Stigmatization of Anorexia Nervosa Versus Atypical Anorexia Nervosa: An Experimental Study

Stigmatization of anorexia nervosa (AN) includes paradoxical attributions of both personal responsibility and feelings of admiration. Despite comparable severity to AN, atypical AN (i.e., meeting all criteria for anorexia nervosa without having low weight) is perceived as a less serious illness. While stigmatization has been compared across eating disorders and within a single eating disorder diagnosis (i.e., varying severity of a specific eating disorder), there are no investigations of how stigmatization may compare across full and subthreshold presentations. The present study experimentally tested the stigma associated with AN versus atypical AN and hypothesized that atypical AN may be associated with greater stigma because individuals do not meet the low-weight criterion. One hundred participants (77.9% female, M-age = 19.06, M-BMI = 23.34) were randomly assigned to read either a vignette describing a female with AN or a vignette describing a female with atypical AN. Following the vignette, participants completed measures of eating disorder stigma. Hypotheses were tested using univariate analysis of covariance (ANCOVA). Participants randomized to the atypical AN condition assigned the target significantly greater levels of overall stigma (p = .037) and illness controllability (p = .031) than participants in the AN condition; however, there were no significant differences across conditions in assignments of selfishness/vanity (p = .094) or illness trivialization (p = .050). Individuals with atypical AN may be viewed as having a more controllable illness than individuals with AN, underscoring the complexity of AN stigmatization, particularly for nonprototypical presentations.