Feeling Like a Fraud: “Atypical” Anorexia Nervosa
Sensing a Problem
Your BMI is on the lower side but it’s fine. The first time I brought up my rapid weight loss to a physician, I was immediately dismissed because I was not clinically underweight.
I had considered the possibility that I had an eating disorder for several months and the surety of this proclamation left me conflicted. On the one hand, I wanted my fears validated. I wanted to know that the physical and mental symptoms I was experiencing had a cause; that I hadn’t made them up. On the other hand, it gave me the perfect ammunition to dismiss the concerns of my friends and family. See? A literal doctor said I’m fine. You can stop freaking out now.
Additionally, it allowed me to justify my eating disorder to myself. I convinced myself that there was nothing wrong with the comfort and safety I found in my new coping mechanism. Instead, it gave me the assurance that I could and should push myself to new extremes with my food intake.
It took me almost a year to advocate for myself again. In the meantime, my eating disorder had consumed me. I became a shell of a person. My eating disorder was the only thing I had room for in my life. I was behind on my schoolwork and commitments, I wasn’t able to form or sustain healthy relationships, and I had no energy to find anything interesting or worthwhile.
I was lucky to have a more compassionate doctor the second time around that was happy to give me a referral after asking me a few questions. Although I didn’t qualify for most treatment plans on the NHS, I was able to take part in an early intervention programme called FREED (First Episode Rapid Early Intervention for Eating Disorders).
The (Second) “Best” Eating Disorder
After finally being assessed at an outpatient hospital, I was told I had a relatively new diagnosis called Atypical Anorexia (TW: weight loss, eating disorder behaviors, experiences of weight stigma) that falls under a wider umbrella labeled OSFED (Other Specified Feeding or Eating Disorder). I felt like I had been slapped across the face. I felt like the word fraud had just been tattooed on my forehead. I felt this overwhelming sense of failure pour into me and wrap around every single cell in my body.
One of the most insidious parts of having an eating disorder is getting lost in the neverending competition; the constantly changing benchmarks of success. I wanted to be diagnosed with Anorexia Nervosa, the gold star in the hierarchy of diagnoses.
I think this is one of the reasons why, for a lot of people, eating disorders defy all sense and reason. Why would you want to be sicker? Isn’t it a good thing that you weren’t dangerously underweight? To me it genuinely wasn’t in a way that is difficult to articulate.
I took so much pride in the weight loss I had achieved that without realizing, achieving and maintaining thinness had become wrapped up in my identity and value as a human being. OSFED signaled that I wasn’t “sick enough” or underweight enough and that I had therefore failed at the one thing that I was supposed to be good at. My incredibly critical inner voice told me I should have just pushed a little harder. Just a few more kilos and you could have gotten what you wanted. Don’t you feel embarrassed? You aren’t even properly Anorexic.
Receiving that gold star diagnosis symbolized a lot of different things for me. It signaled superiority and being deserving of help. I wanted to be part of that exclusive group of people that had actually “succeeded” in their eating disorder. I recognize now how harmful this thinking was but it is unfortunately a common thought process for people with eating disorders.
Life Beyond My Diagnosis
One of the most difficult things I had to come to terms with in the beginning of my recovery is that eating disorders are not weight disorders. Contrary to popular belief, eating disorders do not exclusively target fifteen-year-old suburban white girls that read too many glossy magazines. Less than 6% of people with eating disorders are medically underweight.. Eating disorders come in all shapes and sizes. Being or not being underweight, does not change the validity of your diagnosis.
If you have Atypical Anorexia, please remember that undereating for a sustained period of time is dangerous, regardless of your BMI. Atypical Anorexia is not less physically or mentally harmful than Anorexia Nervosa. Most importantly, there is also no such thing as sick enough and there is no magic number that will make you feel deserving of support. If you are struggling, you deserve support now, no matter what the number on the scale is.
If you are based in the US you can receive a free, confidential assessment through Project HEAL to start your healing journey.
