Atypical anorexia nervosa: A hidden eating disorder with severe risks

Atypical anorexia nervosa (AAN) shares the same symptoms as anorexia nervosa but occurs in individuals with a BMI in or above the 'normal' range. Despite significant weight loss, their weight often remains within this range. The condition was officially recognised in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision, under 'Other Specified Feeding or Eating Disorders (OSFED).' Common symptoms of AAN include severe weight loss, an intense fear of gaining weight, and restrictive eating habits. Sufferers often experience body image disturbance along with physical, psychological, and emotional changes. Healthcare professionals frequently overlook or underestimate AAN because the person’s weight stays within or above the 'normal' range.

A 2021 review suggested that AAN may be more common than low-weight anorexia, yet it appears less often in clinical settings. In recent years, more people in larger bodies have sought care in specialised eating disorder programmes. A 2022 research review found that they now account for 25-45% of those in inpatient medical stabilisation units.

The health risks of AAN are serious. They include nutritional deficiencies, electrolyte imbalances, and gastrointestinal issues. Hormonal disturbances, bone density loss, cardiovascular problems, and mental health complications can also arise. In some cases, these complications are as severe as, or even worse than, those seen in typical anorexia nervosa. AAN is a serious condition with widespread health consequences. Its recognition in diagnostic manuals highlights the need for better awareness and treatment. Early identification and intervention remain critical to addressing its physical and psychological effects.