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Atypical Anorexia: Symptoms, Causes, & Treatment

Atypical Anorexia: Symptoms, Causes, & Treatment

Anorexia nervosa is recognized as a severe eating disorder characterized by a distorted body image, obsession with food and weight, and unwarranted fear of gaining weight. People with this disorder tend to restrict their caloric intake and use various measures to prevent weight gain and promote weight loss. As a result, individuals with this eating disorder tend to be very slim. However, another type of anorexia known as atypical anorexia nervosa isn’t as recognizable. 

What Is Atypical Anorexia Nervosa?

Eating disorders aren’t always as black and white as their diagnoses make them seem. Diagnostic criteria consider the most common symptom combinations of these disorders, but many struggling with them don’t display as clear-cut of a list. For this reason, the Diagnostic and Statistical Manual of Mental Health Disorders (DSM) created the OSFED (Other Specified Feeding and Eating Disorder) category of diagnoses for eating disorders.  

The OSFED category specifies eating disorders that “cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet full criteria for any of the disorders in the feeding and eating disorders diagnostic class.”1 Atypical anorexia nervosa is one of these disorders.  

Atypical anorexia nervosa is an eating disorder in which a person meets all the criteria for anorexia nervosa except that despite significant weight loss, the person is within their normal or recommended weight range, which is also referred to as weight suppression.1 Atypical anorexia is more common than we think, comprising nearly one-third of hospital inpatient eating disorder treatment programs.2 

Causes of Atypical Anorexia

While more research needs to be conducted to understand atypical anorexia as much as anorexia nervosa, below are some known causes of the disorder to be mindful of.  

  • Biological factors: The most notable biological factors that could cause atypical anorexia are genetic predispositions to eating disorders and/or other mental health disorders. Having an eating disorder in the family, especially atypical anorexia nervosa, can also contribute to a relative’s diagnosis.  
  • Psychological factors: As previously mentioned, prior diagnosis of a mental illness increases the risk of developing atypical anorexia, as eating disorders are just as mental as they are physical. Other psychological factors that could cause anorexia atypical type include a tendency or need for perfectionism and rigidity in behaviors and beliefs. A history of trauma can also make the individual more likely to develop an eating disorder.  

Atypical Anorexia Symptoms

An atypical anorexia nervosa diagnosis is different from typical anorexia. Even though they’re different, they share several characteristics, such as extreme emphasis placed on body shape and appearance, fear of weight gain, and restricted caloric/energy intake.  

However, the major difference between typical and atypical anorexia is that people with atypical anorexia are not severely underweight and don’t have to experience significant weight loss to be diagnosed. Because someone with atypical anorexia may be at a normal weight or even overweight, the eating disorder may not be as obvious.  

However, there are still many behaviors and signs associated with the disorder. Common signs and symptoms of atypical anorexia nervosa include:  

  • Making excuses or avoiding situations where food is present 
  • Having an extremely rigid eating schedule or routine 
  • Believing that they are a bigger size than they are 
  • Significant weight loss yet being within normal weight limits 
  • Yellowing/drying skin 
  • Gastrointestinal problems 
  • Reduced immune system 
  • Lethargy and low energy 
  • Obsessing body weight, shape, and size 
  • Low self-worth and self-esteem 
  • Distorted body image  
  • Intense fear of being overweight or gaining weight  
  • Obsessing over food, nutritional content, and/or bodily impact of food 
  • Refusing to eat or to eat in front of others 
  • Mood swings, irritability  
  • Difficulty concentrating and thinking  

People with atypical anorexia nervosa may deem themselves as “not sick enough” or use their weight to “prove” that they’re “healthy” or “fine.” If an individual is not severely underweight, it’s easy for their disorder to slip through the cracks. For this reason, keep these signs and symptoms in mind if you suspect that a loved one may have this disorder and needs eating disorder support 

Treatment for Anorexia

Whether it’s typical or atypical, our Philadelphia eating disorder clinic offers the professional and comprehensive care that you or a loved one needs to recover. We offer anorexia nervosa treatment alongside various other eating disorder programs to ensure that all clients who come to us with an eating disorder diagnosis are helped.  

To learn more about our services or how to get started, call Banyan Treatment Centers today at 888-280-4763 




  1. DSM - Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) 
  2. NIH - Physical and Psychological Morbidity in Adolescents With Atypical Anorexia Nervosa 


Related Reading:  

Common Anorexia Relapse Triggers to Watch Out For 

Coping Mechanisms for Anorexia 

Common Misconceptions About Anorexia 

Alyssa, Director of Digital Marketing
Alyssa, Director of Digital Marketing
Alyssa is the National Director of Digital Marketing and is responsible for a multitude of integrated campaigns and events in the behavioral health and addictions field. All articles have been written by Alyssa and medically reviewed by our Chief Medical Officer, Dr. Darrin Mangiacarne.