What Is Atypical Anorexia?
When we think about eating disorders, certain stereotypes tend to come to mind. Despite their prevalence across individuals of various shapes, sizes, genders, and ethnicities, eating disorders are still commonly seen as an affliction that disproportionately impacts young white women from higher socioeconomic backgrounds. However, this fails to account for the diversity in how eating disorders can present across the weight spectrum.
Not Fitting Anorexia Stereotype
One such diagnosis that typically flies under the radar is atypical anorexia. Traditionally, anorexia nervosa is a disorder defined by three core symptoms: (1) restriction of caloric intake leading to significantly low body weight; (2) intense fears of weight gain, despite low weight; and (3) body shape or weight disturbance. Atypical anorexia carries all of the same symptoms, except that an individual struggling with this disorder can be in a normal, or even an overweight or obese BMI range. Because these individuals don’t present as being underweight, they tend not to get flagged as engaging in disordered eating behaviours.
A recent study found that while rates of atypical anorexia may actually be higher than low-weight anorexia in the general population, those with atypical anorexia were less commonly found in clinical settings, suggesting that they may be less apt to seek treatment (Harrop et al., 2021). Findings from another, qualitative study support this idea, and add that shame and stigma may be barriers to seeking help. The authors interviewed women who had recovered from atypical anorexia, finding that a common struggle to addressing their illness was that they were not perceived as being sick enough by others (Eiring et al., 2021). This highlights the need for those struggling with eating disorders to feel seen and heard, regardless of whether or not their symptoms fit outdated stereotypes as to what someone with an eating disorder is “supposed to” look like.
Changes Needed
Bearing all of this in mind, what can we do? Given that it is National Eating Disorder Awareness week, it’s the perfect time to consider what changes could be beneficial on all levels, from the individual, all the way up to health systems and policy. For those struggling with symptoms of atypical anorexia themselves, there is undoubtedly a need for self-advocation in the context of a system that tends to hold negative views of those living in larger bodies. It’s a system that needs to change to account for the diversity in how eating disorders present. We need increased training such that medical and mental health professionals alike are more aware of what to look for in patients struggling with eating disorders, and less likely to discriminate against those who don’t fit the mold. It’s time to end the standard prescription of “just lose weight” for those living in larger bodies without further assessment or evaluation. Restriction can occur at all sizes; it doesn’t take being underweight for it to be harmful or problematic.
If you think that someone you care about may be struggling with disordered eating, atypical anorexia or otherwise, a valuable source of support you can provide is often just to be a listening ear. Try to set aside your own preconceptions or judgments as to what eating disorders may or may not entail and create a space that is open and nonjudgmental. Avoid giving advice but, rather, practice validating what you hear. In other words, a simple, “That sounds like it’s really difficult. Is there anything you’d like me to do?” can go a long way. Remember that resources do exist, but sometimes just validating, rather than challenging, what someone is going through can be the first step in justifying their decision to seek help.