Atypical Anorexia
While anorexia might be the most well-known eating disorder, most people aren’t aware that it can take a number of different forms. One of those forms is known as “atypical anorexia,” which, as we’ll unpack here, is just as serious and actually much more common than “typical” anorexia.
Atypical anorexia is characterized by the same symptoms that define anorexia nervosa—fear of gaining weight, severe food intake restrictions, and excessive physical activity, among others—but without low body weight. Someone with atypical anorexia meets all the diagnostic criteria for anorexia, except they’re at what’s considered a normal or above-normal weight.
Because most people, including medical providers, associate anorexia only with people who are underweight, atypical anorexia has long been underdiagnosed. Many medical providers fail to recognize the telltale signs of anorexia in patients simply because they have a medium- or larger-sized body. This is a concerning reality, because atypical anorexia is just as serious as anorexia and carries almost all of the same health risks. Every case of anorexia needs to be addressed with evidence-based treatment, regardless of a patient’s weight.
Read on to learn more about atypical anorexia and how it’s treated.
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Why does Equip prefer to avoid the term “atypical anorexia”?
At Equip, we discourage the use of the term “atypical anorexia.” While creating a separate diagnostic term might seem helpful, we believe that it actually does more harm than good.
Here’s why
One of the reasons why we avoid using the term “atypical anorexia” is that it creates a distance from anorexia, leading people to believe that atypical anorexia is somehow a less severe version. But weight doesn’t always indicate an eating disorder’s severity: someone’s illness can still be debilitating and even life-threatening without them reaching a critically low body weight. People who have “atypical anorexia” experience the same physical complications as anorexia patients and possibly even higher rates of mental health complications. Using a separate term from anorexia gives the impression that one diagnosis may be less serious than the other; however, this is never the case.
Separating “atypical anorexia” from anorexia fuels the myth that anorexia only affects people with dangerously low body weight. Anorexia in people who have medium to large bodies is very real and just as dangerous. Making attempts to distinguish the two creates unnecessary confusion and contributes to the concerningly high rates of underdiagnosis.
If someone is suffering through all of the symptoms of anorexia (besides low body weight) but doesn’t receive an anorexia diagnosis, it can feel deeply invalidating and perpetuate the dangerous idea that they’re “not sick enough” for treatment. The term “atypical anorexia” can contribute to the false narrative that this version of anorexia is somehow less urgent and, therefore, less deserving of treatment.
The descriptor "atypical" suggests that this condition is uncommon, when in fact it's estimated to be more prevalent than anorexia (we don’t know the exact numbers because atypical anorexia so frequently goes undiagnosed)
Ultimately, including a weight requirement in the diagnostic criteria for anorexia is more harmful than helpful, and prevents patients from seeking the treatment they need to achieve recovery. Breaking down weight stigma and stereotypes about size is key to helping people get the help they need and deserve. At Equip, we’ll continue to use the term anorexia to refer to all patients struggling with anorexia regardless of their weight, and hope that, in time, the medical community will do the same.
How Equip treats atypical anorexiaBecause atypical anorexia is effectively identical to anorexia nervosa, we treat both diagnoses the same way. All anorexia treatment at Equip includes a tailored plan to normalize eating habits and address any nutritional deficiencies. This includes individual therapy to address any unhelpful body image thoughts and feelings as well as co-occurring conditions like depression or anxiety. It also includes medical monitoring by a medical provider, eating disorder education for both the patient and any loved ones they bring into treatment, and support from mentors who have been through anorexia recovery.
The only difference in treatment for atypical anorexia is that these patients typically don’t need weight restoration, so we begin treatment by normalizing eating habits and stopping disordered behaviors without the focus on weight gain. That said, even if someone isn’t considered “underweight” by BMI standards, they may still benefit from weight restoration in treatment.
There are a number of different evidence-based modalities that can be used to treat atypical anorexia, and the approach we use will depend on each individual patient and their unique needs and challenges.
We use the following evidence-based treatments to craft a personalized treatment plan for each patient who comes to Equip
Family-based treatment (FBT)
A leading evidence-based treatment modality for young people with anorexia, FBT empowers a patient’s loved ones to take a central role in treatment. Family (or chosen family) are brought into treatment and given the knowledge, support, and tools they need to facilitate recovery at home.
Enhanced cognitive behavioral therapy (CBT-E)
CBT-E is a form of CBT designed specifically to treat eating disorders. It helps patients adjust harmful thought patterns that are contributing to disordered behaviors.
Dialectical behavioral therapy (DBT)
DBT is an approach to talk therapy that empowers patients to manage intense emotions by using safe coping skills and supportive relationships rather than disordered eating.
Recovery is possible
No matter the form it takes, anorexia is a serious, potentially life-threatening illness that requires evidence-based treatment. If you or your loved one are struggling with atypical anorexia — or just anorexia as we call it — don’t wait to reach out for help. You deserve the full, joyful life that recovery makes possible, and our team can help you get there.
Contact our team today to learn more about atypical anorexia treatment at Equip or to schedule a free consultation.
References
1. Rienecke, Renee D. “Family-Based Treatment of Eating Disorders in Adolescents: Current Insights.” Adolescent Health, Medicine and Therapeutics, U.S. National Library of Medicine, 1 June 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5459462/.