Can you be anorexic and not extremely thin?
Anorexia nervosa (AN) is a serious eating disorder characterized by an intense fear of gaining weight, an unhealthy desire to be thin, and restricted eating. People with AN often have a distorted view of their body and may continue to see themselves as overweight even when they are dangerously underweight. While many individuals with AN lose a significant amount of weight and become extremely thin, it is not always the case. Some people may be diagnosed with AN without meeting the criteria for being underweight. This condition is sometimes referred to as atypical anorexia nervosa.
Diagnostic Criteria for Atypical Anorexia Nervosa
According to the DSM-5 criteria, atypical anorexia nervosa is characterized by all of the following:
- An intense fear of gaining weight or becoming fat, even though underweight
- A disturbance in the way one experiences their body, such as feeling overweight or having a distorted view of one's size or shape
- Restricted food intake, leading to significantly low body weight for height, age, and sex
- Absence of amenorrhea (in women who have reached puberty)
Weight Criteria for Anorexia Nervosa
The traditional criteria for anorexia nervosa require that individuals meet a specific weight threshold. This is determined by calculating the body mass index (BMI), which is a measure of body fat based on height and weight. Underweight is defined as a BMI below 18.5. However, some individuals may be diagnosed with anorexia nervosa even if their BMI is above 18.5. This can occur if they meet all of the other diagnostic criteria and their weight loss has had significant physical or psychological consequences.
Atypical Anorexia Nervosa vs. Bulimia Nervosa
Atypical anorexia nervosa can sometimes be confused with bulimia nervosa, another eating disorder. People with bulimia typically binge on food and then purge by vomiting, using laxatives, or exercising excessively. Atypical anorexia nervosa involves restricting food intake, and purging behaviors are typically not present.
Treatment for Anorexia Nervosa
Treatment for atypical anorexia nervosa typically involves a combination of medical care, psychotherapy, and nutritional support. The goals of treatment are to restore a healthy weight, address underlying psychological issues, and prevent relapse.