All About Atypical Anorexia: Symptoms, Causes, Health Risks & Treatment

All mental health conditions are biological in nature. Eating disorders are no different. This means that if someone in your family has had an eating disorder, you are more likely to develop an eating disorder. This does not mean that parents are to blame for a child’s eating disorder. In fact, family support is an important part of eating disorder recovery.  

Individuals may be more likely to develop an eating disorder if they are already struggling with mental health issues like anxiety, depression or substance use. Other traits commonly linked with eating disorders include:  

• Experiencing a trauma

• Body image issues (body dysmorphia)

• Perfectionism 

• Rigid thinking or behavior (black or white thinking) 

• Low self-esteem 

• Interpersonal problems 

• Trouble with emotional regulation

Diet culture messaging includes images, videos and content proclaiming that a certain type of body is “better” than others. This messaging can increase the risk of eating disorders. 

Some people hear repeated messages about what their body “should” look like and take drastic measures to change their bodies to look more like that “ideal” body type. They may diet, purge or exercise excessively. These behaviors could lead to an eating disorder.

Sports are a great way for young people to get exercise, socialize and build self-esteem. However, any sport can potentially increase the risk for developing eating disorders.

Trying to achieve the ideal athletic body or attempting to improve performance through increased training and diet changes can lead to eating disorder thoughts and behaviors including:

• Restricting food to lower calorie intake

• Bingeing and/or purging (through self-induced vomiting, laxatives, or other means)

• Exercising excessively (running miles a day even when injured)

Some athletic coaches and dance teachers continue to encourage weight loss in young athletes — via any means necessary. This harmful practice continues even though dieting and food restriction can lead to health complications and decreased athletic performance.

Other risk factors for atypical anorexia include being overweight, being teased about one’s weight, or having a history of dieting.

• A study of teenagers found that 40% of females and 20% of males who were “overweight” were engaging in eating disorder behaviors. [4]

• Another study found that 70% of patients with atypical anorexia had been “overweight” or “obese” in the past. Only 12% of people with anorexia had been “overweight” or “obese.” [5]

• Further research found that people with atypical anorexia were teased about their weight as they were growing up. [6]

People who identify as LGBTQ+ are more likely to experience mental health problems, including eating disorders, than the general public. People who identify as transgender, gender-diverse or gender-non-conforming have higher rates of atypical anorexia than their cisgender peers.

Patients with atypical anorexia may require medical stabilization at the start of treatment to address health concerns. Medical stabilization may include:

• Running labs and assessing for signs of malnutrition

• Addressing any co-occurring medical conditions

• Medical monitoring and medication support 

• Emergency medical intervention, if needed

• Providing adequate nutrition

Each patient will receive an individualized treatment plan that emphasizes skill building to promote recovery.

Once the patient is medically stable, nutritional education and counseling begins. 

• Patients meet with registered dietitians regularly throughout treatment. 

• Mealtime support is provided by members of the treatment team. 

• Patients learn about meal planning, food portioning, food plating and other nutrition fundamentals.

Nutrition support helps patients return to balanced, regular eating habits.

Eating disorder therapy is another important part of treatment. Licensed therapists work one on one with patients. Patients learn new coping skills and therapists challenge negative thought patterns. Evidence-based therapies often used in treatment include:

• Acceptance and commitment therapy (ACT)

• Cognitive behavioral therapy (CBT)

• Dialectical behavioral therapy (DBT)

• Exposure therapy

Additional mental health concerns (anxiety, depression, obsessive-compulsive disorder) are addressed along with the eating disorder, improving mental health, body image and mood.

Group therapy is another standard of eating disorder treatment. In group therapy:

• Patients benefit from peer and professional support.

• Individuals learn how to resolve and repair destructive eating and exercise routines, strict food rules and harmful eating disorder thoughts and behaviors.

• Recovery skills and relapse prevention skills are taught.

• Patients work on body acceptance and body image issues.

Experiential therapies including art, psychodrama, mindfulness, movement and yoga are also incorporated into the program.

Parents, caregivers and other family members play a major role in recovery for individuals of all ages. Family-based treatment (FBT) and emotion-focused family therapy (EFFT) teach parents, partners and others to become agents of change for their loved ones, supporting long-term recovery. 

With virtual eating disorder treatment, individuals with eating disorders can maintain their responsibilities at work, school and home while receiving care from experienced treatment providers. Virtual care can provide similar treatment options that you would find in an in-person intensive outpatient treatment program.

Unfortunately, many individuals with atypical anorexia will not seek help because they don’t think they are “sick enough.” And some healthcare providers will refuse to refer them out for treatment because they appear to be at a “healthy” weight — even though they are experiencing mental and physical health problems related to their eating disorder. Some healthcare providers may even prescribe weight loss to these patients, worsening the eating disorder.