15/07/2022
This is certainly true anorexia can often be missed and dismissed, anorexia has many features and does not have to reflect the common shock horror images often associated with this serious condition. Body shape and size are also not representative of severity or impact on the person. Similarly body shape and size are not an indication of recovery.
Yes, people of all sizes can have anorexia.
An important conversation that we need to keep having is the one about how diagnoses and grouping people by symptoms, although well-intentioned, can actually be really harmful. Take anorexia for example. Anorexia Nervosa (AN) is it's own classification according to the Diagnostic and Statistical Manual Version V (2013). Then there is what's labelled as "Atypical Anorexia Nervosa" (AAN) which falls into a large sub-category of eating disorders called Other Specified Feeding and Eating Disorders (OSFED). Both are serious. Both can be life-threatening. In a study by Whitelaw in 2018 (and btw Melissa is not just "Whitelaw" she is an AMAZING Dietitian from here in Melbourne!!) found that "In adolescents with restrictive eating disorders total weight loss and recent loss were better predictors than admission weight of many physical complications....." OK so let's make this clear - people in ALL bodies can have very much the SAME complications, the SAME symptoms, the SAME struggles AND it needs to be said that people across body sizes are treated VERY differently in the world, and in the health system. We urgently need to re-visit the way we define, group and pathologise bodies for the convenience of our system. When people are being harmed, it's not good enough. People with "atypical" AN are NOT "atypical. In fact, I would suggest they are more typical than anyone of what happens when diet culture and fat phobia collide. See the human. See the human. See the human.
*Please don't come at me with "yeah but in the DSM......" because you'd be missing the point AND doubling on exactly what I'm saying the issue here is (and literature supports), that complications and severity is comparable across weights yet the disparity of care is horrible*