Atypical Anorexia Nervosa: The Overlooked Eating Disorder Hiding in Plain Sight

Atypical anorexia nervosa (AAN) is a serious eating disorder with the same symptoms as anorexia nervosa (AN). Unlike typical AN, people with AAN maintain a weight in the 'normal' or higher BMI range despite significant weight loss. A 2021 review suggested it may be more common than low-weight anorexia but is often overlooked in clinical settings. AAN was officially recognised in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision, under 'Other Specified Feeding or Eating Disorders (OSFED).' It involves restrictive eating, intense fear of weight gain, body image disturbance, and severe physical and psychological health issues.

Healthcare professionals frequently miss or underestimate AAN because the person’s weight does not fall below the expected range. Yet, the medical and psychological complications can be just as severe, or even worse, than those seen in typical AN. These can include nutritional deficiencies, electrolyte imbalances, gastrointestinal problems, hormonal disturbances, bone density loss, cardiovascular issues, and mental health struggles.

In recent years, more people in larger bodies have sought treatment in specialised eating disorder programmes. Treatment for AAN usually requires a team approach, including medical care, nutritional guidance, therapy, medication, family support, and education groups. Despite its severity, AAN often goes unnoticed due to misconceptions about weight and eating disorders. The condition can cause serious health risks, even when weight remains within or above the 'normal' range. Early recognition and comprehensive treatment are critical to addressing its impact.