Historically, it has been assumed that people with anorexia nervosa look thin and very low weight. In fact, before the latest version of the diagnostic manual for diagnosing diseases, a necessary criterion is “weight less than 85% of the expected.”It is less widely recognized that restrictive eating disorders, those characterized by dietary restrictions or weight loss, can manifest in higher weight individuals.
What is atypical anorexia?
Atypical Anorexia (AAN) was added to Diagnosis and Statistics Manual-5 As one of the other specific feeding and eating disorders (OSFED) in 2013.When a person meets all the criteria for anorexia nervosa, he will be diagnosed, “Except for a significant weight loss, the individual’s weight is still within or above the normal range.”
People with AAN still meet other criteria for anorexia nervosa (AN): fear of weight gain or gaining weight, disordered body image, and “significant weight loss.” This may be because these patients started with a higher weight category. However, based on their weight loss trajectory and restrictive behavior, they are actually undernourished, very similar to AN patients.
“Significant weight loss” lacks a widely accepted definition.
Studies have shown that when combined with a strong fear of weight gain or fat and a significant body image disorder experience, only 5% of weight loss may indicate a clinically significant dietary pathology that qualifies the patient to be diagnosed with atypical anorexia nervosa .
Talk to the doctor
Eating disorder therapists may often see people whose weight is generally considered “normal” but who suffer from restrictive eating disorders, accompanied by amenorrhea (missing menstrual periods), which may be a common side effect of ideal weight loss.
Unfortunately, however, many doctors have never considered that heavier people may have amenorrhea due to dietary restrictions. If you or someone you love is struggling with the side effects of anorexia or any eating disorder, be sure to talk to your doctor or healthcare professional. Usually, the side effects will develop into a serious medical condition on their own.
Anorexia Discussion Guide
Get our printable guide to make an appointment for your next doctor to help you ask the right questions.
Atypical Anorexia Research
Lebow and colleagues reviewed 179 intake assessments of adolescents who were assessed for eating disorders at the Mayo Clinic. All teenagers seek help with restrictive eating disorders, which are characterized by weight loss and/or dietary restrictions. The survey results show that compared with people without a history of overweight, people with a history of overweight:
- When seeking treatment, the weight is within the traditionally considered “healthy” range (BMI between 18.5 and 24.9)
- The body mass index has dropped even more
- Been sick for more than 10 months
- Eating disorders are equally severe in terms of common symptoms, rate of amenorrhea, and number of reported physical symptoms.
Although the weight of some teenagers and children (and possibly even adults) may appear healthy or normal, if they are experiencing an eating disorder or eating disorder, their body or mood may be severely damaged.
Studies have shown that patients with a greater percentage of baseline BMI decline have as serious medical problems as those with lower BMI but less overall weight loss.
These findings are of great significance:
- Many serious eating disorders may go undetected because we are too concerned about absolute weight as a barometer of health.
- The physical complications of half-starvation and weight loss-red flags for low-weight individuals-are often overlooked in higher weight patients.
- For some people, BMI belonging to the higher weight category is normal. These people may need the support of professionals to learn to accept a weight that is higher than the average culture thinks.
- Even if there is no low weight, practitioners should pay attention to the physical consequences of malnutrition or eating disorder thoughts and behaviors.
- When evaluating individuals with dietary symptoms and/or weight loss, providers should consider the adult’s weight history (or in the case of adolescents, a complete developmental growth curve) rather than individual data points.
- People with a history of being overweight may suffer from eating disorders for longer periods of time before being discovered. Given that early recognition is the best predictor of complete recovery from an eating disorder, more attention needs to be paid to this population.
Whether in a healthcare environment or in society as a whole, weight loss in larger individuals is often seen as a positive factor. However, it may put higher weight people at risk of developing restrictive eating disorders. In general, scientific support should not encourage extreme dieting. In addition, most importantly, it is important to remember that eating disorders can occur in people of any weight.