When most people think of anorexia, they envision a gaunt teenager, skeletal and frail, who avoids food at all costs, convinced that even a single apple will lead to weight gain. According to the Mayo Clinic, anorexia nervosa is defined by an unusually low body weight, an overwhelming fear of gaining weight, and a distorted perception of one’s body image. Typically, this disorder involves extreme calorie restriction, bingeing and purging behaviors, or both. Those affected often show physical signs like extreme cold intolerance and may resort to deception about their eating habits or skip meals entirely. Many are familiar with these classic symptoms. However, there’s a lesser-known variant called atypical anorexia.
What’s often overlooked is that you do not have to be dangerously underweight to be suffering from anorexia. The eating disorder realm is fraught with weight bias, as noted by Lily Carter, who was considered “obese” when diagnosed with anorexia. She emphasizes that “the treatment and recovery landscape for eating disorders is permeated by weight discrimination.” Atypical anorexia, which refers to anorexia without the extreme underweight classification, is still very much anorexia. The DSM-V categorizes it under “Other Specified Feeding and Eating Disorder (OSFED),” recognizing that not everyone with anorexia fits the stereotypical image.
Like Lily, I too was deemed overweight when I first encountered anorexia. At a size 16, people congratulated me on my weight loss as I began to shed pounds. Atypical anorexia doesn’t mean you haven’t lost enough weight to warrant concern. Engaging in calorie restriction, fasting for days, skipping meals, lying about food intake, and experiencing the physical consequences of starvation signifies that you are grappling with anorexia, regardless of whether you weigh ninety pounds or one hundred and ninety. I was about 160 pounds when signs of anorexia started affecting my health.
People often fail to recognize the signs of atypical anorexia promptly. I had to assertively tell my partner about my eating disorder, yet even then, I felt he didn’t fully comprehend my struggle. Despite my dramatic weight loss from a size 18 to a size 2, family and friends continued to praise my appearance, unaware of the turmoil I was facing. When Lily was hospitalized due to complications from her anorexia, a friend mistakenly assumed she was undergoing gastric bypass surgery.
The risks associated with atypical anorexia are severe and mirror those of its more recognized form. The body, in its desperation for survival, begins consuming its own tissue, with the heart being particularly vulnerable. According to the National Eating Disorders Association, this can lead to a significantly increased risk of heart failure, accompanied by dangerously low heart rates and blood pressure. My recent medical exam revealed the lowest blood pressure I’ve ever recorded.
Individuals with atypical anorexia can also experience severe digestive issues, including constipation, nausea, and fluctuating blood sugar levels. Such complications can arise from inadequate nutrient intake, which the National Eating Disorders Association describes as insufficient to stimulate normal intestinal function. Sleep disturbances, concentration challenges, dizziness, menstrual irregularities, hair loss, chronic coldness, kidney failure, and anemia are also common. The mortality risk associated with these disorders is alarming, with a crude mortality rate of 5.2%, as stated by the National Eating Disorders Association.
Atypical anorexia necessitates serious intervention. It is not simply a matter of losing a few pounds; it’s a critical eating disorder that can lead to dire physical and psychological consequences. Just because someone doesn’t fit the mold of a typical anorexic does not mean their condition is any less severe. They require assistance.
I had to confide in my psychiatrist about my battle, and we are both diligently working towards recovery. As of this writing, I have ceased actively trying to lose weight, but the journey is ongoing and demanding. Eating Disorder Hope reminds us that weight is not the sole criterion for determining if someone needs help; we must examine behaviors that could lead to harmful consequences. Skipping meals or inducing starvation requires immediate medical attention, regardless of one’s weight, and even those who gain weight can still be dangerously ill.
Treatment for atypical anorexia often mirrors that for conventional anorexia. This may include psychotherapy specifically for the eating disorder, dual-diagnosis therapy for co-occurring mental health issues, group therapy, nutritional counseling, and medication, as advised by The Ranch Treatment Centers. With the revised DSM-V criteria, insurance is more likely to cover these treatment options, according to Eating Disorder Hope.
I began my struggle with atypical anorexia in late 2019, weighing over 200 pounds. A year later, I found myself in a size 0—an alarming milestone that I recognized wasn’t a cause for celebration. Thanks to ongoing care from my psychiatrist, I’ve stopped losing weight. The physical ramifications of anorexia are daunting—I still grapple with normal eating habits, and I often wear wigs as my hair continues to recover from earlier loss. I constantly feel cold and have to manage low energy levels. While I strive to improve my eating patterns, the internal voice that tells me I’m overweight remains a challenge. Surrounding myself with body-positive individuals has been crucial, and I actively resist compliments about my appearance. Therapy and medication have been beneficial, but the desire to recover must come from within.
If you suspect you might be dealing with an eating disorder, it’s imperative to seek help. The National Eating Disorders Helpline is a valuable resource.
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In summary, atypical anorexia is a significant and dangerous eating disorder that can affect individuals regardless of their weight. It requires serious attention and intervention. Understanding the behaviors associated with this disorder is crucial for identifying those in need of help.
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