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There are two main subtypes of Anorexia Nervosa which are distinguished by the presence or absence of regular binge eating or purging. The Restricting Type of Anorexia Nervosa is characterized by weight loss via restriction, dieting, fasting, and or/excessive exercise. During the current episode of Anorexia Nervosa there is no evidence of regular binge eating and/or purging.
The Binge Eating/Purging Type, on the other hand, includes all of the features of Anorexia Nervosa (restriction, low weight, fear of fat, etc.) and involves regular binge eating or purging throughout the current eating disorder episode. Binge eating is characterized by a loss of control during the consumption of an objectively large amount of food. Cognitive theories of binge eating theorize that it is the chronic restriction and strict dietary rules that leads to binge eating when a rule is broken.
Purging refers to the attempts to rid the body of calories consumed via vomiting, laxative use, diuretics, or enemas. The binge episodes are reinforced by the purging. Typically, once a cognitive dietary rule is broken, an individual with the binge eating/purging subtype will have already made up their mind that they are going to purge, giving permission to overeat to extremes. Some individuals in this category will engage in purging without having had an objective binge episode. For example, they may engage in self-induced vomiting after eating one bowl of cereal or they may regularly abuse laxatives while at the same time maintaining a severely restricted diet.
Some prominent eating disorders researchers and clinicians, such as Christopher Fairburn at Oxford University, have proposed taking a transdiagnostic view of all eating disorders when administering treatment. This approach considers the core features of all eating disorders to be related regardless of specific diagnostic category
Article by Lindsey Ricciardi, Ph.D
|Lindsey Ricciardi, Ph.D., is a licensed clinical psychologist specializing in eating disorders and obesity. She is the Behavioral Services Director of MindBody Bariatrics and the Clinical Director for Center for Change, both in Las Vegas, NV. She has recently co-authored a book, Obesity Surgery: Stories of Altered Lives, with Marta Meana, Ph.D.|
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