If you were trying to identify an eating disorder in your child, friend or family member, the first thing you would likely consider would be their weight. If they were underweight, you may infer they could be suffering from anorexia nervosa; if they were overweight, you may consider the possibility of bulimia nervosa. While weight can often be a telltale symptom of an eating disorder, it’s important to realize that it isn’t always one. Researchers at the Stanford University School of Medicine and the University of California-San Francisco are reminding the public that weight may not be enough to identify an eating disorder in loved ones, so it’s worth looking at other factors.
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The researchers conducted the largest and most comprehensive study to date on adolescents with anorexia who were considered atypical, due to their normal weight. Previous guidelines for an anorexia diagnosis required individuals to be below 85% of their ideal body weight, however, in 2013, atypical anorexia was formally recognized. Individuals who suffer from this type of eating disorder suffer from the same symptoms of those who suffer from anorexia — restrictive eating, over-exercising, intense fear of weight gain and distorted body image — but their BMI remains in the normal range.
Neville Golden, the study’s senior author, explained, “This group of patients is underrecognized and undertreated. Our study showed that they can be just as sick medically and psychologically as anorexia nervosa patients who are underweight.”
The researchers noted that rapid weight loss, not body weight, is the best way to predict medical and psychological problems in patients who suffer from atypical anorexia. Heart rate and blood pressure levels that are dangerously low, as well as electrolyte imbalances, are also common.
"The bigger context is that, over the past 30 years, the prevalence of adolescent obesity has quadrupled, and teens are being told to lose weight without being given tools to do so in a healthy way," Golden said.
There are multiple anorexia symptoms — some are physical, while others are behavioral or emotional. To learn more about the signs of anorexia, along with treatment options, click here.