Anorexia nervosa restricting type is a subtype of anorexia nervosa that involves restricting food intake without bingeing or purging. Some people who have this subtype also exercise excessively.

Anorexia nervosa is an eating disorder involving an overwhelming fear of gaining weight, a distorted body image, and the consumption of fewer calories than a person’s body needs. All this typically leads to weight loss and can cause a person to have a low body weight.

There are two subtypes of anorexia: restricting type and binge eating/purging type. Binge eating/purging type includes episodes of overeating followed by self-induced vomiting or misuse of laxatives, as well as restriction of food intake.

This article further explains anorexia nervosa restricting type. It discusses the symptoms, causes, and treatment for the condition. Finally, it goes over how anorexia can affect the body.

This article also includes personal stories from Sarah Ezrin about her journey with anorexia nervosa restricting type.

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Anorexia nervosa is an eating disorder that involves:

  • weight loss
  • trouble maintaining a typical body weight for one’s height, age, and stature
  • an unfavorable view of the appearance of one’s body, in most cases

According to the American Psychiatric Association (APA), anorexia has the greatest mortality rate of any mental health condition aside from opioid use disorder. It can be quite a serious condition.

The restricting subtype of anorexia nervosa involves fasting, dieting, and exercising excessively, all of which can lead to weight loss. Unlike those with the binge eating/purging subtype, people with the restricting subtype do not generally engage in overeating or purging behaviors.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), a person has the restricting subtype if they have anorexia nervosa and have not regularly experienced episodes of binge eating or purging in the last 3 months.

Read more about anorexia nervosa.

Sarah’s Story: The beginning

“I was 9 years old when I took diet pills for the first time. My mum was doing this diet system where you supplemented shakes for meals and took pills (which we later learned had Ephedra!) for appetite suppressants. I did that on and off for a year.

As a preteen, I’d go through periods where I’d eat less food and calories throughout the week, but it always led to a bounce-back binge.

It was in college, when I turned 20, that I got serious about my calorie counting, and I dropped down to 98 lbs (around 7 stones, I’m 5 foot 9 inches). At one point I was eating less than 1000 calories a day.”

Note: Ephedra is a plant that includes the compound ephedrine, which can be used in medications. Up until 2004, when the Food and Drug Administration (FDA) banned its use, ephedrine was added to weight loss pills in the belief that it would boost metabolism, increase fat loss, and aid in weight loss. However, it was shown to have negative effects, including seizure, heart attack, and stroke, on the people who used it, leading to its ban in the United States.

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There are certain signs and symptoms of anorexia nervosa, although these may vary from person to person. Common signs include:

  • severely restricted eating
  • emaciation, or extreme thinness
  • persistent efforts to become thin
  • refusal to maintain an appropriate weight for their height
  • fear of gaining weight
  • an inaccurate view of the appearance of one’s body
  • a reliance on perceptions of body shape and weight for self-esteem
  • a denial of the severity of their low body weight

Other possible signs include:

  • preoccupation with food
  • fixation on diets or calories
  • a tendency to hoard, conceal, or waste food
  • a tendency to collect recipes
  • preparation of elaborate meals for other people

Health experts estimate that 50–70% of people with anorexia restrict their food intake without overeating or purging.

Learn more about the signs of an eating disorder.

While health experts do not know the exact cause of anorexia nervosa, certain factors may increase a person’s risk of developing the condition.

These risk factors include:

  • Sex: Females are more likely than males to develop anorexia.
  • Societal pressures: Certain cultures view obesity as unhealthy and unattractive, placing pressure on people to be thin. In the United States, more than 50% of females who have not yet gone through puberty restrict their food intake or make other efforts to manage their weight.
  • Past behaviors: People with a history of dieting or an excessive concern about weight may be more likely to develop anorexia.
  • Age: People ages 13–17 are more likely to develop an eating disorder. However, eating disorders can begin at any age.
  • Genetics: Eating disorders, including anorexia, can run in families.

Complete recovery from eating disorders such as anorexia nervosa is possible. It is important to seek help for these conditions as early as possible, as they can lead to other medical complications and may increase a person’s risk of experiencing suicidal thoughts.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Treatment for anorexia of any type typically includes:

  • psychotherapy
  • nutritional counseling
  • medical care and monitoring
  • medications

Learn more about treatment for anorexia.

Sarah’s Story: Treatment

“It was recommended that I be admitted into the hospital for in-patient because my weight had gotten so low, but we lived in Los Angeles at the time, and one of the foremost experts on eating disorders had an outpatient clinic at UCLA, so I convinced my parents I would do better staying at home and going there.

I went there multiple times a week. I also started treatment with a psychiatrist who prescribed me Prozac, which was very helpful during the refeeding process. Prozac is one of the few SSRIs with low weight gain associated with it, and it’s very helpful.

With food obsession, I also started to work with a nutritionist a few times a week who helped me start to eat properly again. It was a long road, and honestly, even now, 20 years later, I still don’t consider myself fully recovered. I think “once an anorexic, always an anorexic,” even if I’m not currently active in my ED.”

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Anorexia can have various effects on a person’s body, including:

  • stomach pain
  • abnormal laboratory results such as:
    • low iron levels (anemia)
    • low hormone levels
    • low thyroid levels
    • low blood cell counts
    • low potassium
  • slow heart rate
  • dry skin
  • dry, brittle nails
  • dizziness and fainting
  • irregular menstrual cycles
  • impaired immune functioning

Read more about the long-term effects of anorexia.

Sarah’s Story: Anorexia Affects

“I always felt zoomy and tingly, like I was stoned even though I was sober. There was this feeling of disassociation like I was watching the whole world behind Teflon.

I stopped getting my period for years, and my face and body started to get furry. We did a bone scan when I was at my sickest, and there were signs of osteopenia in my hip. I’ve never rechecked it.

My iron levels were always low, but most of my other blood work was “normal” which I took to mean I could get away with this lifestyle longer. I felt winded and tired, but I was also smoking cigarettes at the time, which I’m sure didn’t help matters.”

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The following are some questions people frequently ask about anorexia nervosa.

What are two subtypes of anorexia nervosa?

The two subtypes of anorexia nervosa are restricting type and binge eating/purging type. The main difference is that a person with the restricting type does not engage in overeating or purging behaviors.

What is the primary difference between anorexia nervosa and avoidant restrictive food intake disorder?

Both anorexia nervosa and avoidant restrictive food intake disorder (ARFID) involve restricting food intake. However, in ARFID, the reasons for restriction are not related to weight, body shape, or size.

People with ARFID avoid certain foods or types of foods for various reasons, such as sensitivities to the taste, smell, texture, or appearance of certain foods. They may have had a distressing experience with food or may not recognize that they are hungry in the same way other people do.

Help is available

Eating disorders can severely affect the quality of life of people living with these conditions and those close to them. Early intervention and treatment greatly improve the likelihood of recovery.

Anyone who suspects they or a loved one may have an eating disorder can contact the National Alliance for Eating Disorders, which offers a daytime helpline staffed by licensed therapists and an online search tool for treatment options.

For general mental health support at any time, people can call the Substance Abuse and Mental Health Services Administration 24 hours a day at 1-800-662-4357 (or 1-800-487-4889 for TTY).

Many other resources are also available, including:

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Anorexia nervosa is an eating disorder that involves restricting food intake due to the fear of gaining weight. There are two subtypes of anorexia: restricting type and binge eating/purging type. The difference between the two types is that people with restricting type do not engage in overeating or purging.

A person with anorexia nervosa should seek care from a healthcare or mental health professional. Early treatment is important because anorexia can lead to medical conditions, mental health conditions, and suicidal thoughts and can have long-term effects.

Treatment includes a combination of psychotherapy, medical care and monitoring, nutritional counseling, and medications.