Eating Disorder Awareness Week is February 25 – March 3, 2019. It is a week to recognize the many
disordered eating patterns that can take over and govern people’s
lives. It is a week to take notice of the extreme measures to be
thin enough, which normally fly under the radar.
Most of us have an idea in our head of what an eating disorder looks like:
a person who is emaciated with their bones showing and hollowness around
their eyes, wearing very small clothes that still hang loosely on their
frame, and hair that is brittle. We think we would know someone with an
eating disorder if we saw them. We would know them when they become
thin enough to notice.
Enter Atypical Anorexia Nervosa. According to the
DSM-V, Atypical Anorexia Nervosa is diagnosed when, “all of the criteria
for anorexia nervosa are met, except that despite significant weight loss,
the individual’s weight is within or above the normal range.”
What are those anorexia nervosa criteria?
- Restriction of energy intake relative to requirements leading to a significantly
low body weight.
- Intense fear of gaining weight or becoming fat.
- Disturbance in the way in which one’s body weight or shape is experienced,
undue influence of body weight or shape on self-evaluation, or denial
of the seriousness of the current low body weight.
Along with these criteria are extensive signs and symptoms that manifest
behaviorally, emotionally, and physically. To name only some of these:
- Dramatic weight loss
- Dressing in layers to hide weight loss or stay warm
- Preoccupation with weight, food, calories, dieting, etc.
- Refusal to eat certain foods, progressing to restrictions against whole
categories of food (such as, no carbohydrates)
- Frequent commenting on feeling “fat”
- Denies hunger or claims to have already eaten
- Develops food rituals (such as, excessive chewing, eating foods in certain orders)
- Expresses need to “burn off” calories consumed
- Adheres to strict exercise regimen
- Limited social spontaneity and seems concerned about eating in public
- Has strong need for control and shows inflexible thinking
- Stomach cramps, constipation, non-specific gastrointestinal complaints
- Dizziness and/or fainting
- Difficulty concentrating
- Feeling cold all the time
- Dry skin, nails, and hair
- Poor wound healing
- Impair immune function
- Muscle weakness
- Loss of energy and sleep problems
Do any of these sound familiar? Most likely, because many of these are
considered cornerstones of a
healthy lifestyle. If someone adheres to a strict exercise regimen, they are lauded for their
no excuses approach.
Burning off calories is considered to be practical. Preoccupation with food, calories,
dieting, or weight, are thought to be
conscientious, and people who restrict foods or even entire categories of food are
good and have
Here’s the thing about thin enough: In this society, people who are
thin enough are thought to be morally superior and receive thin privilege, which is
often equated with happiness. In that context, of course people are going
to be enticed to try to be thin.
This is where eating disorders begin.
However, many people who have
larger bodies are not recognized as having eating disorders, such as Atypical
Anorexia Nervosa, because they are not considered
thin enough to be in danger. Rather, their disordered eating behaviors are praised as
at least trying.
The fact remains, though, that
the behaviors are still disordered, no matter a person’s weight.
During this Eating Disorders Awareness Week, recognize that there is no
such thing as
thin enough. Take a look at the way you and those around you approach food, and really
think about whether your behaviors are nourishing or negative. Have compassion
for bodies of all sizes and abilities, and know that just because someone
thin enough does not make them safe from eating disorders.
Jamie Marchetti, MS, RDN, LD, is a
Registered Dietitian at Campbell County Health. For a one-on-one nutrition counseling session,
call 307.688.1731. Learn more at