THE 2 TYPES OF ANOREXIA AND THEIR CHARACTERISTICS - ECONOMÍA - 2025

There are two types of anorexia with different symptoms: restrictive-type anorexia and purgative-type anorexia. "Anorexia" literally means lack of appetite, and it is a symptom that can occur alongside other illnesses, such as a cold.

However, when the person, far from presenting a lack of appetite, controls the intake to be slimmer, that is when we speak of anorexia nervosa. Many people think that the difference between anorexia nervosa and bulimia nervosa is that in the former, people simply restrict their eating, while the latter have constant bingeing and vomiting.

This is a misconception of the types of eating disorders, since there are two clearly differentiated types of anorexia nervosa.

As you will see later, a person with anorexia nervosa can also present vomiting, binge eating and other behaviors more related to the prototype of bulimia nervosa.

Types of anorexia nervosa

-Restrictive anorexia nervosa

It is the prototype that many people have in mind when talking about anorexia nervosa, in which girls lose their weight solely through physical exercise and excessive food restriction.

These people have enough self-control not to get carried away by their desire to eat excessively. In this way, it is not common for this type of anorexia to present bingeing and subsequent compensatory behaviors.

The characteristics that usually present are:

They are perfectionist people

These are girls who stand out in many ways: they are beautiful, successful, with abundant social and popular relationships and who achieve everything they set out to do.

They are very meticulous and spend a lot of time and effort getting everything done in the best possible way.

They are hyper-responsible

Those who have this type of anorexia nervosa, as we have mentioned, have extreme self-control, which allows them to deprive themselves of food even if they have a great desire to eat it. This same self-control manifests itself in other areas of your life, such as in studies or at work.

Anorexic girls of the restrictive type tend to present an impeccable academic record, which leads them to get a high job and in which they are given a lot of responsibility.

However, this occurs in those cases in which the disease has not evolved much or is in the early stages of the disorder, since later on, the girls usually present an academic or work deterioration, since the disease deteriorates practically all the areas of your life.

Behavioral rigidity

Lack of spontaneity is another common feature of this subtype of anorexia nervosa. As we have discussed before, girls have excessive control over themselves, which they carry out at the expense of enjoyment and fun.

Thus, these types of people are more concerned with showing appropriate behavior to others than with enjoying and having fun at parties or other social events.

Feelings of ineffectiveness

Despite everything we've discussed above about perfectionism, hyper-responsibility, etc., these girls feel like they have to try harder to achieve perfection.

When they make a mistake or mistake, they classify it as excessively unpleasant and unbearable, negatively affecting their self-esteem. They are never considered good enough, due to their high capacity for self-criticism.

These feelings of personal ineffectiveness also occur because they are often compared to the people around them, as if they are constantly competing.

-Purgative-type anorexia nervosa

People with this subtype of anorexia nervosa are also underweight in terms of their body characteristics.

However, unlike the previously mentioned subtype, people with purgative anorexia nervosa carry out binges that are usually followed by compensatory behaviors - self-induced vomiting, ingestion of laxatives, diuretics, etc.-.

This is the reason why it has also been called bulimic-type anorexia nervosa. Remember that the difference between this disease and bulimia is that people do not suffer from underweight.

For the rest, this subtype of bulimia has many similarities with bulimia nervosa (especially in relation to the personality characteristics of the people who suffer from it).

The specific characteristics of this purgative subtype are the following, mainly:

Cases of obesity in the family

In the subtype of anorexia nervosa that we are describing, it is common for people who suffer from it to have relatives who have had or are obese.

Premorbid overweight

Girls with purgative anorexia nervosa are also frequently found to have been overweight in the past, which has influenced the individual to present with an eating disorder today.

Frequent dysthymic reactions

This characteristic refers to the fact that people tend to have a depressed, listless or discouraged mood. It can also occur, in some people, in the form of irritability.

On numerous occasions, they state that they find it difficult to enjoy the small pleasures of everyday life.

Emotional lability

This particularity refers to the fact that people with this type of anorexia nervosa tend to be very emotionally unstable. They often experience feelings of sadness and emptiness that alternate with feelings of euphoria.

The lability or sudden changes in the emotional aspect are reflected in the eating behaviors that they carry out, so they often lose control over themselves, just as they cannot control their emotions.

Here we find, therefore, a fundamental difference with respect to the restrictive type of anorexia, in which they had high self-control.

Comorbidity with other addictive behaviors

In the purgative subtype, there are often cases in which this addiction to food is accompanied by other addictions, such as alcohol, tobacco, other substances, etc.

As you can see, the subtypes of anorexia nervosa share some characteristics -such as causes, low weight, etc.-, although they also have numerous differences.

What is anorexia nervosa?

The main characteristic of anorexia nervosa is an interest in continuing to lose weight, even though they are below their ideal weight.

Other criteria already mentioned must also be met, such as amenorrhea in women - absence of at least 3 menstruation cycles - or delayed menarche in prepubertal girls.

An intense fear of gaining weight and a severe alteration in body image are also characteristics that must be present to diagnose an anorexia nervosa disorder.

It is, therefore, a serious mental illness that tends to wreak havoc on the body, due to the starvation suffered by these people. Among the physical symptoms that can occur among people with anorexia nervosa, the most striking are:

• Bradycardia That is, a decrease in heart rate, which can be below 60 beats per minute.
• Hypotension, or excessive drop in blood pressure.
• Lanugo hair growth. It refers to the very fine hair that appears on unusual parts of the body, such as the back, when there is an absence of fat. Fetuses have this type of hair, whose function is to isolate the body and protect it.
• Edema. Fluid retention may occur in some part of the body.
• Alterations in the skin. Like dry skin.

Causes

It is a multifactorial disease, caused by various factors: psychological, biological, socio-cultural, etc. Below we will explain some of the main causes that enhance the appearance of anorexia nervosa:

Family characteristics

Belonging to a controlling, perfectionist family, in which the mother takes control of the daughter's life, are triggers for this disorder.

Likewise, this eating behavior disorder has always been more related to the relevance to an upper-middle class family, although in recent years an increase can be observed in all social classes.

Influence of genetics

According to the latest studies, it seems that anorexia nervosa may have more genetic factors than previously thought.

It has been found, for example, that the concordance rate between monozygotic twins is 70% (70% of identical twin siblings coincide in the presence or absence of the disorder), while there is only a concordance rate in dizygotic twins. 20%.

According to some studies, various genes could be involved - in addition to other types of factors - that would influence the appearance of this disease, especially chromosome 1.

Psychological factors

Some of the psychological triggers that most often influence the onset and progression of this disease are:

• Low self-esteem.
• Feelings of personal inefficiency and social imbalance.
• Emotional problems: depression, anxiety, loneliness, etc.
• Fear of growing up.
• Desire for maternal independence.

Socio-cultural factors

Today's society attaches great importance to physique, especially in the case of women, who are perceived as more successful people and with greater positive qualities when they have a slim figure.

This social pressure is very present at the onset of eating diseases, since the girls are assimilating this idea and begin to give excessive importance to the physical.

Thus, it is found that girls are the ones who present the most problems in relation to eating, especially in the ages between 10-30 years - these ages vary according to specific eating behavior disorders.

Course and prognosis of anorexia

Both the course of this disease and its prognosis are highly variable, since it depends on multiple factors, as has already been seen. A close follow-up of the patient and an early age of onset of the disorder are considered favorable elements for recovery.

On the other hand, some of the factors that worsen the prognosis are:

• Presence of vomiting
• Use of laxatives, enemas or other substances that compensate for excess feeding.
• Obsessive-compulsive personality disorder.
• Chronicity of the disease.

In addition, we found that, unfortunately, between 5 and 25% of cases in which they present anorexia nervosa end in death - the majority due to malnutrition or its consequences, although in other cases they are caused by suicidal behavior.

References

1. García-Camba, E. (2001). Advances in eating disorders: anorexia nervosa, bulimia nervosa, obesity. Masson.
2. López, CM, & Pediatría, B. (2012). Eating disorder.
3. Madruga Acerete, D., Leis Trabazo, R. and Lambruschini Ferri, N. Eating behavior disorders: Anorexia nervosa and bulimia.
4. Sánchez, KG, Velilla, P., Jiménez, V., & Zaragozano, JF (1999). Eating disorder. Medicine, 7 (132), 6234-6239.