What is atypical anorexia nervosa?

We usually associate anorexia with extreme thinness. As its most striking or outstanding symptom, we assume that it is the basis of this disorder. However, it is not always present. There is a percentage of people who suffer from this condition, but who They have a weight considered normal or even above what is expected. This is what happens in the so-called atypical anorexia nervosa.

This disease is not an anecdotal case, but is being seen with increasing frequency. In fact, it is estimated that About 40% of those receiving care for an eating disorder have atypical anorexia nervosa. The fact that patients are not underweight can make it difficult for the environment and even health professionals to detect the problem. For this reason, it is important to know what it is and how it should be approached.

People with atypical anorexia nervosa are within or above the normal range, despite significant weight loss.

What is atypical anorexia nervosa?

This is a relatively new diagnosis, which was not officially codified until the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, professionals had been observing and caring for him for some time.

This is a condition in which All symptoms and diagnostic criteria of anorexia nervosa are present, except low body weight. Thus, the person shows the following signs:

Intense, obsessive fear of gaining weight or being fat. Persistent behavior that prevents weight gain, such as crash dieting, excessive exercise, or fasting. Alteration or disorder in the way the person experiences weight and body shape. Weight It has an excessive and undue influence on the patient’s self-evaluation and self-esteem. It is not recognized that there is a problem or disorder that requires help.

As we said, the main difference with anorexia nervosa, as we know it, is the fact that the person is not underweight. In fact, you may have a normal weight or above what is expected; Therefore, from the outside the person does not look sick, affected or emaciated. However, The truth is that your body is under great stress, and that their perceptions and thoughts are altered.

Main risks and consequences

People with atypical anorexia nervosa usually They experience sudden and dramatic weight loss, due to the stress they subject their body to. by restricting energy intake or exercising excessively. Thus, even though they look healthy on the outside, they are suffering the consequences of this behavior.

They may be medically unstable, and their vital signs may be dangerously low, as occurs in typical cases of anorexia nervosa. So, Bradycardia, orthostatic instability and other consequences of malnutrition may appear.. Among the main ones are delayed growth, bone density problems and the risk of infertility.

These difficulties increase when the person who suffers from it is in adolescence. And this is a critical moment in which if growth is interrupted or bone health is affected, the consequences can be irreversible and remain long-term. In addition, the absence of menstruation caused by dietary restriction and drastic weight loss can compromise future fertility.

Beyond this, on a psychological and emotional level, the problems are also serious and similar to those that occur in typical anorexia nervosa. Patients with atypical anorexia nervosa They show low self-esteem, a very intense concern about food and body image. and psychiatric comorbidities, such as anxiety, depression or suicidal ideation.

Early diagnosis of atypical anorexia nervosa is essential, as is carrying out evaluations with an interdisciplinary orientation.

Intervene in atypical anorexia nervosa

People with atypical anorexia nervosa face challenges even greater than those traditionally associated with the disease. Is about people who have most frequently been overweight or obese, with the stigma and social rejection that this entails. Furthermore, they are usually forced to employ more extreme methods to fight their biology.

For these patients and their environment, identifying that they suffer from a disease is not easy. On the contrary, they usually receive praise, praise and congratulations for their weight loss, without realizing that the cause is actually an eating disorder. In addition, to stabilize vital signs, recover menstruation and begin recovery it is necessary to regain some of the lost weight, something that can be a nightmare for the person.

Nevertheless, Early intervention is essential. We are dealing with a very serious issue, in which the suffering of patients is comparable to that of typical cases. On the other hand, be careful, because we often do not notice the influence we have on others and how hurtful words can be that put pressure on us directly at the point where we are vulnerable, no matter how well-intentioned they may be; Although we think that thinness is synonymous with health, behind a great weight loss there may be a severe eating disorder.

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