Atypical Anorexia: What You Need to Know

When you think of anorexia nervosa, what comes to mind? If you’re like many people, the image conjured up is that of a thin young woman who is obsessed with their weight and appearance. While this stereotype holds true in some cases, it’s crucial to understand that anorexia doesn’t always fit this mold.

Atypical anorexia, also known as an Other Specified Feeding or Eating Disorder (OSFED), is a lesser-known but equally dangerous form of anorexia. This blog post will explore what atypical anorexia is, its diagnostic criteria, as well as how it’s treated.

What is Atypical Anorexia?

Atypical anorexia is like anorexia nervosa in many ways. However, the primary difference between the two is the person’s body weight. Unlike with “traditional” anorexia nervosa, people with atypical anorexia may not appear significantly underweight.

People with atypical anorexia can maintain a “normal” or “above-normal” body weight while engaging in disordered eating behaviours and experiencing extreme anxiety about their weight and body image. But is it really that “atypical?” Research shows that fewer than six percent of people with eating disorders are medically underweight. That means that 94 percent of people with eating disorders are “normal” weight or higher. This highlights the need for updated diagnostic criteria for “atypical” eating disorders.

Currently, to be diagnosed with atypical anorexia, a person needs to meet the following criteria:

1. Restriction of Food Intake: Like people with anorexia nervosa, people with atypical anorexia engage in significant food restriction. This may involve limiting their caloric intake to an unhealthy level while having an intense fear of gaining weight.
2. Distorted Body Image: People with atypical anorexia often see themselves as overweight, regardless of their actual body size. This preoccupation with body size can drive their obsession with food restriction and weight loss.
3. Physical and Emotional Consequences: Despite not being severely underweight, people with atypical anorexia can suffer from the same physical and emotional consequences as those with anorexia nervosa. This can include heart problems, electrolyte imbalances, gastrointestinal issues, social withdrawal, depression, and anxiety.

Risk Factors for Developing Atypical Anorexia

The risk factors for developing atypical anorexia are like those for anorexia nervosa. They can include:

1. Genetics: A family history of eating disorders or mental health conditions can increase the risk of developing atypical anorexia.
2. Socio-Cultural Factors: Pressure to conform to unrealistic beauty standards and societal emphasis on thinness can contribute to the development of atypical anorexia.
3. Personal History: Trauma, low self-esteem, and other psychological factors can play a role in the development of disordered eating patterns.
4. Dieting and Weight Loss: Engaging in restrictive diets and excessive exercise can trigger the onset of atypical anorexia in people who are susceptible to it.

The Importance of Early Detection

Detecting atypical anorexia can be challenging due to the misconception that all people with anorexia are significantly underweight. However, early detection is crucial for preventing the condition from progressing and causing severe health complications.

Some of the signs of atypical anorexia include:

1. Obsessive calorie counting and meal planning.
2. Frequent weight checking and body measurements.
3. Preoccupation with food, dieting, and exercise.
4. Changes in social behaviour, such as avoiding social gatherings involving food.
5. Emotional distress, including anxiety and depression.
6. Physical symptoms like fatigue, dizziness, and digestive issues.

Treatment Options for Atypical Anorexia

Treatment for atypical anorexia typically uses a multidisciplinary approach, including medical, nutritional, and psychological components. Some key treatment options may include:

1. Medical Monitoring: Regular medical check-ups to assess and manage physical health issues associated with atypical anorexia.
2. Nutritional Counselling: Working with a registered dietitian to develop a nourishing eating plan and address food-related fears and behaviours.
3. Psychotherapy: Cognitive behavioural therapy (CBT), acceptance and commitment therapy (ACT), family-based therapy (FBT), and other forms of counselling can help people address the psychological aspects of their eating disorder.
4. Medication: In some cases, medication may be prescribed to manage co-occuring conditions like depression and anxiety.

Anti-Fat Bias, Weight Stigma, and Atypical Eating Disorders

Being classified as “overweight” or “obese” puts people at a higher risk of engaging in unhealthy weight control behaviours such as skipping meals and abusing laxatives, yet people who fall into these weight categories are less likely to be diagnosed with an eating disorder.

In fact, studies show that up to 40 percent of adolescent girls and 20 percent of adolescent boys classified as “overweight” engage in disordered eating behaviours, yet many of these people remain undiagnosed.

Why the disconnect between the prevalence of disordered eating behaviours and eating disorder diagnosis? Anti-fat bias and weight stigma. We live in a society that values thinness above all else, and people in larger bodies are often told to lose weight through any means necessary.

Many of the same behaviours that are seen as a disease in people with anorexia nervosa are praised in people living in larger bodies. This can lead to people not seeking care for their eating disorder and remaining undiagnosed despite their disordered eating behaviours.

Final Thoughts

Atypical anorexia challenges conventional stereotypes of eating disorders and highlights the importance of recognizing that people struggling with this condition may not fit the expected mold.

It’s important to remember that the severity of an eating disorder isn’t solely determined by body weight. Early detection, understanding, and a multidisciplinary approach to treatment are essential in helping people with atypical anorexia on their path to recovery.

If you’re struggling with food and body image and suspect you may have an eating disorder, you’re not alone. At Journey to Health, our therapists and registered dietitians have experience treating many different types of eating disorders. Click here to book a free consultation call to learn how we can help you on your road to recovery.

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