Eating behavior in anorexia nervosa: before and after treatment

The purpose of this study was to assess eating behavior in patients with anorexia nervosa before and after weight normalization and healthy controls using a standardized, multiple-item lunch meal paradigm.

Eighteen patients were studied shortly after inpatient admission and again after gaining to a BMI ≥ 19.5 kg m(-2) . Fifteen healthy controls were studied twice, ∼2-3 months apart.

When underweight, patients with AN consumed fewer total calories (364 ± 208 kcal) and a lower percentage of calories from fat (18% ± 10%) compared to controls (775 ± 228 kcal, p = 0.001; 38% ± 7%, p = 0.001). After weight normalization, despite a modest increase in total calories (364 ± 208 kcal vs. 516 ± 273 kcal, p = 0.04) and in percent of calories from fat (18% ± 10% vs. 23% ± 9%, p = 0.04), patients continued to consume fewer total calories and a reduced percent of calories from fat compared to controls (758 ± 346 kcal, p = 0.03; 38% ± 18%, p = 0.004).

Patients with AN, even after acute treatment, consume fewer total calories and fewer calories from fat, compared to healthy controls. The reduced overall intake and persistent avoidance of fat may contribute to relapse, and therefore are potential therapeutic targets.