Written by: Daniella Marchese
Edited by: Morgan Diep
People often consider only the ‘extremes’ when considering eating disorders—meaning people who appear severely underweight or severely overweight. However, there are a large number of people who have eating disorders that may seem ‘invisible’ to the public. Some of these include Atypical Anorexia Nervosa and Bulimia Nervosa. This article will discuss how these disorders are typically caused, their symptoms and types of treatment often offered for people with them.
Atypical Anorexia Nervosa (AAN), as defined by the DSM, requires all the same criteria for Anroexia Nervosa (AN). Anorexia Nervosa consists of the fear of gaining weight resulting in a person restricting their food intake, procuring a dramatic weight loss (American Psychological Association 2013). However, what distinguishes AAN is that the significant weight loss leaves the person within or above the normal range (Beard & Waller 2024). This makes AAN more difficult to notice and diagnose. People with this eating disorder do not think they have a problem because they are not underweight. However, they are still severely maltreating their body.
Bulimia Nervosa is also an ‘invisible’ eating disorder because it may not be associated with any weight changes. Bulimia Nervosa is categorized as uncontrollable overeating followed by purging to avoid weight gain (American Psychological Assocaition 2013). This can be by forcibly throwing up, using laxatives, working out intensely, or fasting (Jain & Yilani 2023). Weight loss or gain is not usually an indicator of this eating disorder. However there are other signs clinicians look for to determine if someone should be assessed for this disorder. Symptoms include dental erosion, broken blood vessels, hypotension, and dry skin (Jain & Yilani 2023).
Both bulimia nervosa and anorexia nervosa are more common in females (Beard & Waller 2024; Jain & Yilani 2023). However, eating disorders are still very prevalent, and commonly undiagnosed in males. This is partly due to the stigma around men with eating disorders (Halbeisen et al. 2024). Many men “the shame of the disorder on the one hand and the conflict with masculine identity [on] the other” (Halbeisen et al. 2024, 89). This makes it very difficult for men to come forward and ask for help and many clinicians do not know how to approach male patients when they are concerned they have an eating disorder.
The ‘invisible’ eating disorders can be some of the most dangerous. Like many mental disorders, they are invisble and can’t be diagnosed by solely looking at the numbers on a patient — blood tests, weight, BMI, etc. Extensive evaluations should be done on people who seem to present with some of the symptoms of eating disorders, which include talking to the patient and understanding their relationship with food. It is important, as well, to understand how to help populations that may feel more shame when thinking of asking for help. Having a healthy relaitonship with food is key to having good health. Overly restricting, purging, and overeating may seem like they are ‘helping’ someone’s body image or seem ‘healthier’ than some of the foods they want to put in their body. However, eating disorders are very serious to physical and mental health and can be fatal if they are left untreated.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
Beard, J., & Waller, G. (2024). Atypical anorexia nervosa: A scoping review to determine
priorities in research and clinical practice. European eating disorders review : the journal
of the Eating Disorders Association, 10.1002/erv.3092. Advance online publication.
Halbeisen, G., Laskowski, N., Brandt, G., Waschescio, U., & Paslakis, G. (2024). Eating
Disorders in Men. Deutsches Arzteblatt international, 121(3), 86–91.
Jain, A., & Yilanli, M. (2023). Bulimia Nervosa. In StatPearls. StatPearls Publishing.
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