by Alison Swiggard, MS, RDN, LD
“If I’m not underweight, is it even that bad?”
“I eat sometimes. It’s not like I’m starving myself.”
“They said I’m ‘fine’ because my labs look normal.”
These are not just thoughts. They are internalized echoes of a culture that equates severity with thinness, urgency with malnourishment, and worthiness of care with physical evidence. But disordered eating doesn’t always show up in ways that are visible, measurable, or dramatic. And yet, it still hurts. It still steals.
Subclinical Doesn’t Mean Sub-Important
Disordered eating exists on a spectrum. Many people engage in harmful behaviors around food and body without meeting the full criteria for an eating disorder. These subclinical patterns can still cause deep psychological distress and physical consequences.
In fact, one study found that nearly 50% of college-aged women report disordered eating behaviors, including skipping meals, fasting, purging, and using diet pills, but most do not meet diagnostic criteria for an eating disorder (Eisenberg et al., 2011).
Despite this, less than 20% of people with eating disorders ever receive treatment (Hart et al., 2011). Many are told their symptoms aren’t “bad enough.” Others don’t even realize that what they’re experiencing is serious.
When you are dismissed, you start to dismiss yourself.
Weight stigma further complicates who gets seen and who gets silenced. In a society that still glorifies thinness and pathologizes fatness, people in larger bodies often have their disordered behaviors overlooked, or worse, encouraged.
Research shows that individuals in higher-weight bodies are significantly less likely to be diagnosed with an eating disorder, even when presenting with the same symptoms as thinner peers (Becker et al., 2009).
This means someone could be severely restricting, obsessively exercising, or purging, but if they’re not underweight, they’re often praised for “taking care of themselves.”
And yet, atypical anorexia (AN without low weight) can be just as medically serious as classic anorexia nervosa. Studies show that those with atypical anorexia may experience the same bradycardia, electrolyte imbalances, and psychological distress, despite being in “normal” or higher-weight bodies (Sawyer et al., 2016).
The truth is: when the world doesn’t reflect your reality, you start to question your own. That inner voice, the one that says “I should be fine” or “Other people have it worse”, isn’t helping you heal. It’s keeping you stuck.
Healing starts by believing yourself.
Early intervention matters. Disordered eating that goes untreated doesn’t usually go away on its own; it deepens. It gets louder. And it takes more to untangle later.
You don’t need to be underweight.
You don’t need a diagnosis.
You don’t need to wait until it gets worse.
If food and body thoughts are taking up space in your brain and crowding out joy, connection, or peace, you deserve care.
If you’re questioning whether you’re “sick enough,” that may be reason enough to reach out. You deserve support, no matter where you fall on the spectrum. To find a provider who understands, visit the Providers tab on this website and connect with someone who can help.
About the Author
Alison Swiggard, MS, RDN, LD, is a registered dietitian at CV Wellbeing, a nutrition practice offering eating disorder treatment and intuitive eating support across Maine and New England. She has been a member of the Eating Disorders Association of Maine (EDAM) since 2022. She specializes in eating disorder recovery, intuitive eating, and trauma-informed care, with a focus on supporting neurodivergent (ADHD, autistic) and LGBTQ+ individuals. Learn more at www.cvwellbeing.com.
