Key Takeaways

• Anorexia nervosa is one eating disorder diagnosis with two DSM-5-TR subtypes: restricting type and binge-eating/purging type. 
• These subtypes describe patterns of behavior and do not indicate how serious an eating disorder is. 
• A person's anorexia symptoms and subtype can change over time. 
• Terms such as acute anorexia, anorexia athletica, atypical anorexia nervosa, and chronic anorexia nervosa are not additional official subtypes. 
• Treatment should be individualized according to medical, nutritional, behavioral, and psychological needs rather than subtype alone. 
  

Wondering if you may be experiencing symptoms of anorexia? Take our anorexia quiz to learn more.

Are There Different Types of Anorexia?

Yes, there are two recognized subtypes of anorexia nervosa, but there is only one diagnosis of anorexia nervosa. The DSM-5-TR distinguishes between restricting type and binge-eating/purging type based on the behaviors a person has experienced during a specified period. 

With the restricting type, weight loss occurs primarily through dieting or fasting, without recurrent binge-eating or purging episodes during that period. With the binge-eating/purging type, the person has experienced recurrent episodes of binge eating, purging, or both. 

These distinctions help clinicians describe someone's current presentation and identify behaviors that may need to be addressed in treatment. They are not rankings of severity. Either presentation can have serious physical and psychological consequences. 

You may also see "type" or "subtype" used more loosely when discussing anorexia. Terms such as acute anorexia, anorexia athletica, and chronic anorexia may describe particular circumstances or symptom patterns, but they are not additional DSM-5-TR subtypes. 

Atypical anorexia nervosa is also not a subtype of anorexia nervosa. It is classified within other specified feeding or eating disorder (OSFED). 

The Two Types of Anorexia Nervosa

The two anorexia nervosa subtypes describe different patterns of eating disorder behaviors. Although there are distinctions between them, both involve the core features of anorexia nervosa and can result in significant medical, nutritional, and psychological consequences. 

A clinician considers a person's current and recent behaviors when determining which subtype most accurately describes their presentation. 

Anorexia Nervosa, Restricting Type

With anorexia nervosa, restricting type, weight loss is accomplished primarily through behaviors such as: 

• Restricting the amount or types of food consumed 

• Following increasingly rigid food rules 

• Dieting or fasting 

• Skipping meals 

• Other behaviors intended to prevent weight gain 

Someone with the restricting type has not regularly engaged in binge-eating or purging behaviors during the period used to determine their current subtype. 

Restriction can take many forms and is not always obvious to other people. For example, someone may eliminate particular food groups, progressively reduce portions, create strict rules about when they are allowed to eat, or avoid situations where they cannot control what food is available. 

Excessive exercise may also accompany restriction. Exercise may feel rigid, driven, or difficult to stop, even when someone is exhausted, injured, ill, or medically advised to rest. 

Importantly, excessive or compulsive exercise is not exclusive to restricting-type anorexia. It can occur with either presentation and should be assessed as part of the person's overall eating disorder symptoms. 

Anorexia Nervosa, Binge-Eating/Purging Type

With anorexia nervosa, binge-eating/purging type, a person has experienced recurrent episodes of binge eating, purging, or both during the relevant period. 

Purging behaviors may include: 

• Self-induced vomiting 

• Misuse of laxatives 

• Misuse of diuretics 

• Other behaviors intended to compensate for eating 

Some people experience both binge-eating and purging episodes, while others may purge without binge eating. 

The presence of binge-eating or purging behaviors does not automatically mean someone has bulimia nervosa. Anorexia nervosa and bulimia nervosa are distinct eating disorder diagnoses with different diagnostic criteria. A clinician evaluates the person's full pattern of symptoms rather than identifying the diagnosis from one behavior alone. 

This distinction is one reason a comprehensive eating disorder assessment is important. Restriction, binge eating, purging, and exercise behaviors can overlap across eating disorder diagnoses, and determining the appropriate diagnosis requires looking at the complete clinical picture. 

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How Anorexia Nervosa Presentations Can Change Over Time

Anorexia nervosa does not always look the same throughout the course of the illness. A person who primarily restricts food at one point may later experience binge-eating or purging behaviors, while someone with a history of those behaviors may later present primarily with restriction. 

For that reason, a subtype should not be treated as a permanent identity or a prediction of how someone's eating disorder will progress. Clinicians assess current behaviors alongside the person's broader eating disorder symptoms, physical health, nutritional status, and psychological needs. 

Symptoms can also shift during treatment and recovery. A reduction or change in one behavior does not necessarily mean the eating disorder has resolved. Other thoughts, symptoms, or behaviors may remain active and still require care. 

Ongoing assessment allows a treatment team to recognize these changes and adjust care accordingly. The goal is to treat the whole eating disorder and the individual experiencing it, rather than focusing only on a subtype label. 

Other Terms Associated With Anorexia

You may encounter several terms that include the word "anorexia" or are commonly discussed alongside anorexia nervosa. These terms do not all describe official subtypes of anorexia nervosa, and understanding the differences can help reduce confusion when researching eating disorders. 

Acute Anorexia

Acute anorexia is not a separate DSM-5-TR diagnosis or official subtype. The term may be used descriptively to refer to an active or severe presentation of anorexia nervosa, particularly when someone is experiencing significant eating disorder symptoms or medical concerns that require timely intervention. 

An acute presentation can require intensive medical, nutritional, and psychological support. Severity should always be assessed by qualified professionals rather than determined by appearance alone. 

Anorexia Athletica

Anorexia athletica is another descriptive term rather than an official eating disorder diagnosis. It has historically been used to describe patterns involving restrictive eating and excessive or compulsive exercise, particularly when behaviors are connected to athletic performance, fitness, or body composition. 

These patterns can occur among competitive athletes, recreational athletes, dancers, and fitness enthusiasts. Today, clinicians may also consider concepts such as low energy availability and Relative Energy Deficiency in Sport (RED-S) when assessing the effects of inadequate fueling and high activity levels. 

Atypical Anorexia Nervosa

Despite its name, atypical anorexia nervosa is not an anorexia nervosa subtype. It falls under the DSM-5-TR category of other specified feeding or eating disorder (OSFED). 

A person with atypical anorexia can experience the psychological and behavioral features associated with anorexia nervosa without meeting the low-weight criterion for anorexia nervosa. 

Atypical does not mean mild or less serious. Individuals can experience significant psychological distress and medical complications and may require specialized eating disorder treatment. 

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Chronic Anorexia Nervosa

Chronic anorexia nervosa is a descriptive term that may be used when someone has experienced anorexia for an extended period. You may also encounter terms such as longstanding or severe and enduring anorexia nervosa in clinical discussions. 

These descriptions are not additional DSM-5-TR subtypes. Someone who has lived with anorexia for many years can still benefit from individualized treatment, and duration of illness should not be interpreted as evidence that recovery is impossible. 

Symptoms Can Look Different From Person to Person

Anorexia nervosa does not have one appearance. Two people with the same diagnosis may experience very different combinations of restrictive eating, exercise behaviors, anxiety, food rules, body image concerns, physical symptoms, and co-occurring mental health conditions. 

Body size alone cannot tell you whether someone has an eating disorder or how medically or psychologically unwell they may be. Serious eating disorder symptoms can occur across body sizes, and medical instability is not always visible from the outside. 

It is also possible for someone to continue meeting expectations while struggling significantly. A person may attend school, go to work, participate in athletics, maintain relationships, or appear productive while experiencing serious symptoms. Being able to function in some areas does not make an eating disorder less deserving of attention. 

This is one reason professional assessment is so important. Clinicians look beyond appearance and consider eating and exercise patterns, physical health, psychological symptoms, changes in functioning, and other individual factors. 

No one needs to match a stereotypical picture of anorexia to deserve evaluation, support, or treatment. 

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Does the Type of Anorexia Affect Treatment?

The subtype of anorexia nervosa can help a treatment team understand which behaviors need attention, but subtype alone does not determine the treatment someone needs. Care should be individualized based on the person's complete clinical picture. 

A treatment team may consider: 

• Current eating disorder symptoms and behaviors 

• Medical stability and physical complications 

• Nutritional status and nutritional rehabilitation needs 

• Psychological symptoms and treatment goals 

• Restriction, binge eating, purging, or compulsive exercise 

• Co-occurring conditions, including anxiety, depression, PTSD, or substance use 

• Family, school, work, and other individual circumstances 

Treatment may involve medical monitoring, nutritional support, individual and group therapy, psychiatric care when appropriate, and family or caregiver involvement. The appropriate level of care may also change throughout recovery based on medical and psychological needs. 

At Monte Nido, treatment is individualized rather than determined by a subtype alone. Care addresses eating disorder behaviors while supporting physical stabilization, nutritional rehabilitation, psychological well-being, and the development of skills that can support long-term recovery. 

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When to Seek Help for Anorexia

You do not need to know which subtype of anorexia you may have before asking for help. If eating, exercise, or weight-related thoughts and behaviors are becoming increasingly rigid, distressing, or difficult to manage, a professional assessment can help determine what support is needed. 

Signs that warrant attention may include: 

• Significant or increasing food restriction 

• Rapid or concerning weight changes 

• Fainting, dizziness, weakness, or persistent fatigue 

• Compulsive exercise, including exercising despite illness or injury 

• Self-induced vomiting or misuse of laxatives or diuretics 

• Severe anxiety around food, meals, or eating 

• Increasing isolation or avoiding situations involving food 

• Other persistent or concerning physical symptoms 

Eating disorders can become medically serious even when someone does not appear visibly ill. Symptoms such as fainting, chest pain, difficulty breathing, confusion, seizures, or signs of severe dehydration may require urgent medical evaluation. 

Seeking support early can help identify medical and psychological concerns and connect someone with an appropriate level of specialized eating disorder care. 

Every Presentation of Anorexia Deserves Support

No presentation of anorexia nervosa is inherently "less serious" or less deserving of treatment. Whether someone primarily restricts, experiences binge-eating or purging behaviors, or has symptoms that do not fit neatly into one category, their concerns deserve to be taken seriously. 

If eating disorder symptoms are affecting your physical health, mental health, relationships, or daily life, consider reaching out for a professional assessment. A specialized treatment team can evaluate your medical, nutritional, and psychological needs and recommend appropriate support. 

Recovery from anorexia is possible. Individualized, evidence-based treatment can help address current symptoms while supporting a safer, more flexible relationship with food, movement, and your body. 

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