight and being obese can often drive the actions of someone with atypical anorexia. Commonly, individuals with this condition have much greater levels of distress surrounding eating and a distorted body image perception compared to those without the condition. 

In one study that focused on people with atypical anorexia, nearly half of the people examined expressed self-harm and suicidal thoughts, combined with low levels of self-esteem. 

Living with Atypical Anorexia

Atypical anorexia can control a person’s everyday life physically and mentally. If you have this eating disorder, you may be preoccupied with thoughts of food and body image. This may involve counting calories and formulating strategies for avoiding events involving eating or developing an obsession with your weight. 

Other facets of daily life, such as social interaction, work productivity, and connections with friends and family, may also be hampered by this. Malnutrition-related physical or mental health issues like depression or anxiety can also affect those with atypical anorexia.

Symptoms of Atypical Anorexia 

It’s crucial to be aware of the fact that many of the symptoms of atypical anorexia nervosa are identical to those of typical anorexia nervosa and may often be difficult to distinguish. However, some of the common physical signs and symptoms are:

  • Significant weight loss yet remaining within a normal weight range
  • Changes in skins appearance, such as yellowing or dry skin
  • Gastrointestinal problems
  • Reduced functioning immune system
  • Constipation
  • Extreme feelings of low energy
  • Regular abdominal Pain

Similar to other eating disorders, atypical anorexia can produce a range of mental health effects and can lead to other mental illnesses. The difference between typical and atypical anorexia nervosa can be seen in their weight, as they typically do not display extreme weight loss. Consequently, many behavioural and emotional signs are comparable. However, one crucial distinction to be aware of is that people with atypical anorexia could believe they are okay or that their weight means there is no risk in their actions. If a person is not dangerously underweight, their disorder might go unnoticed. 

Behavioural and emotional symptoms to watch for include:

  • Extreme focus on body weight, size, and shape
  • Feelings of lack of self-worth
  • Distorted body image
  • Constant desire to lose weight 
  • Intense fear of becoming overweight or having any form of body fat 
  • Hatred of body shape 
  • Constant thoughts of weight loss 
  • Hyperfocus on food and nutritional value
  • Aversion to food or being seen eating by others
  • Mood swings 
  • Difficulty concentrating 

If you or someone you know displays any of the symptoms above, you must seek medical support and guidance to find the best treatment. 

Long-Term Health Complications of Atypical Anorexia 

Since this condition is labelled “atypical,” many believe that atypical anorexia nervosa is somehow less severe. This is not the case at all, as it frequently has the same physiological and psychological effects as anorexia nervosa, including: 

  • Vital organ damage 
  • Increased risk of muscle and bone loss or injury
  • Decreased energy for daily functioning 
  • Cardiovascular problems. 
  • Increased suicide thoughts and depressive symptoms. 
  • Death. 

The longer the condition goes untreated, the more long-term damage is likely to occur. Therefore, taking action as quickly as possible is essential if you or someone you know relates to the symptoms. 

Diagnosing Atypical Anorexia 

Atypical anorexia nervosa diagnosis requires significant, rapid weight loss and cognitive concern. Careful identification is essential for effective recovery because atypical anorexia nervosa is a more recent diagnostic category for eating disorders in the DSM-5

The doctor must consider a few factors to diagnose atypical anorexia nervosa appropriately. Body weight alone may not be a reliable predictor of anorexia, although unexplained or significant weight loss should be. 

When diagnosing atypical anorexia nervosa, other criteria that you should consider include the following:

  • Regularly skipping meals or eating less and feeling uncomfortable eating in front of people 
  • Drinking excessive amounts of water or non-caloric beverages
  • Displaying a great deal of attention to size and shape 
  • Stomach pains and other gastrointestinal problems

You or a loved one should get a mental health or medical evaluation if you or they fit any of the descriptions above. Fortunately, the stigma surrounding eating disorders is slowly diminishing. However, continuing to speak openly and honestly will encourage people with atypical anorexia to speak about their worries without fear of judgement. 

Causes of Atypical Anorexia

It can be challenging to pinpoint the exact causes of atypical anorexia; however, genetic predispositions to eating disorders and other mental illnesses are the most significant biological variables that may cause atypical anorexia. 

Furthermore, people are prone to developing atypical anorexia if they have previously been diagnosed with a mental condition. The propensity for perfectionism and rigidity in actions and attitudes are further psychological influences. Additionally, having a history of trauma increases the risk of developing the illness.

Treating Atypical Anorexia 

Professional treatment for atypical anorexia is essential for a successful and long-term recovery.Atypical Anorexia Nervosa hospitalisations comprise nearly one-third of hospital inpatient eating disorder treatment programs, so it is important to address any early concerns that could indicate the development of this condition. 

Treatments for anorexia nervosa are frequently utilised and have been proven to be effective with atypical anorexia due to the narrow margin of difference between the two, as was previously indicated. This means that Cognitive Behavioral Therapy, Dialectical Behavior Therapy, and Family-Based Treatment are frequently the most efficient forms of treatment. 

Medical Treatment Centers 

At the beginning of treatment, people with atypical anorexia may need medical stabilisation to address unresolved medical issues. One of the first things the treatment team will do when you arrive for therapy is run lab tests to look for signs of malnutrition. Acutely unwell people are monitored and supported by medical and mental health professionals. In order to help healing, psychiatric drugs and other medications are provided. To address atypical anorexia consequences, nursing experts collaborate closely with the treatment group, providing medical care when an emergency medical intervention is required.

Reintroducing normal eating habits is one of the primary therapy objectives when someone has reached a state of medical stability to normalise eating habits and food intake. Throughout the atypical anorexia treatment, people regularly consult with registered nutritionists. Behavioural health counsellors oversee mealtime support because many people in treatment are anxious about eating or are even hesitant to do so. There are also licenced clinicians and registered nutritionists on hand as needed. The basics of nutrition are explained, along with food amounts and plating.

Treatment at The Wave Clinic

At The Wave Clinic, we offer a wide range of treatment options to help young people overcome many types of eating disorders. Alongside supported clinical treatment, we provide different opportunities to learn new skills, try new hobbies, and establish long-lasting friendships – giving every young person the opportunity to grow and realise their true potential after recovery. Contact us today to make an appointment. 

Fiona - The Wave Clinic

Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).

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