In an ideal and logical world, people would eat only to survive. Instead, many people today center their lives around food and weight issues. And some of these people may not have normal eating behaviors, but they also don’t have an official eating disorder.
A new book released this month which was written by Ph.D. Jennifer J Thomas and Jenni Schaefer, called “Almost Anorexic: Is My (or My Loved One’s) Relationship with Food a Problem?” posits that there is a gray, middle category between normal eating and eating disorders (like anorexia nervosa) which they call “almost anorexia.” The book states that these people “may feel preoccupied with their body image, go on crash diets, and consider drastic weight-loss strategies.”
These people may also suffer considerably to the point where it negatively impacts their everyday lives. According to the book, “almost anorexia” will involve at least one of the following symptoms:
- Infrequent to severe binge-eating
- Compensatory behavior
- Food/eating/diet/weight restriction
- Weight changes
- Negative body image
The book gives numerous examples of people with “almost anorexia,” how to identify it, overcome it and get help.
So do you think you are almost anorexic? A good starting point discussed in the book is taking the EAT-26 self-test in order to get a better idea of your eating-related thoughts and behaviors: http://www.eat-26.com/
Authors Jenni Schaefer, a former sufferer of anorexia nervosa, and Jennifer Thomas, a clinical psychologist, said in an email interview that they estimate that about 1 in 20 adults suffer from “almost anorexia.” Its prevalence could be increased to 1 in 10 for teen girls.
“It is fairly normal for women ... to be concerned about weight and eating, and of course it’s great to eat a variety of foods and enjoy moderate physical activity,” they said in an email interview. “But here’s the bottom line: eating more raw vegetables is healthy, but eating only raw vegetables is almost anorexic.”
Another example of “almost anorexia” could be someone who counts calories excessively and rigidly. Schaefer and Thomas said that counting calories by itself is okay when trying to add balance to your relationship with food, but if you can’t be somewhat flexible with caloric intake, there might be a problem.
“Moreover, trying to compensate for a specific number of calories through compulsive exercise, fasting, and/or purging is almost certainly destructive,” they said.
And some diets or healthy eating habits might be disordered eating in disguise. The authors of “Almost Anorexic” state that inflexible or extreme eating/diet/weight loss behaviors that can contribute to “almost anorexia” can include raw foodism, colonics, juice fasting, slimming teas, and using different forms of diuretics.
“We describe almost anorexic as a vehicle for people who are truly struggling to get much needed help,” Schaefer and Thomas said. “Subthreshold eating disorders, which too often go undetected, can be just as severe as anorexia nervosa in the areas of eating pathology, physical complications and other mental health problems (e.g. anxiety, depression).”
Dr. Ramani Durvasula, a licensed clinical psychologist and author of “You Are Why You Eat: Change Your Food Attitude, Change Your Life,” said in an email that she is familiar with the concept of “almost anorexia” and the new book. She also believes many women are “almost anorexic.”
“Keep in mind that the diagnostic guidelines for anorexia nervosa set the bar pretty high, and some women engage in chronic starvation behavior and have very distorted body image, but never hit that weight threshold of 15 percent below ideal or hit the symptom criterion of amenorrhea,” Durvasula said.
“We are a culture in which most women eat less than they want, have food restrictions, have distorted body image, wish they weighed less, and are almost ritualistic about food behavior or report significant guilt after most meals.”
She doesn’t believe the unofficial label of “almost anorexia” is overpathologizing.
“We are a country with horrifyingly high rates of obesity and lots of people who are very messed up about what to eat and more importantly why they eat,” Durvasula said. “I can't remember the last time I had a meal with a woman where she did not comment on her food or my food - it has become part of the culture.”
Besides seeing a licensed mental health professional who specializes in eating disorders, women with “almost anorexia” have to start changing the way they view food.
“Listen to your body and learn to quit even when there is food on the plate,” she said. “Don't follow arbitrary rules written by others, trust your body, and learn to enjoy it.”
Schaefer, Jenni and Thomas, Jennifer J. Almost Anorexic: Is My (or My Loved One’s) Relationship with Food a Problem? Center City: Harvard Health Publications, 2013. Print.
Schaefer, Jenni and Thomas, Jennifer J. Email interview. July 18, 2013.
Durvasula, Ramani. Email interview. July 22, 2013.
Reviewed July 25, 2013
by Michele Blacksberg RN
Edited by Jody Smith