“You Don’t Look Anorexic”: Atypical anorexia patient experiences of weight stigma in medical care

Eating disorder psychopathology, psychiatric impairment, and symptom frequency of atypical anorexia nervosa versus anorexia nervosa: A systematic review and meta‐analysis

“…First, an improved understanding of the psychological profile of aty-pAN versus AN could be used to inform the diagnosis and classification of restrictive EDs in future editions of the DSM and ICD. Taken together with research indicating that the medical consequences of AN and atypAN are generally similar, aside from more severe bone mineral density and menstrual disturbances in AN (Harrop, 2020;Walsh et al, 2022), results from this study provide initial, although cross-sectional, support for proposals to classify AN and atypAN under a single restrictive ED diagnosis (Phillipou & Beilharz, 2019). If needed, a restrictive ED diagnosis could include a "with low weight" specifier to denote presentations in which weight is less than minimally healthy or minimally expected.…”

“…AtypAN's relegation to the OSFED category and the label "atypical" connotates a less clinically severe ED. However, a growing body of research has begun to question the assumption that atypAN is less severe than AN (e.g., Harrop, 2020;Harrop et al, 2021;Sawyer et al, 2016;Whitelaw et al, 2018). Two recent systematic reviews and meta-analyses found that those with atypAN had commensurate rates of medical complications, such as electrolyte imbalance, bradycardia, hypothermia, and orthostasis, as those with AN (Harrop, 2020;Walsh et al, 2022).…”

“…However, a growing body of research has begun to question the assumption that atypAN is less severe than AN (e.g., Harrop, 2020;Harrop et al, 2021;Sawyer et al, 2016;Whitelaw et al, 2018). Two recent systematic reviews and meta-analyses found that those with atypAN had commensurate rates of medical complications, such as electrolyte imbalance, bradycardia, hypothermia, and orthostasis, as those with AN (Harrop, 2020;Walsh et al, 2022). However, the Walsh et al (2022) review and meta-analysis found that atypAN had lower frequencies of cardiac abnormalities and greater bone mineral density.…”

Few differences in psychiatric comorbidities and treatment response among people with anorexia nervosa and atypical anorexia nervosa

“…Although there are not global differences in eating pathology between individuals with AN and atypical AN, some evidence suggests that adolescents and adults with atypical AN may experience greater distress related to eating and body image compared to people with AN (Eiring et al, 2021;Johnson-Munguia et al, 2024;Sawyer et al, 2016). This elevated distress may be due to those with atypical AN not looking "like they have an ED"-i.e., not being emaciated-which may lead family, peers, and healthcare providers to trivialize those with atypical AN's experiences and ED symptoms (Eiring et al, 2021;Harrop et al, 2023;Sawyer et al, 2016). This, in turn, may lead to fewer adolescents and adults with atypical AN being referred or admitted to higher levels of care for ED treatment (Harrop et al, 2021).…”

A case for re‐conceptualizing the ‘atypical’—A lived experience perspective

“…And our health systems convey this; the experiences of people with anorexia who are not 'clinically' underweight are often doubted, invalidated and nullified as they are 'not sick enough' (Barko & Moorman, 2023) when indeed, they are (Johnson-Munguia et al, 2024). This minimization and pathologization of people with higher weight anorexia can delay identification and treatment, trigger relapses and hinder people's recovery (Harrop et al, 2023) which is deeply concerning as while termed 'atypical', higher weight anorexia is as common if not more so than anorexia nervosa (Harrop et al, 2021). It seems this brute weight-centrism by which we currently conceptualize and refer to 'anorexia' reduces it wrongfully to its bare bones, inevitably medicalizing and colluding with the nature of the disease itself in that less is more.…”