Atypical Anorexia

Atypical Anorexia

What it is and how it differs from what we collectively know of Anorexia Nervosa

Anorexia is most associated with extreme weight loss, causing someone’s physical physique to drastically change. There are so many more ramifications from anorexia than simply weight loss, however with our culture’s fascination and focus on attaining the perfect body, an individual’s weight is often a focal point and a significant part of a lot of conversations. But what about individuals whose extreme weight loss does not garner shock from society, but praise? Comments like “you look amazing!” instead of “Are they okay?”. Appearances can be deceiving and although an individual’s body weight doesn’t fall drastically below what is deemed “healthy” does not mean that they are not in need of help.

What is atypical anorexia nervosa?

According to the American Psychiatric Association, atypical anorexia nervosa is defined “as a condition in which all criteria of anorexia nervosa are met, except, despite significant weight loss, the individual’s weight is within or above the normal range.” As reminder, the below are diagnostic critical of anorexia nervosa:

  • Taking in an inadequate number of calories
  • A fear of gaining weight
  • Beliefs that body size impacts self-worth

Therefore, atypical anorexia is for all intents and purposes anorexia. Both forms of anorexia create the same emotional distress and trauma in an individual, the main difference being what is deemed a healthy body weight.

What are the causes of atypical anorexia nervosa?

The causes of atypical anorexia are not different from anorexia nervosa. They both also do not have a finite list of causes that everyone who is suffering identifies with. Some potential contributing factors to someone developing atypical anorexia nervosa are:

  • Genetics
  • Family history such as alcohol abuse or substance abuse
  • Personality types such as perfectionism or obsessive tendencies
  • History of trauma
  • Other mental health struggles such as anxiety or depression

What are symptoms of atypical anorexia nervosa?

An individual who has atypical anorexia may get overlooked by health care professionals because their body weight may not indicate that they are suffering. However, someone’s physical health is not always a direct correlation to their overall health, and the appearance of a “healthy” body does not directly translate to a healthy mind. And in reverse, an individual with a healthy mind may not fit into society’s standards of what a “healthy body” is supposed to look like. According to VeryWellMind, the following are symptoms of atypical anorexia nervosa:

  • Excessive focus on body weight
  • Fear of gaining weight or having fat
  • Exercising excessively
  • Weight impacts self-worth
  • Preoccupation with food and a refusal to eat certain foods
  • Refusing to eat socially
  • Making excuses for not eating
  • Increased irritability, mood swings, and other difficulties regulating emotions
  • Difficulty concentrating

What are the consequences of atypical anorexia nervosa?

Although a massive consequence of anorexia nervosa is extreme and dangerous weight loss, there is still weight loss associated with atypical anorexia. And although those with atypical anorexia nervosa don’t experience medically dangerous low body weights, weight loss can be problematic for anyone if it is achieved in a dangerous and unsustainable way. According to VeryWellMind, the consequences of atypical anorexia nervosa are:

  • Thinning hair or hair loss
  • Yellow or dry skin
  • Loss of bone mineral density potentially leading to osteoporosis (i.e., fragile bones)
  • Menstrual irregularities in women, including the absence of periods
  • Anemia (i.e., a low red blood cell count)
  • Gastrointestinal issues such as dysphagia or acid reflux
  • Constipation and abdominal pain
  • Low heart rate or low blood pressure
  • Lack of energy
  • Anxiety, depression, or suicidality
  • Death

What is atypical anorexia nervosa treatment?

Those with atypical anorexia should be entitled to receive the same treatment as those who are suffering from anorexia nervosa. An important step in treating anorexia nervosa is the re-feeding stage, which is not always a necessary step, anyway. Atypical anorexia nervosa, although potentially life threatening, is treatable and a full recovery is possible. The needs of those struggling with anorexia nervosa vary. However, therapy with a trained and competent individual is always strongly suggested. Understanding the emotional and psychological roots of anorexia nervosa are critical to recovery and for long term success. This process can take a long time; patience and commitment from the individual suffering and their support network is often needed.

Related Article: Symptoms of Anorexia Nervosa

Frequently Asked Questions

Q:What is the difference between anorexia nervosa and atypical anorexia nervosa?

A: The defining difference between anorexia nervosa and atypical anorexia nervosa is that those with atypical anorexia nervosa are not considered underweight. However, those with atypical anorexia still engage in and display all the same behaviours as those with anorexia. 

Q: What leads to atypical anorexia?

A: Like all eating disorders, there is no one cause or causes that typically lead an individual to developing atypical anorexia. There is a school of thought that those who develop eating disorders have a predisposition to develop them and it is their environment that gently nudges them in the direction of developing one. However, the following are also potential causes:

  • Genetics
  • Family history such as alcohol abuse or substance abuse
  • Personality types such as perfectionism or obsessive tendencies
  • History of trauma
  • Other mental health struggles such as anxiety or depression

Q: Is atypical anorexia more common than anorexia nervosa??

A: Yes, it is believed that atypical anorexia is more common. However, eating disorders are notoriously underreported so the statistics are never an entirely accurate picture of reality. Also, because those with atypical anorexia are not severely underweight, they are commonly misdiagnosed which also misleads statistics.

Dr. Natalie Mulligan graduated from the Canadian College of Naturopathic Medicine (CCNM). She completed her clinical internship at the Robert Schad Naturopathic Clinic with a focused interest in mental health. Prior to attending CCNM, she completed a Bachelor of Science degree at the University of Waterloo.