Different types of anorexia nervosa
In fact, there are two main subtypes of anorexia nervosa:
- Restricting type AN
- Binge/purge type AN
Binge/purge anorexia nervosa is actually similar to bulimia nervosa (BN) or some types of binge eating disorder (BED). This subtype involves periods of binge eating, followed by the use of various purging methods, such as self-induced vomiting, as compensatory behavior.1
Anorexia nervosa restricting type describes someone who restricts their food intake without binging and purging—or, more specifically, someone who engages in these restrictive behaviors without resorting to binging and purging in 3 months or more.1
Instead, people who struggle with this restrictive food intake disorder will severely limit their diet or food intake, though sometimes people with restrictive type AN use other methods to limit the impact of food on their bodies, including laxative and enema misuse and excessive exercise.1
Characteristics of anorexia nervosa, restricting type
Individuals who meet the diagnostic criteria for anorexia nervosa of any type exhibit a fear of weight gain and disturbed eating and behavioral patterns connected to this fear.
What is different about anorexia nervosa restricting type is that people with this form of AN primarily prevent weight gain from restricting their food intake. They may engage in several other maladaptive behaviors, but they will not engage in binging and purging.
There may also be some other subtle differences in how this subtype presents.
The chronic under-eating, and accompanying significant weight loss, that occurs with restrictive type AN can also lead to malnutrition and a host of related health problems.
Binging/purging vs. restrictive subtypes
Those with one type of AN don't necessarily always exhibit the symptoms of that type. It's also possible for individuals with anorexia nervosa to transition from one subtype to the other.
A study in the International Journal of Eating Disorders found that it is common for people to move from restrictive anorexia nervosa to the binge/purge type. And while the results showed that it is not as common for people to transition from the binge/purge to the restricting subtype, that change is certainly still possible.4
One possible reason behind this is the hunger that can build from periods of chronic food restriction, driving people to binge in order to compensate.
A study in The Journal of Clinical Endocrinology & Metabolism found that individuals with AN restricting type tended to have higher levels of ghrelin, a hormone responsible for signaling hunger.5 These increased ghrelin levels could lead to binging episodes, which could, in turn, be followed by a compensatory purging, eventually developing into a regular cycle and thus starting the transition to the binge/purge subtype.
Treatment for anorexia nervosa
Regardless of which subtype it presents as, anorexia nervosa requires treatment from a mental health professional to overcome.
In treatment for anorexia nervosa, someone can work through any underlying psychological issues that may be driving or maintaining an unhelpful eating pattern, learn ways to challenge unhealthy thinking patterns, and develop a healthier relationship with food and themselves.