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Equip has a new look! And we wanted to give you a peek at the “why” behind our new brand. Whether you’re a designer or brand aficionado—or not, hopefully this will feel a bit meaningful to you. <3

When we set out to transform the eating disorder treatment landscape in 2020, we didn’t dare to dream how many lives we’d touch in just three years. Our original brand was built to get us off the launchpad. This new brand is built to reach every single person with an eating disorder. This means we’ll be showing up with more humanity, more vibrance, more depth, and more personal stories.

You might notice a curving line in our new brand—and it’s at the heart of Equip and the world of eating disorder recovery. This line symbolizes the nonlinear path to recovery experienced by nearly everyone affected by an eating disorder.  For those of us who’ve been through it, we know that the recovery journey spans across a vast range of human emotions; travels along peaks and valleys big and small; can feel expansive and constricting even in the same moment; can fill us with fear and hope; and ultimately, moves with us through it all.

This line also symbolizes Equip’s support and presence in our patients’ lives as they move through recovery—wherever they are.

You’ll also notice our brand has a brighter, more dynamic feel. We’re showcasing more diverse faces and bodies to represent the far-reaching stories of eating disorders. The new, modernized Equip look matches the innovation of our treatment model, and brings a sense of vibrancy and color to an issue that can feel heavy at times—but one we face with infinite hope, optimism, and motivation.

, which has been fully reimagined to provide a more content-rich, interactive, intuitive user experience that ensures every single person has easy access to the information they need in that moment—whether it’s a provider looking to learn about screening for eating disorders, an athlete wondering if they may have a problem, or a parent trying to understand the treatment options for their child. We know that eating disorders affect people in countless different ways, and built our new site to speak to all the questions and concerns that arise on the road to recovery.

As we continue forward in our mission to make eating disorder treatment that works accessible to everyone who needs it, we hope our new branding and website serve as powerful platforms from which to make strides toward this ambitious goal.

Equip's New Branding: Exploring the Meaning Behind Our New Look

the food isn’t always the scariest part of meals in recovery. In fact, for anyone struggling in their relationship to food (whether it’s disordered eating or an eating disorder), the time after the meal can often be even more fraught than the meal itself. In these moments, it’s as if the disordered part of the brain is trying to do damage control, because eating anything—and especially a full meal—is its biggest threat and worst-case scenario. Those minutes to hours after your last bite may include a storm of difficult thoughts, emotions, and urges that can feel crippling and insurmountable. Read on to learn more about post-meal distress, why it occurs, and how to move through mealtime aftermath in healthy and supportive ways.

Types of post-meal distress and why it happens

Post-meal distress can come in many different forms: emotional, psychological, and physical.

In terms of physical distress, gastrointestinal pain or discomfort is often the primary symptom. Post-meal fullness and abdominal distension 

 from people with eating disorders, followed by bloating, nausea, stomach pain, early satiety, constipation, heartburn, and gastritis. “These physical discomforts can exacerbate emotional distress, can be extremely distressing, and may contribute to a cycle of negative thoughts and behaviors surrounding food and eating,” explains eating disorder dietitian 

 shows GI disorders like irritable bowel syndrome and 

 (chronic indigestion that comes with bloating and stomachaches after meals) in eating disorder patients are significantly high and often linked to psychological, hormonal, and functional factors.

, RD, anyone who has been restricting may experience stomach stretching once they are having regular meals or eating more than their typical intake, because their body has adjusted to different intake patterns and fullness cues. Parker explains, “this stretching, which is a normal response to food and fluid intake, sends a signal to the brain that the person is getting full and to stop eating, and when this happens early in the meal, it can make it physically difficult to eat enough.” She says such physical issues can cause the eating disorder voice to pipe up, saying things like, “You're supposed to honor your hunger and fullness cues, and you are full.” This can be particularly confusing, because while this might sound valid, people in early eating disorder recovery often 

trust their hunger and fullness cues, and need to actively override them. Parker adds that those with 

 may have different types of physical distress, like delayed fullness if eating too quickly.

In my practice, I also see clients who experience other post-meal visceral responses—typically triggered by their nervous systems sensing a perceived threat—such as rapid heart rate, sweating, clamminess, and disassociation.

Several of my clients also experience emotional and mental distress following meals. Most commonly, it starts with harsh, judgmental thoughts from the eating disorder brain, telling a story about why eating that meal was the worst thing possible. Those thoughts typically lead to highly uncomfortable emotions, including guilt, anxiety, anger, fear, and shame about the quantity or types of foods eaten, and feeling a loss of control and safety. Such feelings are common for those with disordered eating and across eating disorder diagnoses. “While the specific experiences may vary, the emotional impact can be quite similar across different eating disorder diagnoses,” Leocata says. “For instance, those with 

 may struggle with an intense fear of weight gain after eating, whereas people with 

 may feel a strong urge to engage in compensatory behaviors like purging, excessive exercise, or future restriction.”

The reasons for such emotional and mental distress are often linked to the psychological and emotional functions of the eating disorder or disordered eating, which are threatened when their rigid food rules and rituals are broken. “Deviating from these rules, even slightly, can provoke significant distress due to feelings of failure or inadequacy,” Leocata explains. Body image may also be negatively impacted, Leocata says, since after eating, someone with an eating disorder might “perceive their body negatively, leading to feelings of disgust and self-hatred. They might catastrophize the consequences of eating or have irrational beliefs about food and its effects on their body.”

Eating disorders and disordered eating also often have an emotional purpose and function as a maladaptive coping tool. So, if someone is using their eating disorder to numb out feelings of sadness by restricting food intake, for example, eating an adequate meal is going to feel exceptionally difficult. Often, they haven’t yet developed healthy ways of coping with sadness or other tough emotions, and so I describe this as being thrown out to sea without a life raft to hold onto. “Emotionally, eating disorders use a fixation on food as a coping mechanism,” Parker says, “and so anything that causes discomfort, whether physical, or against the eating disorder, will create a heightened emotional reaction.”

Additionally, eating disorders often co-occur with other mental health issues like depression, anxiety, and trauma-related disorders, according to Leocata. “These underlying psychological factors can amplify post-meal distress,” she says. When someone’s trauma is at the root of their eating disorder, it can be particularly hard to feel safe after meals, since their body may perceive eating as a serious threat, and old wounds can become entangled with the eating disorder.

Having challenging moments after eating is an inevitable part of eating disorder recovery—but there are things you can do to make those minutes or hours more manageable.

Here are several approaches that you can try to cope with post-meal distress:

During the meal, Parker suggests eating relatively slowly and avoiding drinking excessive fluids. This will minimize physical distress and promote an easier post-meal period.

Work with a therapist to learn healthy emotional coping skills.

 One of the hardest parts of recovery can be learning how to feel the full spectrum of human emotions, after months or years of numbing them through behaviors like restriction. However, it’s critical to learn how to navigate all emotions, including the hard ones that can surface after meals, and to replace unhealthy coping tools with life-supportive ones.

There are three steps to applying self-compassion to your experience, according to researcher 

. First, extend kindness to yourself instead of judgment; my clients tend to find it helpful to imagine they’re speaking to a loved one who is struggling. You can also show yourself kindness through action, like giving yourself a hug or wrapping yourself up in a blanket with a warm cup of tea. Second, tap into common humanity: remember that you’re not alone and that other people are having difficult emotions after meals, too. Here are some 

 to integrate self-compassion into your post-mealtimes. Lastly, remember that you’re not your thoughts or emotions. Try to be mindful of them instead of over-identifying with them, even though they can feel all-consuming.

To develop a more mindful approach to your hard thoughts and feelings after meals, be intentional about choosing a specific practice to support the process. Leocata suggests guided meditations (

 you can try when flooded with eating disorder thoughts after meals). Many of my clients like to pick a sense (sight, sound, taste, smell, or touch), and engage with it, to help them get more present in the moment and less fused with their thoughts. 

, or self-soothing through sense engagement, reduced post-meal distress by 10 to 20 percent in eating disorder patients. Sensory tools like essential oils, weighted items, and massage and rocking chairs can be helpful for connecting with your body’s senses.

Since the time after a meal can feel emotionally unsafe in recovery, it can be helpful to create a safer internal environment by regulating your nervous systems. Regulating practices include sensory modulation (as mentioned above), using cold water or an ice pack on your face or hands, being with a person who feels safe to you, petting your dog or cat, spending time outside or in nature, and taking several rounds of 

. Parker adds that deep diaphragmatic breathing, which activates the parasympathetic (or rest-and-digest) nervous system, can help calm anxiety.

Distraction is a powerful tool, so planning an activity for after meals can be helpful: crafting, journaling, listening to podcasts, reading, watching TV, listening to music, anything that will help take your mind off of the meal or snack. Music might be particularly helpful—

 shows music therapy significantly reduced post-meal distress and anxiety in patients with anorexia, when compared with a standard post-meal therapy group.

shows that staying occupied and supported after meals can help soften hard thoughts and emotions and prevent compensatory behaviors.

Whether alone or with a support person, identifying and safely expressing your feelings can provide some relief after meals. Depending on what you’re feeling, safe emotional expression can include talking about it, drawing or painting, journaling, crying, yelling into or punching a pillow, or whatever helps you healthfully express yourself.

Dealing with post-meal distress can be physically, emotionally, and mentally exhausting. However, by taking each meal at a time, and using your tools intentionally and consistently, your brain will build new, supportive neural pathways in place of the destructive ones put in place by an eating disorder.

The Overlap Between Eating Disorders and Gastrointestinal Disorders

https://med.virginia.edu/ginutrition/wp-content/uploads/sites/199/2022/08/August-2022-Eating-Disorders-and-GI-Disorders.pdf

‌Hanel, V., Schalla, M. A., & Stengel, A. (2021). Irritable bowel syndrome and functional dyspepsia in patients with eating disorders ‐ a systematic review. 

Functional Dyspepsia: Symptoms, Diet, Treatment & Living With

https://my.clevelandclinic.org/health/diseases/22248-functional-dyspepsia

Clarke, R. (2014). Sensory modulation and post meal distress at Royal Melbourne Hospital Eating Disorders Specialist Unit. 

https://doi.org/10.1186/2050-2974-2-s1-p4

‌Brown, A., Tse, T., & Fortune, T. (2018). Defining sensory modulation: A review of the concept and a contemporary definition for application by occupational therapists. 

Scandinavian Journal of Occupational Therapy

https://doi.org/10.1080/11038128.2018.1509370

‌Bibb, J., Castle, D., & Newton, R. (2015). The role of music therapy in reducing post meal related anxiety for patients with anorexia nervosa. 

https://doi.org/10.1186/s40337-015-0088-5

‌Monaghan, M., & Doyle, L. (2022). “It stopped you thinking about food” – The experiences of mealtimes and attending a post‐meal support group for young people with anorexia nervosa. 

International Journal of Mental Health Nursing

Post-Meal Distress in Eating Disorder Recovery: Why It Happens and How to Cope

While eating disorders are complex enough to navigate on their own, research shows that 

people with eating disorders are also dealing with at least one other co-occurring condition. For instance, 

 are common among adults with eating disorders—affecting some 48% of those with 

 (BED)—and the risk of depression is also higher for people affected by eating disorders, 

. More recently, research has also drawn a link between ADHD and binge eating.

Attention-deficit/hyperactivity disorder, or ADHD

, is one of the most common neurological disorders in children, but it can also affect adults. And while people with any type of eating disorder might also have ADHD, there does seem to be a particularly strong link between BED and ADHD. Read on to understand why binge eating and ADHD often go hand in hand, and how to find the most effective treatment for lasting recovery.

What the research says about ADHD and binge eating

While not every person with ADHD experiences eating issues, research has shown that the odds of having a clinical eating disorder are higher among the ADHD population. 

 found that those with ADHD are more likely to experience binge eating and purging behaviors and to restrict food intake, and 

 have indicated a specific correlation between ADHD and binge eating.

“There is evidence that there are greater rates of binge-spectrum disorders, including both bulimia and BED, in people with ADHD, compared to people without ADHD,” says Equip’s Director of Program Development, Tana Luo. She cites one sample that found that 

, as compared to a prevalence rate of 2.6% for the general population. And according to some estimates, she says, up to 

 experience ADHD symptoms, compared to 5% for the general population.

How do the symptoms of ADHD relate to binge eating?

, but some of the most common and universal include persistent patterns of:

Inattention (i.e. not being able to focus on or complete a task/listen/pay attention, etc.)

Hyperactivity (i.e. having an unusually high level of excitement or activity)

Impulsivity (i.e., acting on sudden feelings, ideas, or desires).

“People with ADHD tend to struggle with executive functioning, things like planning ahead, prioritizing, and managing time,” Luo explains.

Meanwhile, BED is characterized by recurrent episodes of binge eating, in which a person consumes a large amount of food while feeling like they can’t control their compulsion to do so. Though the overlap with ADHD may not be immediately obvious, Luo points out that both conditions share some characteristics, which may make someone more prone to one if they’re actively experiencing the other.

“It’s possible that the symptoms of ADHD increase risk of binge eating behaviors,” Luo says. “For example, it could be that challenges with executive functioning make it hard for people with ADHD to stick to a regular plan of eating. And we know that skipping meals, whether intentional or unintentional, 

increases vulnerability to binge eating later in the day

. Furthermore, some people with ADHD struggle with awareness of their hunger and satiety cues, and this could also lead to disrupted eating patterns.”

Get the support you need to manage ADHD and stop binge eating.


It’s not your fault, and you’re not alone. 

How the brain might explain the ADHD-eating disorder link

Like all mental disorders, ADHD doesn’t have one single cause, nor can we point to a clear reason why it correlates with binge eating. There are, however, some theories around the connection between ADHD and binge eating in certain brain processes.

“There are a few different hypotheses as to why there’s a link between ADHD and binge eating,” Luo says. “It may be that ADHD contributes to binge eating, or vice versa. Or that certain comorbidities in ADHD, like depression, increase risk of binge eating disorder. And finally, it’s possible that ADHD and binge eating share the same underlying neurobiological vulnerabilities.”

 found that both ADHD and binge eating involve similar processes in the brain. Specifically, both groups had dopamine systems (the reward circuit in the brain) that reacted more positively to food when in a heightened emotional state, and both also showed higher scores for impulsivity and more difficulty processing and regulating emotions.

It’s also worth noting that there’s some evidence to suggest a connection between ADHD and anorexia, but Luo explains that this association isn’t as well understood.“While there is evidence to indicate co-occurrence between ADHD and bulimia and BED, the 

relation between ADHD and anorexia has been shown to be mixed

,” she says. “With that being said, people with ADHD tend to experience difficulties regulating their emotions. And, oftentimes, disordered eating behaviors serve as a way to regulate painful emotions. People with ADHD may also experience interoceptive differences, meaning they may have trouble detecting, accurately interpreting, or attending to their body’s cues, including hunger and fullness cues. Challenges with interoception may increase overall risk for developing an eating disorder.”

How to treat ADHD and binge eating together

When it comes to treating binge eating, a variety of therapeutic strategies, like cognitive behavioral therapy (CBT), integrative cognitive-affective therapy (ICAT), and 

 can be effective, as can certain medications. For 

, the standard protocol typically combines medication, skills training, education, and counseling. And importantly, with the right care, it’s possible—even preferable—to treat both conditions at the same time.

“Non-pharmacological treatments for ADHD include both behavioral and cognitive-behavioral approaches, both of which can work very well alongside eating disorder treatment,” Luo says. “For example, both 

enhanced cognitive behavioral therapy (CBT-E)

 teach patients skills like emotion regulation, mindfulness, identifying triggers and high risk times, meal planning, and structuring home/school/work environments to support regular eating. Many of these skills also apply to symptoms of ADHD.”

When people come to Equip with both binge eating and ADHD symptoms, their multidisciplinary care team works collaboratively to create an effective, evidence-based plan of action to address both conditions. “At Equip, providers work with each patient and their loved ones to identify how the patient’s specific symptoms of ADHD may be impacting eating disorder symptoms,” Luo says. “This understanding then informs how different strategies are applied to address eating disorder symptoms. For example, someone with ADHD may benefit from additional tools, like setting alarms or reminders to eat, coming up with a detailed plan of eating before a big event, and extra focus on certain distress tolerance and emotion regulation skills.”

Regardless of whether you or a loved one has been diagnosed with ADHD or BED, if you’re worried about specific symptoms or patterns, it’s important to seek immediate expert support. With the right team and plan, both conditions can be effectively treated, making a healthier, happier future possible.

“Attention-Deficit/Hyperactivity Disorder in Adults: What You Need to Know.” 2021. National Institute of Mental Health (NIMH). 2021. 

https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know#:~:text=These%20adults%20may%20have%20a

“Binge Eating Disorder: Causes, Treatments & Complications.” 2023. Cleveland Clinic. April 17, 2023. 

https://my.clevelandclinic.org/health/diseases/17652-binge-eating-disorder

Bleck, Jennifer R., et al. 2014. “The Comorbidity of ADHD and Eating Disorders in a Nationally Representative Sample.” The Journal of Behavioral Health Services & Research 42 (4): 437–51. 

https://doi.org/10.1007/s11414-014-9422-y

Centers for Disease Control and Prevention. 2023. “Symptoms and Diagnosis of ADHD.” Centers for Disease Control and Prevention. September 27, 2023. 

https://www.cdc.gov/ncbddd/adhd/diagnosis.html

Kaisari, Panagiota, et al. 2017. “Attention Deficit Hyperactivity Disorder (ADHD) and Disordered Eating Behaviour: A Systematic Review and a Framework for Future Research.” Clinical Psychology Review 53 (April): 109–21. 

https://doi.org/10.1016/j.cpr.2017.03.002

Mattos, Paulo, et al. 2004. “Transtornos Alimentares Comórbidos Em Uma Amostra Clínica de Adultos Com Transtorno Do Déficit de Atenção Com Hiperatividade.” Revista Brasileira de Psiquiatria 26 (4): 248–50. 

https://doi.org/10.1590/s1516-44462004000400008

Mayo Clinic. 2018. “Binge-Eating Disorder - Diagnosis and Treatment - Mayo Clinic.” Mayoclinic.org. Mayo Clinic. 2018. 

https://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/diagnosis-treatment/drc-20353633

Mayo Clinic. 2023. “Adult Attention-Deficit/Hyperactivity Disorder (ADHD) - Diagnosis and Treatment - Mayo Clinic.” Www.mayoclinic.org. January 25, 2023. 

https://www.mayoclinic.org/diseases-conditions/adult-adhd/diagnosis-treatment/drc-20350883#:~:text=and%20certain%20medications-

Reinblatt, Shauna P. 2015. “Are Eating Disorders Related to Attention Deficit/Hyperactivity Disorder?” Current Treatment Options in Psychiatry 2 (4): 402–12. 

https://doi.org/10.1007/s40501-015-0060-7

Seymour, Karen E. et al. 2015. “Overlapping Neurobehavioral Circuits in ADHD, Obesity, and Binge Eating: Evidence from Neuroimaging Research.” CNS Spectrums 20 (4): 401–11. 

https://doi.org/10.1017/s1092852915000383

Svedlund, Nils Erik et al. 2017. “Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among Adult Eating Disorder Patients.” BMC Psychiatry 17 (1). 

https://doi.org/10.1186/s12888-016-1093-1

Is There a Link Between ADHD and Binge Eating?

The information in this article originally appeared in an Equip Academy presentation. Watch the presentation 

 to learn about other eating disorder-related topics and earn free CE credits.

When most people think about eating disorders, they think of anorexia, bulimia, or maybe binge eating disorder. But it’s actually a lesser-known eating disorder that has the largest financial impact in the United States. In 2018-2019, other specified feeding and eating disorder (

, or 35% of the $64.7 billion total financial burden of eating disorders. For reference, binge eating disorder cost the country $19.4 billion, while bulimia and anorexia cost $11.4 billion and $11.2 billion, respectively. OSFED is just as serious as other eating disorders, as evidenced by its massive economic toll.

So what is OSFED? Put most simply, it’s a catch-all diagnosis used to describe eating disorders that significantly impact a person’s health and life but do not meet diagnostic criteria for another eating disorder. Though it can be used as a general diagnosis, there are several specific diagnosis that fall under the OSFED umbrella, including:

Binge eating disorder of low frequency or limited duration

Bulimia nervosa of low frequency or limited duration

Here, we’ll be looking closely at one of the most misunderstood OSFED diagnoses, 

Atypical anorexia is a diagnosis that describes someone who meets all of the criteria for anorexia nervosa (AN) except that despite significant weight loss, the individual’s weight is within or above the normal range.

Atypical anorexia and anorexia nervosa share many of the same diagnostic criteria, including:

Restriction of energy intake relative to requirements

Intense fear of gaining weight or becoming fat, or persistent behavior that interferes with weight gain

Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of illness

The primary difference between the two is that in anorexia nervosa, the restricted intake leads to significantly low body weight, whereas in atypical anorexia nervosa, it does not. Additionally, those with anorexia nervosa fail to recognize the seriousness of their illness and low body weight, whereas those with atypical anorexia fail to recognize the seriousness of their illness only (since low body weight isn’t present).

Despite the name, atypical anorexia is actually more “typical” than anorexia nervosa: AAN has a 

. And this number is likely low, given that many people with atypical anorexia are misdiagnosed or undiagnosed due to weight stigma and anti-fat bias in medical spaces. Often, people with atypical anorexia are assumed to have bulimia or binge eating disorder based on their body size alone (if an eating disorder is suspected at all). What’s more, patients with atypical anorexia may even be prescribed restrictive eating behaviors, which can exacerbate symptoms and highlights the confusion that many patients with AAN experience.

Because of stigma, misconceptions, and lack of awareness, there’s currently limited research on the effective treatment of atypical anorexia. In fact, atypical anorexia wasn’t even added to the DSM until the publication of the DSM-5 in 2013.

Prior to 2013, patients with atypical anorexia presented for treatment, but were often turned away or given a diagnosis of eating disorder not otherwise specified (EDNOS). In an effort to reduce the number of patients diagnosed with EDNOS, atypical anorexia was added to the DSM-5 in 2013 under the new OSFED diagnosis. It’s important to note that patients who met AAN criteria were always there, but were often overlooked by doctors for treatment because there was no established diagnosis that fit their presentation.

Is atypical anorexia less serious than anorexia nervosa?

The atypical anorexia diagnosis has been referred to as “subthreshold anorexia nervosa” by some researchers, likening it to other OSFED categories of bulimia nervosa of low frequency or duration or BED of low frequency or duration. However, this separation puts patients in danger, because data show clearly that atypical anorexia is just as serious as anorexia nervosa.

Patients with atypical anorexia experience:

More severe eating disorder symptoms and greater body dissatisfaction

Similar rates of suicidality and suicide attempts to those with anorexia nervosa

High levels of depression and anxiety, similar to rates among those with anorexia nervosa

Atypical anorexia is also more prevalent among cisgender boys/men, BIPOC individuals, and transgender and gender diverse people, all of whom already experience barriers to care.

Atypical anorexia comes with many of the same physical health complications as anorexia nervosa, 

How do you actually differentiate between AAN and AN?

That’s a good question, and we wondered the same thing. To get to the answer, we began by trying to gain clarity about the difference between atypical anorexia and anorexia nervosa.

The primary distinction between AN and AAN is that people with AAN are at a weight that is within or above normal range—but there’s no consensus on what this means. In fact, a recent systematic review found that in 75 separate studies of AAN, 29 unique definitions of AAN were used.

The four most common definitions for atypical anorexia are:

 BMI at admission to treatment is greater than or equal to19 kg/m2 for adults aged 18 or older, or above the median BMI for patients under 18.

 BMI at admission to treatment is greater than 18.5 kg/m2 for adults or over 85% of the median BMI for adolescents and children.

 BMI at admission to treatment is over the 10th percentile (only relevant for children/adolescents).

BMI at admission to treatment is greater than or equal to 19 kg/m2 for adults or above the median for adolescents, and they had reported no previous treatment experience beyond outpatient treatment. The BMI thresholds are the same as the DSM-5 definition. However, patients with previous eating disorder treatment at a higher level of care (e.g., treatment at a residential treatment center) were classified as AN even if their BMI was above the threshold, as previous treatment may have resulted in weight gain that would place patient BMI above the threshold.21–23

Little information is available about treatment for atypical anorexia, and few studies have examined effectiveness. Some research supports the preliminary effectiveness of family-based treatment (FBT) and PHP-level care, but this research notes complicating factors related to treatment.

 examining FBT for AAN described treatment and outcomes for 42 adolescents with atypical anorexia. The research showed symptom improvement and preliminary support for using FBT to treat adolescents with atypical anorexia, but called for more in-depth studies into its effectiveness.

Providers who have used FBT to treat atypical anorexia report a few challenges, most notably:

Difficulty identifying when an AAN diagnosis is appropriate

Pushback in setting target weights for adolescents with AAN

Increased need to emphasize seriousness of AAN to families during FBT

To learn more about what treatment works for AAN—and whether AAN requires a different treatment approach than AN—we conducted a robust study that compared treatment for the two populations. Our aims with this research were to:

Compare symptom severity at admission between AN and AAN

Evaluate treatment response among AAN patients

Compare change over treatment among patients with AN and AAN

We used all four of the most common definitions of AAN to ensure that outcomes were not affected by the definition being used.

Our patient population included 1,463 patients with AN or OSFED, with a median age of 15.3. Seventy percent were white, and 85.4% were cisgender girls or women. The outcomes we measured were eating disorder symptoms, anxiety, depression, caregiver burden, and weight.

The number of patients classified into the AN and AAN analysis groups varied greatly depending on which definition of AAN was used. Some patients were classified as AAN under all four definitions (n = 308), some were classified as AN under all four definitions (n = 299), and a majority were mixed (n = 856).

Of the patients classified as AAN, 70.4%-80.7% required weight restoration, compared with 85% to 94% for those with AN, depending on the definition used. Eating disorder symptoms were significantly greater for those with atypical anorexia compared with anorexia for three out of the four AAN definitions. For patients with AAN who required weight restoration, the amount of weight gain required varied depending on the definition used. BMI-10th AAN required the most weight gain to meet target weight (an average of 17.1 lbs).

We had three key takeaways from symptoms at admission: