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The Truth About Atypical Anorexia Nervosa

Anorexia definition: Anorexia nervosa is a deadly eating disorder that is characterized by an unhealthy disturbance in body shape and the image resulting in the refusal to maintain minimum body weight. According to this definition by the DSM-V, it assumes that individuals must be underweight at the time of diagnosis and does not take into account disordered eating and rapid weight loss in individuals who are normal weight or overweight. Atypical anorexia is the same as anorexia nervosa except for “the refusal to maintain minimum body weight.” Individuals with atypical anorexia nervosa may be within or above a normal weight range for their age and gender, which makes the presentation “atypical.”

Myth: Individuals with atypical anorexia are of average body weight and size or just barely over the weight limit for an anorexia nervosa diagnosis.

Fact: Restrictive eating as seen in anorexia nervosa does not have to “look a certain way.” Atypical anorexia nervosa is not only reserved for a select few people who are just over the weight limit for anorexia. Atypical anorexia nervosa encompasses a vast range of individuals of varying weights from morbidly “obese”, and “obese” to overweight and normal weight. Atypical anorexia is an inclusive eating disorder diagnosis that breaks down the weight barriers and allows more individuals who engage in restrictive eating and who hold a weak disturbance in body image to seek professional help.

Myth: Individuals with anorexia nervosa are individuals who have not been diagnosed with “real” anorexia yet.

Fact: Restricting does not always lead to weight loss, and the way one’s body adapts to not eating is highly dependent on genetics. Regardless of an individual’s weight, the body will start storing energy differently. It does not matter if one has a ton of extra weight stored already; the body will store more. The metabolism will slow down, and one will gain weight. After the weight gain, it is common to restrict, even more, hoping that this will result in weight loss, turning this into a self-defeating cycle.

Myth: The health consequences associated with atypical anorexia nervosa are not as severe as anorexia nervosa.

Fact: Individuals with atypical anorexia nervosa still engage in restrictive eating and binging/purging, and therefore they are still causing harm to their bodies. Electrolyte imbalances, a lack of nutrients, dehydration, depletion of protein stores and bone loss are all common complications with individuals who are diagnosed with atypical anorexia nervosa.

Myth: Individuals with atypical anorexia nervosa do not need intensive treatment

Fact: While most individuals with atypical anorexia will not get intensive treatment, most do need it. Unfortunately, insurance companies look at the individual’s weight on admission and determine if they are “sick enough” to go into a higher level of care, the weight loss history and disordered eating patterns are what determines whether an individual is at risk of serious complications. Eating disorder therapists can work with insurance companies to establish this, and many clients should be aware of some of these roadblocks. Initial weight on admission should not be the sole determinant of an individual’s level of care.

Center For Discovery