In their eminently practical and reassuring Almost Anorexic: Is My (or My Loved One’s) Relationship with Food a Problem? authors Jennifer J. Thomas, PhD and Jenni Schaefer describe that broad range of people who do not have a full-blown eating disorder but who exhibit some symptoms of one. Despite the lack of dramatic and obvious symptoms, those who inhabit this gray zone on the health/illness continuum can nevertheless experience a great deal of anguish.

The person living with “almost anorexia” may obsessively count calories, eat the same meals every day as a way of restricting intake, or eat only at prescribed times. Bingeing and purging might occur occasionally, and the poor body image that often accompanies almost anorexia can be debilitating to one’s social life and happiness.

To get technical here for a moment, the majority of people with almost anorexia would fall into the latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5) category of OSFED, or “Other Specified Feeding and Eating Disorders.” Some of you might know it by its previous title EDNOS (the wonderful world of psychiatric acronyms is ever-inventive and evolving): Eating Disorders Not-Otherwise Specified.

After laying out the various guises that this sub-clinical condition, almost anorexia, can wear, Dr. Thomas and Schaefer describe how you can “kick Ed (your almost eating disorder) to the curb.” In her excellent book Life Without Ed: How One Woman Declared Independence from Her Eating Disorder and How You Can Too, Schaefer described how she named her eating disorder Ed, and learned to talk back to, ignore, and eventually banish Ed’s ceaseless negative chatter from her thoughts. The authors offer comebacks to Ed here, too, as well as insights into what “normal eating” looks like and how to cultivate it.

One of the most interesting aspects of the book is the authors’ description of how when both going into and coming out of a full-blown eating disorder you will inevitably go through a period of almost-anorexia limbo. In a chapter titled “Don’t Settle for Almost Recovered,” Dr. Thomas and Schaefer describe how tempting it is to consider yourself recovered without eliminating those last safety-blanket behaviors. They call this “pseudorecovery,”which can mean that you restrict, binge or purge just once in a while, loathe your body, or exercise primarily to maintain your weight (instead of for the health benefits and feeling of well being regular exercise imparts).

As Marcia and I tell readers in our book, full recovery from an eating disorders is possible. Dr. Thomas and Schaefer concur, encouraging readers to strive for that instead of settling for almost recovered. Why? They give many good reasons, but this quote, from Schaefer’s former dietitian, Reba Sloan, will have to suffice here: “Treating an eating disorder is like fighting a forest fire. We must put the entire fire out. If an ‘ember’ is still smoldering, there is a chance that the fire will be reignited.”

About the Authors

Marcia Herrin, Ed.D., M.P.H., R.D.

Marcia Herrin, Ed.D., M.P.H., R.D., is the founder of Dartmouth College's nationally renowned nutrition programs. Currently, Dr. Herrin conducts a private practice in Lebanon, NH.

Nancy Matsumoto

Nancy Matsumoto is a freelance journalist who has written numerous stories on health, eating disorders, and body image.

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