Table of ContentsView AllTable of ContentsDSM CriteriaCausesSymptomsConsequencesTreatment

Table of ContentsView All

View All

Table of Contents

DSM Criteria

Causes

Symptoms

Consequences

Treatment

Atypical anorexia nervosaincludes all the signs and symptoms of anorexia nervosa with the exception that those with atypical anorexia are not underweight.

In fact, people with atypical anorexia are within or above what is considered a normal weight range. As is characteristic of all types of anorexia, they’ve undergone significant weight loss due to restrictive caloric intake. Having atypical anorexia nervosa doesn’t mean you require any less help or treatment than those with typical anorexia.

Atypical Anorexia Nervosa in the DSM

It was defined as a condition in which all criteria of anorexia nervosa “are met, except, despite significant weight loss, the individual’s weight is within or above the normal range.”

Diagnostic Criteria

Diagnostic criteria for anorexia include:

Atypical Anorexia Is Often Misdiagnosed or Overlooked

Even though people who have atypical anorexia show the same symptoms as people with anorexia, the fact that they’re not underweight leads to people overlooking or misdiagnosing them.

In fact, parents and doctors may even praise the weight loss of those with atypical anorexia because, even though the speed with which they’ve lost the weight is unhealthy, they don’t “look” sick or emaciated.

However, it’s important to note that we can’t necessarily see if someone is sick—not from their body, shape, or appearance. It’s important to look beyond someone’s appearance and not assume that someone is healthy, or not healthy, from how they look.

Atypical anorexia is actually quite common. Under 8% of people witheating disordersare underweight,with one studyshowing that, in addition to being considered a healthy weight, approximately 25% of those with atypical anorexia are overweight or haveobesity.

Causes of Atypical Anorexia Nervosa

The causes of atypical anorexia are the same as those of other eating disorders. And while the causes of eating disorders in general are not especially well understood, there are a number of risk factors that may leave certain people more vulnerable.

These risk factors can be genetic, psychological, or sociocultural, and include:

Causes and Risk Factors of Anorexia

Atypical Anorexia Nervosa Symptoms

In many cases, because there’s such a strong association betweenanorexiaand low body weight, people with atypical anorexia are often overlooked. In addition, those who have atypical anorexia may point to their body weight to prove they aren’t sick.

However, there are a number of symptoms of atypical anorexia (and typical anorexia) that aren’t based on an individual’s size or shape. These include:

Although there is a lot of symptom overlap, it’s worth noting that the DSM-5-TR (text revision) states that the physiological signs of anorexia and atypical anorexia aren’t necessarily the same.

The Connection Between Body Image and Eating Disorders

Consequences of Atypical Anorexia Nervosa

Because these symptoms are so often overlooked, those with atypical anorexia are often sicker for a longer period of time and are less likely to get the focused treatment they need.

Yet, due to the prolongedmalnutritionpeople with atypical and classic anorexia experience, the medical consequences can be equally severe for both groups.

These consequences can impact every part of the body, and in some cases, affect the individual for the rest of their life. They include:

Research has shown that adolescents with atypical anorexia who are overweight or have obesity are just as likely as those with anorexia to suffer from low heart rate and a rapid rise in heart rate when standing up.

Themortality rateamong those with anorexia is six times higher than that of people without anorexia,and although there is less research on those with atypical anorexia, given the similar medical consequences, it’s likely the mortality rate for people with this condition is equally high.

Meanwhile, research shows that people with atypical anorexia often exhibit greater eating disorder psychopathology, including distress aroundbody imageand eating, than people with anorexia.

Atypical Anorexia Nervosa Treatment

The sooner someone with atypical anorexia nervosa seeks and receives treatment, the more likely they are to recover.

However, due to the perception that people of normal, overweight, or obese body weights cannot have eating disorders, it may be challenging to get the care they need.

One studyshowed that when family members, peers, or healthcare providers expressed skepticism at their symptoms, people with atypical anorexia were left feeling confused and ashamed, and in some cases, it worsened their condition.

Meanwhile, another studyfound that atypical anorexia occurs more frequently than anorexia, but those with atypical anorexia are less likely to be referred to and treated for their eating disorder.

Unfortunately, due to the lack of research on atypical anorexia, there are fewer guidelines on how to treat people with the condition.

Treatment Can Be Challenging

It’s essential that a doctor, clinician, or inpatient treatment program can prioritize, treat, and monitor each of these issues.

In order to ensure the best possible outcome, people experiencing symptoms of atypical anorexia should seek out healthcare professionals who specialize in eating disorders, adhere toHealth at Every Sizeprinciples, and practiceweight-inclusivecare.

If you’re experiencing symptoms that might indicate an eating disorder, it’s important that you seek medical care right away. Also, a mental health professional can help you cope with any body image or self-esteem issues you may be feeling. Remember that you are not alone and recovery and healing are possible.

Eating Disorder Recovery: 12 Tips to Aid in the Process

12 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA: American Psychiatric Association; 2013.Warme A.Atypical Anorexia Nervosa - Not So Atypical?Nutrition Connection. 2022.Rastogi R, Rome ES.Restrictive eating disorders in previously overweight adolescents and young adults.Cleve Clin J Med. 2020;87(3):165-171.Forney KJ, Brown TA, Holland-Carter LA, Kennedy GA, Keel PK.Defining “significant weight loss” in atypical anorexia nervosa.International Journal of Eating Disorders. 2017;50(8):952-962.What Are Eating Disorders: Risk Factors.National Eating Disorders Association. 2022.Brazier Y.Anorexia nervosa: What you need to know.Medical News Today. 2021.Rittenhouse M.What is Atypical Anorexia Nervosa: Symptoms, Causes, and Treatment.Eating Disorder Hope. 2021.American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders.5th ed, text revision. Washington, D.C.; 2022.Sawyer SM, Whitelaw M, Le Grange D, Yeo M, Hughes EK.Physical and Psychological Morbidity in Adolescents With Atypical Anorexia Nervosa.Pediatrics. 2016;137(4). doi:10.1542/peds.2015-4080Eiring K, Wiig Hage T, Reas DL.Exploring the experience of being viewed as “not sick enough”: A qualitative study of women recovered from anorexia nervosa or atypical anorexia nervosa.J Eat Disord. 2021;9(142). doi:10.1186/s40337-021-00495-5Harrop EN, Mensinger JL, Moore M, Lindhorst T.Restrictive eating disorders in higher weight persons: A systematic review of atypical anorexia nervosa prevalence and consecutive admission literature.International Journal of Eating Disorders. 2021;54(8):1328-1357. doi:10.1002/eat.23519Nagata JM, Garber AK, Buckelew SM.Weight restoration in atypical anorexia nervosa: A clinical conundrum.International Journal of Eating Disorders. 2018;51(11):1290-1293. doi:10.1002/eat.22953

12 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA: American Psychiatric Association; 2013.Warme A.Atypical Anorexia Nervosa - Not So Atypical?Nutrition Connection. 2022.Rastogi R, Rome ES.Restrictive eating disorders in previously overweight adolescents and young adults.Cleve Clin J Med. 2020;87(3):165-171.Forney KJ, Brown TA, Holland-Carter LA, Kennedy GA, Keel PK.Defining “significant weight loss” in atypical anorexia nervosa.International Journal of Eating Disorders. 2017;50(8):952-962.What Are Eating Disorders: Risk Factors.National Eating Disorders Association. 2022.Brazier Y.Anorexia nervosa: What you need to know.Medical News Today. 2021.Rittenhouse M.What is Atypical Anorexia Nervosa: Symptoms, Causes, and Treatment.Eating Disorder Hope. 2021.American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders.5th ed, text revision. Washington, D.C.; 2022.Sawyer SM, Whitelaw M, Le Grange D, Yeo M, Hughes EK.Physical and Psychological Morbidity in Adolescents With Atypical Anorexia Nervosa.Pediatrics. 2016;137(4). doi:10.1542/peds.2015-4080Eiring K, Wiig Hage T, Reas DL.Exploring the experience of being viewed as “not sick enough”: A qualitative study of women recovered from anorexia nervosa or atypical anorexia nervosa.J Eat Disord. 2021;9(142). doi:10.1186/s40337-021-00495-5Harrop EN, Mensinger JL, Moore M, Lindhorst T.Restrictive eating disorders in higher weight persons: A systematic review of atypical anorexia nervosa prevalence and consecutive admission literature.International Journal of Eating Disorders. 2021;54(8):1328-1357. doi:10.1002/eat.23519Nagata JM, Garber AK, Buckelew SM.Weight restoration in atypical anorexia nervosa: A clinical conundrum.International Journal of Eating Disorders. 2018;51(11):1290-1293. doi:10.1002/eat.22953

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA: American Psychiatric Association; 2013.Warme A.Atypical Anorexia Nervosa - Not So Atypical?Nutrition Connection. 2022.Rastogi R, Rome ES.Restrictive eating disorders in previously overweight adolescents and young adults.Cleve Clin J Med. 2020;87(3):165-171.Forney KJ, Brown TA, Holland-Carter LA, Kennedy GA, Keel PK.Defining “significant weight loss” in atypical anorexia nervosa.International Journal of Eating Disorders. 2017;50(8):952-962.What Are Eating Disorders: Risk Factors.National Eating Disorders Association. 2022.Brazier Y.Anorexia nervosa: What you need to know.Medical News Today. 2021.Rittenhouse M.What is Atypical Anorexia Nervosa: Symptoms, Causes, and Treatment.Eating Disorder Hope. 2021.American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders.5th ed, text revision. Washington, D.C.; 2022.Sawyer SM, Whitelaw M, Le Grange D, Yeo M, Hughes EK.Physical and Psychological Morbidity in Adolescents With Atypical Anorexia Nervosa.Pediatrics. 2016;137(4). doi:10.1542/peds.2015-4080Eiring K, Wiig Hage T, Reas DL.Exploring the experience of being viewed as “not sick enough”: A qualitative study of women recovered from anorexia nervosa or atypical anorexia nervosa.J Eat Disord. 2021;9(142). doi:10.1186/s40337-021-00495-5Harrop EN, Mensinger JL, Moore M, Lindhorst T.Restrictive eating disorders in higher weight persons: A systematic review of atypical anorexia nervosa prevalence and consecutive admission literature.International Journal of Eating Disorders. 2021;54(8):1328-1357. doi:10.1002/eat.23519Nagata JM, Garber AK, Buckelew SM.Weight restoration in atypical anorexia nervosa: A clinical conundrum.International Journal of Eating Disorders. 2018;51(11):1290-1293. doi:10.1002/eat.22953

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA: American Psychiatric Association; 2013.

Warme A.Atypical Anorexia Nervosa - Not So Atypical?Nutrition Connection. 2022.

Rastogi R, Rome ES.Restrictive eating disorders in previously overweight adolescents and young adults.Cleve Clin J Med. 2020;87(3):165-171.

Forney KJ, Brown TA, Holland-Carter LA, Kennedy GA, Keel PK.Defining “significant weight loss” in atypical anorexia nervosa.International Journal of Eating Disorders. 2017;50(8):952-962.

What Are Eating Disorders: Risk Factors.National Eating Disorders Association. 2022.

Brazier Y.Anorexia nervosa: What you need to know.Medical News Today. 2021.

Rittenhouse M.What is Atypical Anorexia Nervosa: Symptoms, Causes, and Treatment.Eating Disorder Hope. 2021.

American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders.5th ed, text revision. Washington, D.C.; 2022.

Sawyer SM, Whitelaw M, Le Grange D, Yeo M, Hughes EK.Physical and Psychological Morbidity in Adolescents With Atypical Anorexia Nervosa.Pediatrics. 2016;137(4). doi:10.1542/peds.2015-4080

Eiring K, Wiig Hage T, Reas DL.Exploring the experience of being viewed as “not sick enough”: A qualitative study of women recovered from anorexia nervosa or atypical anorexia nervosa.J Eat Disord. 2021;9(142). doi:10.1186/s40337-021-00495-5

Harrop EN, Mensinger JL, Moore M, Lindhorst T.Restrictive eating disorders in higher weight persons: A systematic review of atypical anorexia nervosa prevalence and consecutive admission literature.International Journal of Eating Disorders. 2021;54(8):1328-1357. doi:10.1002/eat.23519

Nagata JM, Garber AK, Buckelew SM.Weight restoration in atypical anorexia nervosa: A clinical conundrum.International Journal of Eating Disorders. 2018;51(11):1290-1293. doi:10.1002/eat.22953

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