Restrictive eating behaviors are a nonweight-based marker of severity in anorexia nervosa

Kyle P. De Young*, Jason M. Lavender, Kristine Steffen, Stephen A. Wonderlich, Scott G. Engel, James E. Mitchell, Scott J. Crow, Carol B. Peterson, Daniel Le Grange, Joseph Wonderlich, Ross D. Crosby

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


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 nonweight-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.

Original languageEnglish
Pages (from-to)849-854
Number of pages6
JournalInternational Journal of Eating Disorders
Issue number8
StatePublished - Dec 2013
Externally publishedYes


  • anorexia nervosa
  • dietary restriction
  • severity
  • subtypes


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