A fine-grained analysis of eating behavior in women with bulimia nervosa

In the current study, we were interested in developing a typology of eating in patients with bulimia nervosa (BN) based on the size of the eating episode, whether the episode was followed by self-induced vomiting, and the degree of loss of control (LOC) self-reported by participants.

Twenty-one women with BN, purging type, were evaluated using the Nutritional Data System for Research, the Eating Disorders Examination, and the Matrix.

The most common type of episode resembled what might be termed "normal" eating, which involved the consumption of <1,000 kcal with no sense of LOC and no vomiting. There was an increase in severity of self-assessed LOC in objectively large eating episodes with vomiting. Self-reported hunger prior to eating episodes did not seem to be predictive of subsequent behavior. Most people were engaged in other behaviors while eating.

The results of this study suggest a typology that included primarily four types of eating episodes. The results also suggest that when LOC is assessed on a Likert-scale rather than as a dichotomous variable, there is considerable variability in self-assessed degree of LOC.