Yes, Atypical Anorexia Is A Thing

Photo: Evgeniia Vasileva / Shutterstock
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Trigger Warning: this article contains descriptions of eating disorders and associated behavior that may not be suitable for all readers. Fearless community, please read with care.

For two decades, I believed because I wasn’t emaciated, and never had been, that I never really had an eating disorder.

RELATED: 4 Things You Need To Know About Why You Have An Eating Disorder (And How It Relates To Anxiety)

Eating issues? Certainly. A weird set of rules and punishments associated with what I did or didn’t eat? Doesn’t everyone do that? The inability to eat in front of other people because I was so ashamed thinking was I too fat to be eating?

Well… I suppose that should have been a red flag.

Regardless of this unhealthy dialogue, the only advice I received at my doctor’s office was to lose some weight. They never said how much I should lose. They never took it into consideration because I was a dancer that my legs were solid muscle.

I, like Tess Holliday, was never thin enough to cause concern — in fact, it was the opposite.

At the time, those doctors did not realize the weight of their words would help me justify and validate all those words I said to myself. And that I would subsequently grapple with atypical anorexia for the next two decades.

What is Atypical Anorexia?

Society has painted a picture of what people who have an eating disorder look like. They’re white, straight, incredibly thin women hyper-fixed on their appearance. Because of their portrayal, sometimes they aren’t even considered necessarily sick. They’re just vain women.

But as long as a woman is straight-sized, or maybe even mid-sized, society will give them a pass and call their weight-loss journey admirable.

As long as they are going in a direction that involves losing weight.

People who suffer from atypical anorexia engage in the same activities as those who are plagued with a typical case of anorexia, without becoming underweight.

“According to the National Eating Disorders Association, a restrictive eating disorder does not have “a look,” and the only difference between a diagnosis of anorexia nervosa and atypical anorexia is weight.”

They restrict their food, over-exercise, and are preoccupied with their body shape and size. These behaviors are causes for concern in thin, or underweight individuals, but are actually encouraged for people who are not.

At the beginning of May, Ryann Maegen Hoven, known as Tess Holliday, an American plus-size model, shared she has been struggling with an eating disorder:

“I’m anorexic & in recovery. I’m not ashamed to say it out loud anymore. I’m the result of a culture that celebrates thinness & equates that to worth, but I get to write my own narrative now. I’m finally able to care for a body that I’ve punished my entire life & I am finally free” — Tess_Holliday (Twitter)

It was an unexpected announcement, but one that is monumental for the body-acceptance movement. Holliday speaking out about her struggle with anorexia sheds light on the fact that people in mid-size or plus-size bodies struggle just as much as our straight-sized counterparts with eating disorders.

From personal experience, I’ll argue that we [people in mid-size or plus-size bodies] struggle even more with eating disorders or unhealthy eating habits.

Why? Because society celebrates every time someone loses weight, regardless of how it was lost.

“I’ve had a lot of messages from folks that are anorexic that are livid and angry because they feel like I’m lying… I am plus size but advocating for diversity in larger bodies, and so I think for people hearing me say I’m anorexic was really jarring.” — Tess Holliday in an interview with Good Morning America.

Why this is so dangerous? There has not been one time in my life where my weight loss was not fueled by restricting calories, over-exercising, and/or appetite suppressants.

RELATED: The One Secret To Dealing With An Eating Disorder And Live A Healthier Lifestyle

At the same time, there has never been a time in my life where my weight registered anywhere near underweight on the BMI index according to my height.

So being a mid-size woman who has fluctuated between straight-sizes and plus-sizes during my life, could I really suffer from an eating disorder?

According to Neville Golden, MD, individuals struggling with atypical anorexia “can be just as sick medically and psychologically as anorexia nervosa patients who are underweight” but that they are “underrecognized and undertreated”.

It was only this year, when I started therapy, that my therapist called out the possibility. During a discussion about the relationship I had with my ex, she asked me if I thought there was any truth to the words he used to describe my body. ‘Do you really think your body is fat, disgusting, and worthless?’

I knew the answer she wanted to hear. I should have said no.

I should have said I didn’t agree. I should have said I knew it isn’t true. Those were just words he had used to break down my self-esteem and maintain control.

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But I couldn’t bring myself to lie. Because in all honesty, in the beginning, well before I had met him or ever had a relationship, those words were also my words. I just never said them out loud.

That is the most insidious thing about eating disorders and other mental illnesses. Many people who endure them are trapped in a grey area.

The space in between being ‘sick enough’ for others to recognize they need help and feeling like they aren’t sick at all.

In fact, they’re bettering themselves and being cheered on by the society we live in for making the choice to pursue a smaller body.

Don’t get me wrong. This isn’t about people who eat well and fuel their bodies or about those who exercise for pleasure. This isn’t even to say your choice to lose weight is a bad thing.

This is a conversation for all the people who don’t eat because they feel like they are too fat and don’t deserve to.

This is a conversation for all the people who exercise to punish their bodies for not being slim, trim, and fit.

Losing weight as a result of unhealthy, dangerous habits is not okay. Regardless of the message society sends to us, your emotional, mental, and physical health are more important than the size is on the tag of your clothing.

Most important of all. Whether you’re a size 2 or 22, your struggle with your body image and weight loss is valid. 

You are deserving and worthy of getting the help you need to live your life to the fullest.

RELATED: 4 Types Of Eating Disorders & What Could Have Caused Them

Eating disorders are very common. According to the ANAD (Association of Anorexia Nervosa and Associated Disorders), eating disorders affect 9 percent of the population worldwide, and 28.8 million Americans will have an eating disorder in their lifetime. Eating disorders disproportionately affect BIOPC, LGBTQ+, and people with disabilities. Second to only opioid overdose, eating disorders are among the deadliest mental illnesses with 10,200 deaths each year as the direct result of an eating disorder — that’s one death every 52 minutes. If you or a loved one are struggling with disordered eating, contact the National Eating Disorder Helpline’s toll-free phone number: 1-800-931-2237.

Estrella Ramirez is a writer and poet. She has been featured in Medium, Scary Mommy, Psychology Today, and more. Follow her blog.

This article was originally published at Medium. Reprinted with permission from the author.