Almost Anorexic: Is My (or My Loved One's) Relationship with Food a Problem?

by Jennifer J. Thomas, Jenni Schaefer

Determine if your relationship with food is a problem, develop scientifically based strategies to change unhealthy patterns, and learn when and how to get professional help when needed with this inviting, hopeful guide.

Millions of men and women struggle with disordered eating. Some stand at the mirror wondering how they can face the day when they look so fat. Others binge, purge, or exercise compulsively. Many skip meals, go on diet after diet, or cut out entire food groups. Still, they are never thin enough.

While 1 in 200 adults have experienced full-blown anorexia, at least 1 in 20 (1 in 10 teen girls!) have exhibited some key symptoms. Many suffer from the effects but never address the issue because they don’t fully meet the diagnostic criteria. If this is the case for you, then you may be “almost anorexic.” Drawing on case studies and the latest research, Almost Anorexic combines a psychologist’s clinical experience with a patient’s personal recovery story to help readers understand and overcome almost anorexia.

Determine if your (or your loved one’s) relationship with food is a problem
Gain insight on how to intervene with a loved one
Discover scientifically proven strategies to change unhealthy eating patterns
Learn when and how to get professional help when it’s needed

Genres: Nonfiction, Self Help, Psychology, Health, Mental Health, Mental Illness

336 pages, Paperback

First published July 1, 2013

Reviews

[Deb · Rating 5 out of 5]

** No _almost_ about it **

Eating disorders exist on a spectrum--from the sub-clinical to the fully diagnosable. But, an eating disorder need not meet the diagnostic criteria of “full blown” anorexia/bulimia/binge eating disorder to warrant the need for attention and intervention.

With _Almost Anorexic_, Jenifer Thomas and Jenni Schaefer (author of Life Without Ed and Goodbye Ed, Hello Me) provide the first steps to recognizing those eating disorders that have fallen under the clinical radar:
“Diagnostic criteria are just guidelines, and people whose symptoms don’t quite fit those parameters can still suffer. Forget about the key symptoms of anorexia for a minute, and just consider this: to what extent is a preoccupation with eating, shape, and weight impacting your life? If *almost anorexic*seems to describe you or a loved one, we hope that this book will provide help and a real path to healing.”(p. 4)

This much-needed book is the perfect blend of clinical information, personal stories, and useable tools to help readers assess and address eating disorders, wherever they may fall on the spectrum. As an eating disorder therapist, I’m excited to use many of the gems found in this book to help my clients (and their loved ones) better understand eating disorder treatment and recovery.

Diagnosable or not, struggles with food, weight, and body image are serious issues that need to be addressed. Kudos to the authors for taking the lead in showing how those with *almost* anorexia also deserve *complete* validation, treatment, and recovery.

Life Without Ed: How One Woman Declared Independence from Her Eating Disorder and How You Can TooGoodbye Ed, Hello Me: Recover from Your Eating Disorder and Fall in Love with Life

[Missie · Rating 5 out of 5]

Almost Anorexic is a book published by the Harvard Medical School’s The Almost Effect series, which discusses the grey area of medical conditions that aren’t necessarily a diagnosable condition but are still definitely not in the “healthy” range. Eating disorders and other medical conditions exist on a spectrum. This book is about falling on the spectrum between healthy and full blown eating disorder, in the grey area with subthreshold conditions that don’t get the attention diagnosable conditions receive. It was a collaboration written by Dr. Jennifer J. Thomas, an assistant professor at Harvard Medical School, and Jenni Schaefer, author of the book “Life Without Ed”, who has recovered from anorexia nervosa, and is chair of the Ambassadors Council of the National Eating Disorders Association. I discovered Almost Anorexic while searching for books that would actually address my personal experiences with disordered eating. This book was the key to helping me to unlock and unearth what was probably my dirtiest not-so-secret secret. I call it this because it is not something that I am proud of and I have a great deal of shame and guilt surrounding the subject and while a few people know, I have never blatantly verbalized or acknowledged it publicly, so perhaps this is a revelation of sorts as well as a review on this helpful book.

People look to the DSM (Diagnostic and Statistical Manual of Mental Disorders) to know if they have a true problem, but while helpful, it also can be one of the biggest impediments to their actual healing if they can’t find themselves in the book. How do you properly treat your illness if you don’t feel you have a legit problem or it isn’t even recognized as one by professionals, family, or friends? This is one of the things that Almost Anorexic addresses. A lot of the reason people think that they don’t have a problem is because of the diagnostic criteria. Sadly, this can keep them from getting the help they really do need. If someone doesn't meet all the criteria for a disorder, they are typically diagnosed as EDNOS (Eating disorders not otherwise specified) or OSFED (Other specified feeding and eating disorders), which aren't even considered officially recognized eating disorders. I would have been in this group dubbed by some clinicians as “diagnostic orphans”. The point is all subclinical eating disorders are worthy of help.

I never became underweight which is required for an anorexia nervosa diagnosis but, like many other diagnostic orphans, I exhibited all of the same behaviors as someone diagnosed with anorexia nervosa. Had I taken the EAT-26 (Eating Attitudes) test back then, I'm sure it would have indicated I had a real problem. I also lost 35% of my body weight which actually WOULD get an anorexia nervosa diagnosis according to earlier versions of the DSM, which called for a weight loss of at least 25%. The DSM has changed since then a couple of times and is now on its 5th edition. In the newest edition I would be diagnosed as OSFED, atypical anorexia nervosa. Even though I gained all of the weight that I lost back after I stopped restricting on top of my intense exercise regime, I still carried many of these behaviors with me into my 30’s; I still struggle with the Binge/Purge pattern even in other areas of my life. Ed is still in my head and still has a big say in my daily life, whether I am fully aware of it or not. Awareness is half the battle. Eating disorders are behavioral disorders, and let’s face it...behaviors don’t just magically go away because you refuse to acknowledge them or time passes. There is still a residue. And while I am not currently dealing with full blown disordered eating anymore, I am still dealing with a lot of behavioral residue from the days when I was. I believe you need to acknowledge and change behaviors or you will unconsciously relive them repeatedly. You can’t change what you don’t acknowledge.

There is a drastic difference between healthy weight loss and an eating disorder. What I did in high school was not healthy and I know now that I most likely lost my gall bladder at the age of 16 because of how fast I lost the majority of the weight. I also know now that intense restriction is not a sustainable way to achieve weight loss...period. Restriction wasn't my only problem, though, as I also developed an obsessive relationship with exercise. Exercise is one of the best things you can do for your body, but not when you force your body to do it as a punishment when you haven't fed it anything for a week. I starved and abused my body, I desecrated my temple. My body didn't trust me anymore after this ordeal, and I am still working on regaining it's trust 20 years after the fact.

I was amazed by how much I found myself in this book, maybe not so much my current Self, but pieces of my Self, and especially that younger aspect of my Self. She was there in all of those pages. The book uses many case studies and personal anecdotes that I definitely found relatable. Almost Anorexic deals with the subclinical end of the eating disorder, while using stories from Jenni’s personal recovery to explain the obsessive relationship people can develop with food and exercise. It not only covers food related problems like binge eating and restricting, but also discusses compensatory behaviors and the highly important subject of body image. Dr. Thomas and Jenni discuss the physiological and psychological changes that occur in “almost eating disorder” syndromes. The second half of the book gives solutions and suggestions for recovery, and also includes helpful activities for you to do on your own, including identifying your social support network, and creating a personalized relapse prevention plan. An interesting exercise from Chapter 6 has you write two letters to your eating disorder, one as if it were a friend, and one as if it were a foe.


In my therapy, I have recently started to dive into this aspect of my story. I thought it would be helpful to "tell someone" as this book instructs. This secret casts a dark shadow on me and I am now working on bringing everything into the light. “For good and for real.” This book is a wonderful read for anyone who has had, has, thought they had, or may have an eating disorder. It is filled with an extensive amount of resources for help. I encourage anyone that thinks that they may have a problem with food and body image to read this book. I also encourage anyone who thinks that their loved one may have a problem with food to think about reading this book. I spent the majority of my life in a state of limbo, somewhere stranded in the middle of the spectrum. Almost recovered isn’t the same as fully recovered and while I’m almost there, I’m not going to settle for almost recovered anymore.

[Terri · Rating 5 out of 5]

I read this for one of my classes. It's a great read! It gets you thinking about diet culture and how entrenched we are in pursuing the unrealistic thin body ideal in relation to disordered eating. The eating disorder (ED) realm is so grey and people with disordered eating issues can have preoccupations with one thing while another person in a similar situation does not. ED and disordered eating is not clear cut.

I don't like the phrase "Almost Anorexia." It should be replaced with "disordered eating" since it's also referenced a bit with other types of ED in the book besides anorexia nervosa, such as bulimia nervosa, binge eating disorder, etc. Other than that, totally recommend!

[Meghan · Rating 4 out of 5]

A critical book for those who fall into the “gray area” of disordered eating, and are forgotten there. Written with great attention to inclusivity - case studies include men, women, LGBTQ folks, and people of many races and ethnicities. It’s certainly meant to be a starting point, and not an exhaustive dissertation on recovery from what they call “almost anorexia.” But it’s a great starting point.

[Marshall Praml · Rating 4 out of 5]

i read this book early into my eating disorder recovery. it shines an important light on how you don’t have to be a certain weight or have a diagnosis in order to work on your relationship with food. i learned a lot about my own beliefs about what an eating disorder is. i would recommend this book to folks who have an eating disorder, have a loved one with ANY eating disorder or disordered eating, and people who want to educate themselves. i will say it can be triggering at times but worth the read. also i read this a while ago but walked away with education and motivation to recover

[Izzy Gallanar · Rating 5 out of 5]

Okay, first of all: terrible, terrible, terrible title for this book—however it is part of a series called “the almost effect” so don’t let this deter you.

Incredibly insightful book for future clinicians, those who are interested in learning more, or for individuals worried about a loved one. So much information that can be utilized to support clients in challenging their ED and having compassion for their experience. Highly recommend!

[Vee · Rating 3 out of 5]

I am glad this book exists and I imagine a lot of people could find it validating or helpful for a loved one. I liked the worksheets and tables it presented. Not a lot of new information but information that is presented in an accessible format to read.

[Zhuo Zhang · Rating 5 out of 5]

Very helpful. As a support for my loved one, I desperately need some guidance on how to help.

[Kimberly · Rating 3 out of 5]

3.5

[Gabby Rao · Rating 4 out of 5]

Insightful read about how disordered eating that exists on a sub-clinical level can be just as devastating as clinically diagnosed eating disorders

[Denise Reed · Rating 5 out of 5]

Practical self-help book on overcoming eating disorder

[Chelsey Carroll · Rating 4 out of 5]

Read a long time ago and it was helpful

[Bree Taylor · Rating 5 out of 5]

Excellent book about food disorders that don't qualify as clinical anorexia.. a must read.

Review 6/19/19

After reading Life without Ed per my counselor's suggestion, something registered in me that I had read this author's work before. And so decided to give Almost Anorexic another read - 5 years later.

There is no question in my mind that I could easily be diagnosed with an eating disorder. I wouldn't be diagnosed anorexic or bulemic. I'm not the typical case. I always thought that I wasn't anorexic because I wasn't strong enough. Didn't have enough persistence. I liked food too much. I wasn't thin enough simply because I lacked the willpower. It's even tough to write about or discuss. Because here's the deal. I'm not a stick. My BMI doesn't list me as underweight. In fact, according to that totally antiquated measure, I'm overweight bordering on obese. So, how does a person with those weight issues qualify as almost anorexic?

Simple. My views on food and my body and how they are interrelated are out of the norm. I'm subclinical. In fact, when viewed through the EAT-26 test for eating disorders, I'm actually way off the charts. When looked at feelings in my life that are always there.... terror of being overweight, guilt after eating (even if it's healthy food), preoccupation with weight and size, food and size being a controlling factor in every decision I make. Not slightly, but every single decision. I wake up thinking about food for the day. I worry that people will see me eating cheesy puffs and think I'm a terrible person. Yes, a TERRIBLE PERSON. Because I ate ice cream. Or ramen. Or a latte. All of these things add up to a messed up view of food. There was even a time in my life that I avoided bananas and sweet potatoes because they were unhealthy. I'd rather drink a processed protein shake than eat something natural.

I'm in recovery. I'm working on it. In part due to the works of people like Jennifer Thomas and Jenni Schaeffer. These women, with this book, taught me that just because I'm not a clinical case of anorexia doesn't mean my views on food and size are normal. Their book provides a way out and validation. There's nothing strong or particularly wonderful about being strong and persistent enough to almost kill yourself from not eating or bingeing or purging. There's nothing sexy about being skin and bones. There's nothing to be gained from a preoccupation with food and the number on the scale.

There's everything to be gained from recovery and feeling amazing in your own skin. More people should read and be aware that eating disorders are more than just being as skinny as possible.

Think you have a problem? Think a loved one has a problem? This is an excellent starting point.

[locrian · Rating 4 out of 5]

This book covers a really important topic that is often ignored in psychology, the existence of patients whose symptoms do not quite meet diagnostic criteria yet who are nonetheless symptomatic. It provides an overview of the different types of eating disorders and disordered eating, possible causes and influencing factors, how they can be treated and what you can do about it. Recommended for anyone with any eating disorder symptoms, anyone worried about someone's possible disordered eating, or anyone interested in learning about eating disorders. This book should really be read by everyone because while reading it you will really realize how prevalent behaviors and beliefs symptomatic of eating disorders are and how strongly they are encouraged in western culture.

[Paula · Rating 4 out of 5]

Very interesting read regarding how you don't need to meet all the clinical criteria for a full blown eating disorder before you should (or deserve to) seek help. Disordered eating is dangerous and adversely impacts the lives of many--whether or not it progresses to a degree of severity that is clinically diagnosed.

[Benj · Rating 5 out of 5]

Was curious about ways I could be better about my attitudes and language choices for friends and acquaintances that have struggled with eating disorders, and ended up learning a ton!

[Katrin · Rating 4 out of 5]

Real good book! I even copied her pages for my use. Gave me things to think about.

[cold brew luvr 444 · Rating 4 out of 5]

Good book, uses both analytical and personable tones to keep readers engaged while conveying a serious and important message. Pushes reader to think deeper.

[Meghan · Rating 1 out of 5]

I didn't finish. I'm stretching to give it three stars.