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.