Upfront

Hiding in plain sight

Even people who aren’t especially thin could be suffering from anorexia nervosa, a disorder characterized by restrictive eating, overexercising, distorted body image and intense fear of weight gain.

Dangerously low heart rate and blood pressure, as well as serious electrolyte imbalances and psychological problems are common among patients with the condition.

Illustration by Gary Taxali

According to a new study led by researchers at Stanford and the University of California-San Francisco, teens and young adults with atypical anorexia nervosa can have normal body weights and still be dangerously ill.

Traditionally, individuals had to be below 85% of their ideal body weight to be diagnosed with anorexia nervosa. But in 2013, atypical anorexia nervosa was recognized for people who meet all other diagnostic criteria of the disorder but have a normal body weight.

“This group of patients is underrecognized and undertreated,” said the study’s senior author, Neville Golden, MD, professor of pediatrics at Stanford.

The research, published Nov. 5 in Pediatrics, showed that large, rapid weight loss is the best predictor of medical and psychological problems in atypical anorexia patients.

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