What is Atypical Anorexia?

Category: Eating Disorders
9 minute read.

Take a moment to consider the following statistics provided by The National Association of Anorexia Nervosa and Associated Disorders (ANAD).

  • In the United States, at least 30 million people of all ages and genders suffer from an eating disorder.
  • Every 62 minutes, one or more people die as a direct result of an eating disorder.
  • Eating disorders have the highest mortality rate of any mental illness.
  • In a large national study of college students, 3.5% of sexual minority women and 2.1% of sexual minority men reported having an eating disorder.
  • 16% of transgender college students reported having an eating disorder.
  • Eating disorders affect all races and ethnic groups.
  • Genetics, environmental factors, and personality traits combine to increase eating disorder risk.

The statistics speak for themselves in terms of the severity of this epidemic. Eating disorders are not biased regarding who may live with one of many different illnesses.

Understanding Eating Disorders

Contrary to the name, eating disorders are about more than food and eating choices. Eating disorders are complex and challenging mental health conditions that often require comprehensive mental health intervention and medical treatments at a specialized treatment facility like The Los Angeles Outpatient Center.

Another misconception about eating disorders is that they are a choice or “voluntary.” This unfortunate and dangerous misconception about the physical and emotional challenges faced by someone with an eating disorder can lead to dangerous implications for those who need but refuse to seek help due to misunderstandings and ongoing stigma.

The term eating disorder is an umbrella term for various psychological conditions that lead to unhealthy eating habits. Depending on the illness and the individual, symptoms may start with an obsession with food, concerns about body weight, or a desire to achieve or maintain a particular body shape. In the most severe circumstances, disordered eating can lead to death if left untreated.

Eating disorders are most often reported in adolescents, teens, and young women. However, it is essential to note that anyone, regardless of age or gender identity, can have an eating disorder. Recent data on eating disorders, in general, suggests up to 9% of the US population has an eating disorder, and up to 13% of youth will experience symptoms of at least one eating disorder before reaching age 20.

To date, researchers have yet to discover a single cause or risk factor that increases your risk of developing an eating disorder. Experts suggest the root cause of these illnesses may stem from several factors, including social pressures, genetics, cultural expectations, personality traits, and brain chemistry.

Several eating disorder diagnoses are listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The most familiar include anorexia and bulimia.

What is Anorexia?

Anorexia (anorexia nervosa) is perhaps the most well-known eating disorder. Anorexia Nervosa typically develops during adolescence and young adulthood, and as with many eating disorders, it often impacts women more frequently than men. People with anorexia nervosa often see themselves as overweight even if, by published medical standards, they are dramatically, even dangerously underweight. The mental health challenges associated with anorexia will force them to monitor their weight consistently, severely restrict calories and avoid eating certain types of food to obtain or maintain a specific body weight.

Common anorexia nervosa symptoms include:

  • restricted eating patterns
  • intense and overwhelming fear of gaining weight
  • distorted body image
  • denial of being underweight
  • a significant influence of body weight on the perception of self and self-esteem
  • being significantly underweight when compared to others of similar age and height.

Anorexia is typically categorized into two illness subtypes: binge eating and purging and restricting. Someone with the restricting type will lose weight through fasting, excessive exercise, or dieting. Someone with the binge and purging type of anorexia nervosa may binge on large amounts of food or eat very little. After finishing their food (regardless of how much they ate), they will purge using activities such as laxatives, vomiting, diuretics, or excessive exercise.

There are also several types of anorexia. Often these conditions are listed in the DSM under the category “Other Specified Feeding or Eating Disorders.” Examples pertaining to anorexia include anorexia athletica and atypical anorexia.

What is Atypical Anorexia?

Many assume that someone with anorexia will be significantly underweight or exhibit dramatic weight loss. However, some individuals who restrict eating or engage in abnormal eating behaviors commonly associated with anorexia nervosa are of average body weight. This condition is called atypical anorexia nervosa or atypical anorexia. Someone with atypical anorexia nervosa will not meet the traditional low weight criteria for diagnosing anorexia nervosa as described in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) or DSM-5.

According to the diagnostic criteria for anorexia nervosa listed in the DSM, someone with traditional anorexia nervosa “will have a restriction of energy intake relative to their caloric requirement, which leads to a significantly low body weight in the context of several factors, including gender, physical health, age, developmental trajectory, and more. Other criteria include an intense fear of gaining weight and/or becoming fat and a disturbance in body perception.”

Someone with atypical anorexia will exhibit the same illness criteria without weight loss. Often, someone with atypical anorexias weight will fall within or above a “normal” range for their age, sex, etc. This is why their illness presentation is considered “atypical.” In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), atypical anorexia nervosa is listed under Other Specified Feeding or eating disorders  (OFSTED), one of the most prevalent eating disorders among adults today.

Why Atypical Anorexia is Extremely Dangerous

Many who experience atypical anorexia nervosa do not realize their symptoms suggest a severe and dangerous eating disorder. For some, it is because they do not meet the weight-related criteria people commonly equate with someone with anorexia nervosa. Because their body weight falls within or exceeds a normal weight range, they may believe their symptoms are not severe enough to have an eating disorder. Or, because they do not check the boxes of particular symptoms, medical and mental health providers may overlook their condition leading to a dangerous delay in treatment.

This dangerous thought process may prevent someone who needs life-saving medical and mental health treatment from reaching out for help. It is essential to remember that body weight is not the sole diagnostic criteria for an eating disorder like anorexia. You can have an eating disorder regardless of weight, size, or overall body shape.

Because atypical anorexia nervosa does not present with the classic symptoms attributed to anorexia nervosa, it can be debilitating and extremely dangerous for someone experiencing symptoms and who cannot get the help they need to get well.

Because someone with atypical anorexia does not know or realize they are sick, they do not understand the potentially dire need for comprehensive medical and mental health support.

Another common challenge to seeking and receiving eating disorder treatment is weight stigma among healthcare providers, also mentioned above. Weight stigma is very dangerous and occurs more often than people may realize. Although someone may display classic signs and symptoms of an eating disorder, many medical health professionals overlook other potential eating disorder criteria because the individual’s weight falls within appropriate guidelines.

Treatment for atypical anorexia generally follows the same basic principles treatment providers use when treating “traditional” anorexia. Similar interventions, including food exposure therapies, nutritional education, dietary advice and support, and mental health education around body image, are combined with therapies such as cognitive behavioral therapy (CBT) as part of a comprehensive treatment program to help you heal physically, emotionally, and spiritually.

The eating disorder treatment that works best for you will depend on your unique symptoms and treatment needs. Like treatment plans for most mental health conditions, treatment for eating disorders must be individualized to ensure your specific treatment needs and goals are addressed as part of your therapy.

Without proper diagnosis and treatment, at least 20% of people with anorexia nervosa will die from health complications directly related to their illness. These complications can include a range of physical and psychological challenges. Some of the most common include heart problems, gastrointestinal problems, and suicide.

Unfortunately, statistics continue to suggest that many who could benefit from treatment will not get the help they need. The most current research suggests only one in ten people (10%) with an eating disorder (not just anorexia nervosa) will seek and receive treatment. Research indicates that treatment for eating disorders is the most effective when early intervention occurs before many of the potential medical effects associated with the eating disorder have an adversely impacted the individual’s health.

A specialized eating disorder treatment program like ours at The Los Angeles Outpatient Center is often the most successful intervention for treating disordered eating. For treatment to be the most effective, it must be comprehensive and multifaceted, including medical care, mental health care, and nutritional education. Therapy sessions will often include a combination of individual therapy, family therapy, peer support groups, and group therapy sessions.

At The Los Angeles Outpatient Center, we understand it can be challenging to choose to seek treatment to overcome an eating disorder. The challenges are far more significant when you have vague symptoms or do not realize you have an eating disorder. Eating disorders can lead to overwhelming and debilitating physical and psychological difficulties without treatment.

In some cases, symptoms of an eating disorder can lead to dangerous and even deadly medical complications. If you or a loved one are concerned about eating disorder symptoms or your feelings about body image and food seem unhealthy, reach out to your primary care provider or a mental health provider here at The Los Angeles Outpatient Center. Members of our admissions team are here to answer your questions and help you learn more about how our programs can help you overcome an eating disorder like atypical anorexia.