Atypical Anorexia

Throughout most of modern medicine, low body weight is considered a key symptom or sign of anorexia. As research grew and new details emerged, the medical community recognized atypical anorexia.

People with atypical anorexia nervosa (AAN) meet all the same criteria as those with anorexia. The only difference is that people consider their body weight “normal” or higher. Atypical anorexia is increasingly prevalent. Recognizing its signs and symptoms is crucial. This awareness can safeguard the mental and physical health of our communities.

What is Atypical Anorexia?

Atypical anorexia and anorexia share the same criteria for diagnosis, which includes:

  • Restricting calorie intake, leading to a significant reduction in body weight
  • A strong fear of increasing body weight
  • Deep concern with the size and shape of the body

To diagnose atypical anorexia, a person must have a body weight that is “normal” or higher. Because of this, someone with AAN may not match the stereotypes of what malnourishment “looks like.” However, that does not make this condition any less serious.

Atypical anorexia is an eating disorder that has been known by several names. This change happened as researchers learned more about it over the years. Before the DSM-5 was created, the condition used to be part of Eating Disorders Not Otherwise Specified (EDNOS). This update recognizes atypical anorexia as a distinct condition.

Symptoms of Atypical Anorexia

People with atypical anorexia may have different symptoms. These symptoms affect the entire person, just like many other mental health issues. They include:

  • Physical symptoms: Vomiting or the use of laxatives, which can contribute to weight loss and cause complications such as electrolyte imbalances and gastrointestinal problems.
  • Psychological symptoms: Individuals with this condition may feel depressed. They might become overly concerned about their body image. Mood swings can also occur.
  • Behavioral symptoms: People with AAN may spend a lot of time exercising, as well as thinking and talking about body image.

Causes and Risk Factors of Atypical Anorexia

There isn’t one clear cause of atypical anorexia. Still, some factors can raise the risk of developing it. These factors include:

  • Biological factors: People who have a history of eating disorders and mental health conditions in their families are at a higher risk. Those who are assigned female at birth are also at a higher risk for AAN.
  • Psychological factors: Traits such as perfectionism and low self-esteem can play a role in this condition.
  • Sociocultural factors: A person’s environment can impact the development of this condition. People who are exposed to certain body ideals or take part in weight-centric activities, like diving and wrestling, are at a greater risk.

Impact of Weight Stigma in Atypical Anorexia Nervosa

Today, weight loss meds, fad diets, and heavily edited ads create strong body image pressures. Most people feel these ideals daily. Society often glorifies thinness, and the medical community is not immune to weight stigma. Some people with larger bodies say their atypical anorexia symptoms were often ignored by doctors. They also mention that their weight loss was praised at first.

One damaging stigma is the belief that individuals with AAN are “not sick enough” to warrant treatment. This misunderstanding can lead people to overlook their symptoms. They might wait to get help, thinking they don’t match the typical image of someone with an eating disorder. However, this is a harmful and incorrect assumption.

There are also concerns with the name of this condition itself. By calling the condition “atypical,” it can further alienate those in need of help. Some people say anorexia nervosa and atypical anorexia are the same condition. They think these disorders happen at different points on the weight spectrum.

Diagnosis of Atypical Anorexia

Atypical anorexia can be hard to spot. If you or a loved one think you might have it, find a provider who knows this condition well.

To diagnose atypical anorexia, a provider will start with a medical history and check for symptoms. The medical team will also perform a series of blood tests to rule out any underlying physical complications. These tests can also help to understand the severity of the condition if an AAN diagnosis is made.

If no physical causes are identified, a provider will likely use the DSM’s criteria for evaluating atypical anorexia. If a diagnosis is made, a referral to a clinic or eating disorder specialist may follow.

Treatment Options

After a doctor makes a diagnosis, the healing process can begin. A good approach to treating this condition usually has three main parts: counseling or therapy, care for co-occurring issues, and nutritional counseling with medical oversight.

A therapist, psychologist, or counselor trained in eating disorders can help. They provide healthy coping skills to change unwanted and unrealistic thoughts. Cognitive Behavioral Therapy (CBT) can be particularly effective for this. Family therapy is useful. It teaches family members how to spot signs and symptoms of eating disorders. It provides specific tools to help their loved one.

Addressing co-occurring conditions is also important when treating those with non-typical anorexia. Trauma, anxiety, depression, and other mental health issues often happen alongside eating disorders like AAN. Treating these conditions together gives patients the best chance for hope and healing.

A registered dietitian and physician can help those with AAN regain their physical health. This can include nutritional restoration, reintroducing foods or food groups that people with atypical anorexia may have been avoiding, and overall health monitoring.

Living with and Recovering from Atypical Anorexia

Recovery from atypical anorexia can take years, and early intervention improves outcomes. Creating a care network is important. It should include medical professionals, therapists, and supportive friends or family.

Self-care is also an essential part of recovery. Engaging in activities that promote joy and relaxation can improve overall well-being. Some activities to consider are:

  • Journaling
  • Picking up a creative hobby like coloring or knitting
  • Gardening
  • Swapping screen time for reading

When to Seek Help

There is never a wrong time to ask for help, just as it is never too early to seek professional treatment. If you or someone you care about has any AAN symptoms, feels down, or struggles at mealtimes, it’s time to get help.

If you or a person close to you is experiencing a mental health crisis, call or text 988 or visit: https://988lifeline.org/ for support.   

Atypical Anorexia is More Common Than We Realize

Atypical anorexia nervosa is neither less common nor less severe than anorexia nervosa. Just like any mental health condition, this disorder does not discriminate and can impact anyone.

Seeking help is critical. Early intervention can prevent the condition from worsening and can hasten the recovery process.

You can find treatment providers with experience in atypical anorexia, despite its name. With the right help and support, recovery is possible.

Rachel Collins, LCSW
Site Director of Northbrook PHP and IOP

Rachel Collins, LCSW, is the Site Director of SunCloud Health’s Northbrook Partial Hospitalization (PHP) and Intensive Outpatient (IOP) programs for both adolescents and adults. Rachel earned her bachelor’s degree in psychology and went on to complete her master’s degree in social work from Michigan State University. She has since worked in a wide range of settings, including inpatient treatment, PHP/IOP programs, therapeutic group homes, and private practice. Rachel specializes in treating trauma (using Cognitive Processing Therapy) and anxiety, practicing through a relational, compassionate, and client-centered lens. She is passionate about creating a therapeutic space in which clients feel safe and able to explore various parts of themselves with curiosity as opposed to judgement. In addition to her leadership and clinical work, she is passionate about creating art, and learning about the intersection between creativity and mental health.

Kayla Corirossi, MA, LCSW
Site Director, Naperville PHP/IOP (Adolescents & Adults)

Kayla Corirossi, MA, LCSW, is the Site Director of SunCloud Health’s Naperville Partial Hospitalization (PHP) and Intensive Outpatient (IOP) programs for adolescents and adults. She brings extensive experience working with individuals across the lifespan, including adolescents, adults, and geriatric populations, and specializes in the treatment of mood disorders, trauma, substance use, family systems, forensic populations, and individuals in crisis.

Kayla has worked in a wide range of clinical and community settings, including community-based interventions, police crisis response, correctional facilities, inpatient treatment, PHP/IOP programs, and with vulnerable and underserved populations. In addition to her clinical and leadership work, she is passionate about providing mental health education and advocacy within the community.

Kayla earned her Bachelor’s degree with a double major in Psychology and Sociology from Aurora University and went on to complete her Master’s degree in Forensic Social Work, also at Aurora University. Her clinical approach is evidence-based, compassionate, trauma-informed, and integrative, emphasizing collaboration and individualized care.

Driven by a personal mission to meet individuals where they are, Kayla is committed to helping clients feel safe, supported, and understood. She strives to create a natural and empathetic healing environment while ensuring individuals from all backgrounds and identities know they are not alone and have access to meaningful resources and support.

Elizabeth E. Sita, MD
Medical Director of Adult Services
Dr. Elizabeth E. Sita, MD, is a Board Certified psychiatrist specializing in the care of patients with eating disorders. She completed her undergraduate training at the University of Chicago and graduated with Highest Honors. She then earned her medical degree at Northwestern University Feinberg School of Medicine and was recognized with the Chairman’s Award for Excellence in Psychiatry. She subsequently completed residency with the Department of Psychiatry and Behavioral Sciences at McGaw Medical Center of Northwestern University, where she was elected Chief Resident and received the Resident Psychiatrist Leadership & Service Award. Upon completing her training, Dr. Sita came to Ascension Alexian Brothers Behavioral Health Hospital, where she served as Assistant Medical Director of the Center for Eating Disorders and Director of Transcranial Magnetic Stimulation Services before transitioning to lead the new inpatient eating disorder unit as Medical Director of Eating Disorder Services at Ascension Saint Joseph Hospital – Chicago. In these roles, she has cared for a multitude of adolescents and adults struggling with anorexia nervosa, bulimia nervosa, binge eating disorder, and other eating disorders as well as severe, cooccurring mood, trauma, personality, and substance use disorders. Dr. Sita has been recognized throughout her training and practice for a commitment to excellence in patient care and for her ability to engage patients in their most challenging moments. Her passions include the care of treatment-resistant eating and mood disorders as well as questions of medical capacity and end-of-life decision making. She believes that, first and foremost, human connection is key to mental health and well-being and strives to share this philosophy in each and every patient encounter. She is excited to bring her expertise to SunCloud Health as the Medical Director of Adult Services!   VIDEO: Meet Elizabeth E. Sita, MD, Medical Director of Adult Services  
Lacey Lemke, PsyD
Assistant Vice President of Clinical Services

Dr. Lacey Lemke (she/her) is a licensed clinical health psychologist with specialized expertise in the treatment of eating disorders and the practice of medical and health psychology. She completed her doctoral training in clinical psychology with a Primary Care emphasis at the Adler School of Professional Psychology. Dr. Lemke went on to complete both her predoctoral clinical internship and postdoctoral fellowship through Ascension Health, where she gained advanced training working with individuals experiencing eating disorders and self-injurious behaviors, as well as within pediatric subspecialty settings including endocrinology, neurology, and adolescent medicine.

Dr. Lemke is deeply committed to providing evidence-based, compassionate care and collaborates closely with interdisciplinary teams to ensure comprehensive treatment. Her professional mission is to support patients in achieving their fullest potential by guiding them to the most appropriate level of care and empowering them to make meaningful, sustainable progress toward improved health and well-being.

VIDEO: 2. Meet Lacey Lemke, PsyD.