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.
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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.