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Could Your Higher Weight Patient Have Atypical Anorexia?

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Some Guiding Principles to Remember

When a patient has atypical anorexia nervosa or another eating disorder, an “eating disorder self” and a “healthy self” are both present (Costin, 2007). The psychologist should respectfully challenge and disempower the eating disorder related attitudes and behaviors, while strengthening the healthy and well parts of the patient. The ongoing objective is for the healthy self to become more present and influential than the illness. Some actions that support this include:

  • Redefining “health” as broad and multifaceted instead of weight-centric.
  • Modeling appreciation for bodies of all shapes and sizes.
  • Teaching about the effect of weight stigma and being attuned to our own.
  • Helping patients establish and maintain regular, steady nourishment throughout waking hours.
  • Facilitating patients’ flexibility in eating and other domains of life.
  • Bolstering patients’ capacities for identifying feelings and tolerating distress.
  • Ensuring treatment is at a level of care commensurate with patients’ symptoms and medical status.
  • Using patients’ preferred language about weight and shape, which is respectful.

Spotts-De Lazzer, A., & Muhlheim, L. (2019). Could your higher weight patient have atypical anorexia? Journal of Health Service Psychology, 45, 3–10.

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