You don\u2019t have to look very thin to have an eating disorder. People with atypical anorexia nervosa often don\u2019t think they\u2019re \u201csick enough\u201d for eating disorder treatment. But if you have atypical anorexia, you\u2019re at risk for serious health complications. Learn more about the symptoms, risks and treatment for atypical anorexia nervosa. What Are the Symptoms of Atypical Anorexia? Atypical anorexia is sometimes called the invisible eating disorder. Most people picture a very thin person when they think of anorexia. People with atypical anorexia usually are a normal weight. Sometimes they\u2019re considered overweight. Many times the condition flies under the radar. Those closest to them and even healthcare providers may not recognize the condition. If you\u2019re struggling with atypical anorexia, you may feel you have a serious problem with food and weight. You may also feel invalidated because you don\u2019t fit the mold of someone with an eating disorder. Others don\u2019t see your suffering so you may question your own concerns. Atypical anorexia is as serious as other eating disorders. Symptoms of atypical anorexia are the same as anorexia nervosa. The only difference is that the diagnosis doesn\u2019t include a low body weight. Atypical anorexia is classified with other atypical eating disorders. They fall under the DSM 5 category: OSFED. This stands for other specified feeding or eating disorder. Signs and symptoms of atypical anorexia nervosa include: Intense fear of weight gain \t Continuing to fear gaining \tweight even after losing weight \t Distorted body image \t Using extreme measures for \tweight loss such as fasting or excessive \texercise \t Disordered eating and \tweight-control measures interfere with everyday functioning \t Unrealistic idea of weight \t Preoccupation with food, weight \tloss, exercise and dieting \t Calorie counting \t Cutting out entire food groups \t \t Ritualistic eating behaviors \tlike only eating certain food groups or food colors \t Spitting out food instead of \tswallowing it \t Preoccupation with food sources \tor cleanliness \t \t Skipping meals \t Avoiding social situations with \tfood \t Labeling some foods as \u201cbad\u201d \tand others as \u201csafe\u201d \t \t Isolation and social withdrawal \t Avoiding eating in public \t Wearing baggy clothing \t Why Atypical Anorexia Is Dangerous Atypical anorexia has serious physical and mental health risks. A 2016 study by The University of Melbourne compared atypical anorexics to anorexics. They found atypical anorexics: \tHave more severe disordered eating symptoms \t \tLose more weight over a longer period of time \t \tExperience lower self-esteem \t \tHave greater distress over body image and food The study didn\u2019t find major differences between atypical anorexics and anorexics in: \tLow body temperature \t \tBinge and purging episodes \t \tLow heart rate \t \t \tCo-occurring mental illnesses \t \t \tSuicidality or self-harm \t \t \tResting pulse rate \t \tLow blood pressure \t \tHospital admissions \t Another study found 31% of atypical anorexics have the same complications as anorexia. These include both physical and mental issues. The researchers urged medical professionals to always ask questions about weight loss. Too often weight loss seems like a positive thing. In reality, it could be an indicator that the person needs help. Like anorexics, atypical anorexics might also experience: \tSleep problems \t \tFainting spells \t \tDehydration and electrolyte imbalances \t \tMalnutrition: affecting hair, nails, teeth, skin and other physical \tappearances \t \tAbnormal blood counts \t \tSensitivity to cold temperatures \t \tThinning hair \t \tFatigue \t \tMenstrual cycle stopping \t \tConstipation and other gastrointestinal issues How Do You Treat Atypical Anorexia? There aren\u2019t universal clinical guidelines for treating atypical eating disorders. Clinicians treat OSFEDs like their most similar eating disorder. Eating disorders are complex. Long-term residential care in a treatment center may be necessary. Treatment for atypical anorexia nervosa may include: Family Therapy Strained relationships often go hand-in-hand with anorexia. Research shows the importance of family therapy in treatment of anorexia. In a 2017 study, patients had fewer mental health symptoms with family-based treatment. Psychotherapy Intensive therapy with counselors trained in eating disorders is important. Anorexics have distorted thinking and ingrained views about themselves and their world. Therapists often need to use a variety of approaches. It can be difficult to open the lines of communication. It\u2019s hard to change inaccurate beliefs and views. Psychotherapy can help anorexics understand what's behind their fear of weight gain. Dual Diagnosis Treatment Co-occurring disorders like mental illness are common in people with eating disorders. One study followed women in residential treatment for eating disorders. Researchers found 97% also struggled with mental illness. It\u2019s imperative that eating disorder treatment include mental health treatment. Untreated issues like depression, anxiety and personality disorders can make eating disorders worse. Group Therapy Relationship issues and isolation affect people with eating disorders. Group therapy can help by giving people insights into themselves and how others see them. Hearing from others with eating disorders helps them feel less alone. Group therapy is a safe place to practice relationship skills. This helps improve relationships outside of treatment. Nutrition Counseling Treatment for atypical anorexia should include work with a nutritionist or dietician. People with eating disorders need to change their relationship with food. A nutritionist can help them maintain a healthy body weight. Medication Co-occurring mental health issues are common in people with anorexia. Clinicians may prescribe medications to treat both anorexia and co-occurring disorders. Preliminary research shows some medications may help. They can reduce depression and eating disorder symptoms in atypical anorexics. These medications are fluoxetine or venlafaxine. They\u2019re most effective in combination with cognitive behavioral therapy (CBT).