What is the restricting type of anorexia?

No items found.
No items found.

Anorexia nervosa (AN) is a serious eating disorder, which involves an intense fear of weight gain, combined with restricted food intake. Individuals with this disorder are so restrictive with their diets that they can become dangerously underweight and malnourished, leading to serious psychological and physical long term health consequences. (1) 

When people imagine anorexia nervosa, they often picture someone who consumes very little food and subjects themselves to starvation. While this can be characteristic of some cases of anorexia, there are multiple subtypes of the disorder. Anorexia nervosa restricting type describes someone who restricts their food intake without binging or purging within the last three months. The other main category of AN is the binging/purging type in which the individual overeats and then compensates by restricting or “purging”. (1)

While both subtypes fall on the spectrum of anorexia nervosa, there are many differences between the two. Here, learn about the specifics of anorexia nervosa restricting type.

Last updated on 
In this article

Characteristics of anorexia nervosa, restricting type

Individuals who meet diagnostic criteria for anorexia nervosa show a fear of weight gain and resulting changes to their eating pattern, regardless of subtype. What is different about anorexia nervosa restricting type, is that people with this form of anorexia do not have regular episodes of binging and/or purging. They simply restrict their food intake on a chronic basis. 

A 2016 study found that individuals with restrictive anorexia nervosa tend to have a lower body mass index and are less likely to use diet pills when compared with the binge/purge subtype. (2) Another study found that those who have the restricting subtype of AN are more likely to have medical complications related to being underweight, such as lower bone mineral density, liver problems, and low blood sugar levels. (3) The chronic undereating that occurs with restrictive AN can lead to malnutrition and a host of related health problems.

Transitioning to binging/purging subtype from restricting subtype 

There are some differences between the binging/purging and restricting subtypes of anorexia, but individuals who live with anorexia may transition from one subtype to another. A study in the International Journal of Eating Disorders found that it is common for people to move from anorexia nervosa restricting type, to the binge/purge type. Conversely, it seems based on this study that it is not as common for people to transition from the binge/purge to the restricting subtype, although certainly possible. (4) This is likely because chronic food restriction actually drives people to binge in order to compensate for the deprivation from undereating.

A study in The Journal of Clinical Endocrinology & Metabolism found that individuals with AN restricting type tended to have higher levels of the hunger hormone ghrelin (5). Over time, severe food restriction can lead to compensatory binges because of increased levels of ghrelin. A person who is deprived and undernourished from prolonged restrictive AN may therefore begin to engage in regular binge episodes, and thus transition to the binge/purge subtype. This can quickly become a cycle, in which they restrict food for a period of time, binge when their appetite becomes ravenous, and then return to restricting because of guilt over the binge. These cycles can be difficult to overcome.

You might be interested in

Treatment for anorexia nervosa

Regardless of whether it is the restricting or the binge/purge subtype, AN requires treatment from medical professionals. In treatment for anorexia nervosa, people can overcome underlying psychological issues that have led to eating disorder behaviors, learn ways to challenge unhealthy thinking patterns, and develop a healthier relationship with food.

If you’re living with AN restricting subtype, or another eating disorder, support is available. A team of treatment professionals can help you to move beyond the grips of the eating disorder and develop healthy patterns of eating that nourish your body and allow you to live a healthier, happier life.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Resources

  1.  Substance Abuse and Mental Health Services Administration. (2016, June). DSM-5 changes: Implications for child serious emotional disturbance. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t15/
  2. Peterson, C.B., Pisetsky, E. M., Swanson, S.A., Crosby, R.D., MItchell, J.E., Wonderlich, S.A., Le Grange, D., Hill, L., Powers, P., & Crow, S.J. (2016). Examining the utility of narrowing anorexia nervosa subtype for adults. Comprehensive Psychiatry, 67, 54-58. https://doi.org/10.1016/j.comppsych.2016.02.010
  3. Rylander, M., Brinton, J.T., Sabel, A.L., Mehler, P.S., & Gaudiana, J.L. (2017). A comparison of the metabolic complications and hospital course of severe anorexia nervosa by binge-purge and restricting subtypes. Eating Disorders: The Journal of Treatment & Prevention, 25(4), 345-357. https://doi.org/10.1080/10640266.2016.1269555
  4. Peat, C., Mitchell, J.E., Hoek, H.W., & Wonderlich, S.A. (2009). Validity and utility of subtyping anorexia nervosa. International Journal of Eating Disorders, 42(7), 590-594. https://doi.org/10.1002/eat.20717
  5. Germain, N., Galusca, B., Grouselle, D., Frere, D., Billard, R., Epelbaum, J., & Estour, B. (2010). Ghrelin and obestatin circadian levels differentiate binging-purging from restrictive anorexia nervosa. The Journal of Clinical Endocrinology & Metabolism, 95(6), 3057-3062. https://doi.org/10.1210/jc.2009-2196

FAQs

Further reading

Thumbnail image of an article

Differences between anorexia and anorexia nervosa

The two terms “anorexia” and “anorexia nervosa” have different meanings. When...
Thumbnail image of an article

How does anorexia nervosa affect mental health?

Anorexia nervosa (AN) is an eating disorder that leads to a fixation on...
Thumbnail image of an article

What is the restricting type of anorexia?

Anorexia nervosa restricting type describes someone who restricts their food intake...
Thumbnail image of an article

What is acute anorexia?

Acute anorexia nervosa is the most advanced stage of anorexia nervosa, which is...
Thumbnail image of an article

What causes anorexia nervosa?

Anorexia nervosa (AN) is a very serious eating disorder, second only to opioid use as the...
Thumbnail image of an article

What are the long term effects of anorexia?

In individuals with anorexia nervosa (AN), some may experience its effects in the...
Thumbnail image of an article

The limitations of diagnosing anorexia with BMI

Body mass index (BMI) is a way of measuring a person’s weight compared to their height...
Thumbnail image of an article

The dangers of anorexiant diet pills

Anorexiant diet pills have increased dangers for those with an eating disorder. There...
Thumbnail image of an article

Signs you need treatment for anorexia nervosa

There are many anorexia health risks, which present as symptoms and signs of...
Thumbnail image of an article

Signs and symptoms of anorexia nervosa

Anorexia nervosa (AN) is a serious illness that may manifest in several ways...
Thumbnail image of an article

Is anorexia genetic?

For decades, many assumed anorexia nervosa (AN) was a psychosocial illness...
Thumbnail image of an article

Identifying anorexia risk factors

Eating disorders, specifically anorexia nervosa (AN), are complex and serious...
Thumbnail image of an article

Is anorexia a disease?

Anorexia nervosa (AN) is not a disease. A disease is when there is a harmful change in...
Thumbnail image of an article

How to help someone with anorexia nervosa

If you’ve found yourself on this page, it’s likely because someone in your life has...
Thumbnail image of an article

How does anorexia nervosa develop?

Anorexia nervosa (AN) is a serious eating disorder that involves caloric restriction...
Thumbnail image of an article

Hidden characteristics of anorexia nervosa

Anorexia nervosa (AN) is one of the most widely-known types of eating disorders, but...
Thumbnail image of an article

Harmful outcomes of the pro-ana movement

Imagine that there were websites that encouraged people not to get treatment for...
Thumbnail image of an article

Examining the anorexia death rate

Eating disorders are routinely cited as being among the most lethal mental health...
Thumbnail image of an article

Early warning signs of anorexia nervosa

Facing an eating disorder, like anorexia nervosa (AN), in your own life or that of a...
Thumbnail image of an article

Can you have mild anorexia?

“Mild anorexia” is not currently a diagnosis in the Diagnostic and Statistical...
Thumbnail image of an article

Can anorexia nervosa be cured?

Anorexia nervosa (AN) is a serious, and, unfortunately, sometimes deadly disorder. But...
Thumbnail image of an article

Anorexia nervosa recovery tips

Once you have been through treatment for anorexia nervosa (AN), it’s so important...
Thumbnail image of an article

Anorexia nervosa statistics: Gender, race and socioeconomics

When examining anorexia statistics, or eating disorder rates in general, the results...
Thumbnail image of an article

What is anorexia nervosa (AN)?

More than 28 million Americans, or roughly 9% of the population, will experience...