“I don’t have an eating disorder until I look a certain way”: Examining the impact of weight stigma on the illness perceptions of individuals with atypical anorexia nervosa
Date
2025
Authors
DaSilva, Sage
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Abstract
Eating disorders (EDs) have among the highest mortality rates of any psychiatric illness. Anorexia nervosa, categorized by extreme food restriction, is the most extensively studied ED. In contrast, research on atypical anorexia nervosa (AAN) - a diagnosis given when an individual meets all criteria for anorexia nervosa, except that, despite experiencing considerable weight loss, they are not classified as underweight - remains limited. Existing literature on AAN, though scarce, suggests that the diverse populations affected by this disorder experience severe physical and psychological health complications, including risk for suicide. Despite the harmful implications of AAN, weight stigma continues to perpetuate the false belief that restrictive EDs are exclusively associated with thinness. This misconception leads friends, family, and medical professionals to dismiss higher-weight individuals with the disorder. Accordingly, this study explored the impact of weight stigma on the illness perceptions of individuals with AAN to better understand how they come to identify the legitimacy and severity of their ED. Qualitative data were collected via semi-structured interviews and analyzed using Descriptive Phenomenological Analysis. Participants reported delayed illness recognition, self-doubt regarding the existence of their ED, uncertainty about their worthiness of recovery, and hesitation to disclose their symptoms to others. The findings indicate a need for increased ED education across schools, workplaces, and healthcare settings to raise awareness of the signs and symptoms of AAN. In addition, systemic barriers were found to hinder the diagnosis and treatment process for those with AAN, suggesting that healthcare professionals and governing bodies alike must challenge the influence of weight stigma and ED misconceptions to better support individuals in recognizing and recovering from their illness.
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Keywords
eating disorder, anorexia, atypical anorexia, weight stigma