F50.01: the sometimes coveted diagnostic code for anorexia nervosa. Not to be confused with “atypical” anorexia nervosa. Which is a different diagnosis.
A particular young woman always oscillates back and forth when telling her story. She understands that she had a restrictive eating disorder. And she knew that she wasn’t eating enough and that her body weight had decreased. She definitely had orthorexia. An obsession with pure and clean eating that made her feel better about herself than others. But anorexia nervosa, oh how she wanted anorexia nervosa.
They say that healthy people don’t want to be sick. But oh how she wanted to feel sick enough. It is a common sentiment amongst individuals who have eating disorders to not believe they are sick enough to recover. In fact, Dr. Jennifer Gaudiani wrote a whole book with that exact title; “Sick Enough.” She is one of the few internal medical doctors with a specialized certification in eating disorder treatment in the country.
What is “atypical” anorexia nervosa?
“Atypical” anorexia shares the same symptoms as anorexia nervosa except for one. Symptoms of anorexia and “atypical” anorexia nervosa include: restriction, malnourishment, associated medical complications, fear of weight gain, and body image distress. The only difference is someone with “atypical” anorexia nervosa does not fall in the underweight BMI category. However, studies show that those with atypical anorexia nervosa experience similar pathologies to those with anorexia nervosa.
Our society glamorizes weight loss and praises disordered behaviors, such as dieting.
The same behaviors that are praised in individuals in larger bodies are considered disordered and dangerous in individuals in smaller bodies.
Sadly, it is very challenging for people in larger bodies to find a treatment that is respectful and accepting of the body diversity of humanity. Individuals with larger bodies are routinely dismissed because of their weight. As a result, they are delayed or prevented from receiving adequate help and treatment for their eating disorders.
Indicative of a disordered society is the number of individuals with eating disorders that desire to be sick. To this very day when asked about her story, she hesitates. “Am I lying by saying I had anorexia? Am I diminishing my struggles and feeding into the lies of fatphobia when I say I had “atypical” anorexia? Do I even believe that diagnosis to be the truest narrative?”
We all long to be validated in our struggles. The naming of our pain and trauma is the beginning of healing. Because we understand, and we know that others understand where we have been. Then, we are able to move through our emotions and grapple with the places we find ourselves.
Fatphobia – what is that?
What is fatphobia, you may be asking? It is a fear of fat people and of becoming fat or having fat on one’s body. As a society, we have been routinely taught that fat is bad and something to avoid.
However, body size has no moral value, no matter how deeply we have come to believe that narrative.
Fat people can be healthy at every size. And fat people can be determined. They can have just as much willpower as those smaller people. Without a doubt, they are worthy of love and belonging. Just like those in thinner bodies. While this viewpoint may seem easy to embody, we all struggle with some degree of internalized fatphobia.
Think of how you look at your body in the mirror. And how you speak to yourself about your body. Consider how you eat. Is it to honor your hunger and fullness cues and to eat what sounds good to your body? Do you listen to and respect those needs? Look at the associations and assumptions you automatically make about fat people. Are they different than those stories you make about thin people?
So, what does this mean for you, reader? If you have a disordered relationship with food and your body (anything that strays from an intuitive, respectful, and trusting relationship), you are worthy of recovery and healing.
If you have been diagnosed with “atypical” anorexia, You are not any less sick or less worthy of recovering than anyone else.
You are worthy of healing and recovery and are just as sick as those with “typical” anorexia nervosa.
If you know someone with an eating disorder, encourage them to seek treatment and support. remind them often that they are sick enough. You don’t have to prove anything through behaviors or continued maintenance of the disordered behaviors.
Remind your people their pain is acknowledged and seen for all that it is. And that it’s okay to heal now.
(Last Updated: September 1, 2022)