Why Atypical Anorexia Nervosa Isn’t “Atypical”

Atypical anorexia nervosa is a serious eating disorder that often goes unrecognized – and it’s time we talk about why.

Heads up: This post is for informational purposes only and isn’t meant to replace professional medical advice. Always chat with your healthcare team about any medical decisions.

As eating disorder professionals, we often support people who are struggling with food restriction, overexercise, and intense fear of weight gain – but don’t believe they’re “sick enough” for treatment because they don’t meet the weight criteria for anorexia nervosa. 

This delayed care due to weight stigma often leads to worsening atypical anorexia symptoms and unnecessary suffering – which is why it’s vital to understand that weight isn’t a good indicator of how “bad” your eating disorder is.

TL;DR: If you’re struggling with disordered eating, you deserve to be heard and to receive treatment – whether or not your body has changed size.

What Is the Difference Between Anorexia Nervosa and Atypical Anorexia Nervosa?

Historically, the main distinction between these diagnoses has been body weight.

While both conditions share the same psychological symptoms and behavioral patterns, atypical anorexia nervosa is diagnosed when someone experiences all the symptoms of anorexia nervosa but maintains a weight that isn’t considered “significantly low” by traditional medical standards.

While the label “atypical” implies that it’s uncommon for this to happen, “atypical” anorexia is actually 2-3x more common than “typical” anorexia.

However, we want to be clear: this distinction is problematic and can prevent people from receiving the care they need and deserve.

What Qualifies as Atypical Anorexia?

When we look at “atypical” anorexia symptoms, we see the same patterns that characterize any restrictive eating disorder:

• Significant restriction of food intake
• Intense fear of gaining weight or becoming “fat”
• Disturbance in how one experiences their body weight or shape
• Strong drive for thinness or weight loss
• Overexercise or compensatory behaviors
• Basing self-worth heavily on body shape and weight

The key difference is that people with atypical anorexia may not show the same degree of weight loss or may maintain what’s considered a “normal” or higher weight, despite engaging in the same harmful behaviors.

Recognizing Atypical Anorexia Symptoms

Here’s what we want everyone to understand: eating disorders can occur at any size. The severity of atypical anorexia symptoms isn’t determined by body weight – it’s reflected in the physical and psychological impact of restrictive behaviors, which can be severe regardless of size.

Physical symptoms might include:

• Fatigue and weakness
• Dizziness or fainting
• Irregular heartbeat
• Gastrointestinal problems
• Loss of menstrual periods
• Temperature sensitivity
• Sleep disturbances

You can learn more about the symptoms of atypical anorexia here.

Can You Be Hospitalized for Atypical Anorexia?

Yes, and it’s important to understand that atypical anorexia nervosa can be just as medically serious as traditional anorexia nervosa. People of any size can experience significant medical complications from restriction and eating disorder behaviors. As outpatient providers, we help our clients recognize when higher levels of care might be needed, which could include hospitalization for:

• Heart problems
• Electrolyte imbalances
• Severe malnutrition
• Other medical complications

Part of our role is helping connect clients with appropriate care when needed, while providing ongoing outpatient support throughout their recovery journey. The notion that you need to be underweight to require intensive medical support is dangerous and false. Your suffering is valid, and you deserve appropriate care, regardless of your body size.

Breaking Down Barriers to Care

We’ve seen too many clients who delayed seeking help because they didn’t think they were “sick enough.” This is why we believe the “atypical” qualifier does more harm than good – it perpetuates the misconception that some eating disorders are more “real” or “serious” than others.

Your lived experience is valid whether or not you receive an “official” diagnosis. If you’re struggling with food, exercise, or body image, you deserve support – period. The diagnostic criteria weren’t created with a weight-inclusive perspective, and we recognize that these unnecessary distinctions can create roadblocks to getting the help you need.

Getting Support for Atypical Anorexia

Recovery is possible, and you deserve support regardless of your weight or diagnosis. When seeking care, we recommend:

1. Working with HAES-aligned professionals (therapists and dietitians) who understand that eating disorders occur at every size
2. Finding a treatment team that validates your experience without focusing on weight as a measure of illness severity
3. Connecting with support groups that embrace body diversity
4. Prioritizing your mental and physical health over arbitrary diagnostic criteria

Taking the First Step

If you recognize yourself or someone you love in these descriptions, we want you to know that you don’t have to wait until things get “bad enough” to seek help. 

In fact, getting help as soon as possible can prevent worsening symptoms and medical complications.

Ready to talk with someone who gets it? Our team offers virtual consultations for eating disorder therapy and nutrition counseling, and we’d be honored to support you.