Restrictive Eating Behaviors are a Non-Weight-Based Marker of Severity in Anorexia Nervosa
Date Published: Dec 2013
Objective—The purpose of this study was to compare the type and frequency of restrictive eating behaviors across the two subtypes of anorexia nervosa (AN; restricting [ANr] and binge eating/purging [ANbp]) using ecological momentary assessment (EMA) and to determine whether subtype differences in restrictive eating behaviors were attributable to severity of the disorder or the frequency of binge eating.
Method—Participants (N = 118) were women at least 18 years of age with full (n = 59) or subthreshold (n = 59) AN who participated in a two week (EMA) protocol.
Results—General estimating equations revealed that individuals with ANbp generally reported more frequent restrictive eating behaviors than individuals with ANr. These differences were mostly accounted for by greater severity of eating psychopathology, indicating that the presence and frequency of restrictive eating behaviors in AN may be non-weight-based markers of severity. Binge eating frequency did not account for these findings.
Discussion—The present findings are especially interesting in light of the weight-based severity rating in the DSM-5.
Conclusions—Findings support the validity of these personality-based subtypes, suggesting the potential utility of addressing within-diagnosis heterogeneity in the treatment of AN.
Kyle P. De Young, Ph.D.1,*, Jason M. Lavender, Ph.D.2, Kristine Steffen, Pharm.D., Ph.D.2,3, Stephen A. Wonderlich, Ph.D.2,4, Scott G. Engel, Ph.D.2,4, James E. Mitchell, M.D.2,4, Scott J. Crow, M.D.5, Carol B. Peterson, Ph.D.5, Daniel Le Grange, Ph.D.6, Joseph Wonderlich, B.A.2, and Ross D. Crosby, Ph.D.2,4
1University of North Dakota, Department of Psychology, Grand Forks, North Dakota
2Neuropsychiatric Research Institute, Fargo, North Dakota
3North Dakota State University, Fargo, North Dakota, Department of Pharmaceutical Sciences
4University of North Dakota School of Medicine and Heath Sciences, Department of Clinical Neuroscience, Fargo, North Dakota
5University of Minnesota, Department of Psychiatry, Minneapolis, Minnesota
6The University of Chicago, Department of Psychiatry and Behavioral Neuroscience