Eating behavior in bulimia nervosa: multiple meal analyses

Ten bulimic individuals were admitted to an inpatient unit and for 7 consecutive days eating behavior was observed and recorded. Age, sex, and weight-matched control subjects (n = 10) were admitted to the same unit for 4 d. All food and fluid intake, frequency of binge eating and purging, and ratings of appetite and mood before and after eating were recorded every 24 h. Bulimic patients demonstrated chaotic eating patterns that varied within as well as between individuals. Total daily energy intake was significantly higher for bulimic patients (41982 +/- 113 kJ; 10,034 +/- 2701 kcal) than for control subjects (8050 +/- 0427 kJ; 1924 +/- 102 kcal). On average, patients binged 1.6 times, purged three times, and ate one snack or meal without purging daily. Macronutrient analyses of intake revealed significantly less energy from protein and more energy from fat in bulimic patients compared with control subjects. Some improvement of mood was noted after binges, the magnitude of which was greatest after purging.