Types of anorexia
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Types of Anorexia: A Comprehensive Overview
Anorexia Nervosa (AN): Core Characteristics and Subtypes
Anorexia Nervosa (AN) is a severe eating disorder characterized by an intense fear of gaining weight, a distorted body image, and extreme food restriction leading to significant weight loss. It is often accompanied by psychiatric comorbidities such as depression and anxiety . AN is primarily divided into two subtypes: restricting type and binge-eating/purging type.
Restricting Type Anorexia Nervosa
The restricting type of AN is marked by severe restriction of food intake without regular binge-eating or purging behaviors. Individuals with this subtype often engage in excessive exercise and fasting as methods to control their weight . This subtype is associated with a higher level of control over eating behaviors and is less likely to involve impulsive actions .
Binge-Eating/Purging Type Anorexia Nervosa
The binge-eating/purging type involves episodes of binge eating followed by purging behaviors such as self-induced vomiting or misuse of laxatives. This subtype is associated with poorer outcomes and more severe psychological symptoms compared to the restricting type . Hormonal differences have been observed between the subtypes, with variations in levels of peptide YY (PYY), brain-derived neurotrophic factor (BDNF), and leptin, which are linked to eating behaviors and emotional regulation .
Atypical Anorexia Nervosa (Atypical AN)
Atypical Anorexia Nervosa is a variant described in the DSM-5, where individuals exhibit many of the psychological characteristics of typical AN but do not meet the low weight criteria despite significant weight loss. The psychological symptoms and physiological complications in atypical AN are generally similar to those in typical AN, although some physical complications may occur less frequently . The full diagnostic criteria for atypical AN are still under development, and its relationship to other eating disorders like bulimia nervosa remains unclear .
Anorexia of Aging
Anorexia of Aging refers to appetite loss in older adults, often due to physiological changes, comorbidities, and polypharmacy. This type of anorexia is prevalent among hospitalized and institutionalized elderly individuals and is associated with increased comorbidity and mortality rates . Factors such as changes in sensory perception and social circumstances also contribute to reduced appetite and food intake in this population . Various interventions, including flavor enhancement and oral nutritional supplements, have been explored to address this issue, but no definitive treatment has been established .
Activity-Based Anorexia (ABA) Model
The Activity-Based Anorexia (ABA) Model is an animal model used to study AN, where rats are given access to a running wheel and restricted food, leading to self-starvation and hyperactivity. This model mimics core features of human AN and has been used to study brain alterations, hormonal changes, and immune system adaptations associated with the disorder . The ABA model helps in understanding the underlying pathophysiology of AN and testing potential pharmacological interventions .
Conclusion
Anorexia encompasses various types, each with distinct characteristics and underlying mechanisms. Understanding these differences is crucial for developing targeted treatments and improving outcomes for individuals affected by this complex disorder. Further research is needed to refine diagnostic criteria, explore the neurobiological underpinnings, and identify effective interventions for each type of anorexia.
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