Extreme food restrictions, abnormal eating behaviors, intense fear of gaining weight, but maintaining a normal or above-normal weight – could it really be an eating disorder?  

Atypical Anorexia (AN) is an eating disorder included in (OSFED) Other Specific Feeding and Eating Disorder category.  Its features are similar to typical anorexia without meeting low weight criteria, and those with AN are often living in a larger body or may have been living in a larger body and lost a significant amount of weight and received positive comments from family, friends, and physicians only to keep encouraging them to keep up what they are doing.  

Was their weight loss it due to a change in lifestyle?  Or surgery, cancer, depression, grief, or and eating disorder? 

It’s important to look behind someones weight loss, don’t just assume it is healthy. 

They may exhibit:  

extreme fear of being fat

adding up all the numbers of the foods they eat, 

forcing exercise to burn a certain amount of calories

cutting out foods and food groups, 

avoiding social events with food,

anxiety over meeting a friend for lunch

deciding if they can eat dinner or not

body dysmorphia

distress over body image. 

Those suffering from AN often do not show physical signs of suffering, therefore it is important to look beyond their weight.  Eating disorders in someone living in a larger or normal size body can be a deadly psychiatric illness with physical and psychological complications.  It may be accompanied by low blood pressure, amenorrhea (loss of menses), depression, OCD, self-harm, or suicidal thoughts.  

AN in not a lesser diagnosis than anorexia, it is just a different manifestation. Many individuals who have atypical anorexia may not even realize that they are struggling with a severe and deadly eating disorder, simply due to the weight stigma that surrounds this disease.  A person may think, “I am not sick enough to have an eating disorder”, because they may be within a normal or above weight range. There is a 3:1 ratio of females to males with the diagnosis of AN.  

All eating disorders can be debilitating for an individual who is struggling. If you or a loved one may be dealing with an eating disorder, be sure to reach out to someone and talk about your struggles. 

A treatment team consisting of an eating disorder dietitian and therapist will focus on evidence based treatment, Cognitive Behavioral Therapy, Exposure Based Therapy, Nutrition Rehabilitation and normalizing eating behavior.  

Don’t let any type of eating disorder keep you from achieving health and happiness. 

Suzanne Iovanni, RDN, CSSD, CLT

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